title: Extensive abdominal surgery after caustic ingestion.
abstract: OBJECTIVE
  To report the authors' experience in extensive abdominal surgery after caustic ingestion, and to clarify its indications.
  
  
  BACKGROUND
  After caustic ingestion, extension of corrosive injuries beyond the esophagus and stomach to the duodenum, jejunum, or adjacent abdominal organs is an uncommon but severe complication. The limit to which resection of the damaged organs can be reasonably performed is not clearly defined.
  
  
  METHODS
  From 1988 to 1997, nine patients underwent esophagogastrectomy extended to the colon (n = 2), the small bowel (n = 2), the duodenopancreas (n = 4), the tail of the pancreas (n = 1), or the spleen (n = 1). Outcome was evaluated in terms of complications, death, and function after esophageal reconstruction.
  
  
  RESULTS
  Five patients required reintervention in the postoperative period for extension of the caustic lesions. There were two postoperative deaths. Seven patients had secondary esophageal reconstruction 4 to 8 months (median 6 months) after initial resection. Three additional patients died 8, 24, and 32 months after the initial resection. Three survivors eat normally, and one has unexplained dysphagia.
  
  
  CONCLUSIONS
  An aggressive surgical approach allows successful initial treatment of extended caustic injuries. Early surgical treatment is essential to improve the prognosis in these patients.
authors.affiliation: Department of Digestive Surgery, Hôpital Saint-Louis, Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Cattan
authors.forename: N
authors.initials: N
authors.lastname: Munoz-Bongrand
authors.forename: T
authors.initials: T
authors.lastname: Berney
authors.forename: B
authors.initials: B
authors.lastname: Halimi
authors.forename: E
authors.initials: E
authors.lastname: Sarfati
authors.forename: M
authors.initials: M
authors.lastname: Celerier
mesh_terms: D000328:Adult; D002057:Burns, Chemical / Q000601:surgery*; D002424:Caustics / Q000009:adverse effects*; D003251:Constriction, Pathologic; D004386:Duodenum / Q000293:injuries; D016629:Esophagectomy / Q000379:methods; D004947:Esophagus / Q000293:injuries* / Q000601:surgery; D005260:Female; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D007583:Jejunum / Q000293:injuries; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy; D013154:Spleen / Q000293:injuries
chemical_list: D002424:Caustics