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Caustic injuries

Hasret Ayyildiz Civan, Didem Gulcu, Tulay Erkan
Benzalkonium chloride (BAC) is a caustic agent which is used in farms, homes and hospitals for cleaning skin and wounds as an antiseptic solution. It may lead to digestive system injuries in case of ingestion. We present a two-days-old newborn case which was carried to the emergency unit with complaints of poor breastfeeding, uneasiness and crying for 4-6 hours. Her mom confessed that she had given a spoon of 10% BAC solution for her cough. Initial laboratory tests were in normal ranges. A gastroscopy performed in the second hour of her admission revealed an hyperemic and edematous mucosa in the middle third of esophagus and a circumferential ulceration followed in the distal portion...
September 2016: Pediatric Gastroenterology, Hepatology & Nutrition
Alexis José Ormeño Julca
Exposure to potentially toxic substances represents 0.3% of annual visits to a pediatric emergency department, being a situation likely to be prevented and that generates a non-negligible morbidity and mortality. The most common route of exposure is the oral and drugs are the products most frequently involved. Esophagitis caustic ingestion of corrosive substances in childhood is now a public health problem in developing countries. Clinical manifestations vary from no injuries serious commitment to high risk of death observed more frequently in patients between one and three years old...
July 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Thibault Voron, Morgan Anyla, Helene Corte, Eric Roland, Nicolas Munoz-Bongrand, Emile Sarfati, Pierre Cattan, Mircea Chirica
OBJECTIVE: The study purpose was to report the indications, technical aspects, and outcomes of cervicosternolaparotomy during revision surgery after esophageal reconstruction for caustic injuries. METHODS: Patients who underwent cervicosternolaparotomy during revision surgery for graft dysfunction between 1999 and 2015 were included. Cervicosternolaparotomy was performed to mobilize and pull up the primary conduit during surgery for strictures (rescue cervicosternolaparotomy) or to allow retrosternal access for management of other graft-related complications (exposure cervicosternolaparotomy)...
November 2016: Journal of Thoracic and Cardiovascular Surgery
Victor A Ferraris
No abstract text is available yet for this article.
November 2016: Journal of Thoracic and Cardiovascular Surgery
Behdad Gharib, Masoud Mohammadpour, Bahareh Yaghmaie, Meisam Sharifzadeh, Mehrzad Mehdizadeh, Fatemeh Zamani, Rouhollah Edalatkhah, Reihaneh Mohsenipour
We present a case of caustic ingestion by a 1.5-year-old boy. The caustic agent was drain opener which is a strong alkaline substance. Children in Iran and many other countries are still exposed to not "child proof" (child resistant packaging) toxic substance containers. Ingestion of caustic agents may lead to necrosis, perforation, and strictures. Substances that are ingested more frequently are liquid alkali material which causes severe, deep liquefaction necrosis. Common signs and symptoms of caustic agents are vomiting, drooling, refusal to drink, oral burns, stridor, hematemesis, dyspnea, dysphagia and abdominal pain...
July 2016: Acta Medica Iranica
Briny Omar Rodríguez Vargas, Eduardo Monge Salgado, Pedro Montes Teves, Sonia Salazar Ventura, Edson Guzmán Calderón
OBJECTIVE: To describe the clinical and endoscopic features of caustics injuries in the upper gastrointestinal tract in patients of the National Hospital Daniel Alcides Carrión. MATERIALS AND METHODS: A descriptive study was conducted; the study populations were patients diagnosed with caustic ingestion who were admitted into the Gastroenterology service of the HNDAC to perform an upper endoscopy during the period of January 2009 to December 2012. We documented the type of caustic substance ingested, cause of intake, amount ingested, intake mode, signs or symptoms present, endoscopic findings as classified by Zargar, presence of complications and treatment performed...
April 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Ioannis Ntanasis-Stathopoulos, Stamatina Triantafyllou, Vasiliki Xiromeritou, Nikolaos Bliouras, Chriso Loizou, Dimitrios Theodorou
INTRODUCTION: Esophageal squamous cell carcinoma has been described as a long-term consequence following ingestion of corrosive substances. PRESENTATION OF CASE: We report a rare case of a 62-year-old female patient with a history of acidic caustic injury 35 years ago, for which she had undergone near total esophagogastrectomy with right colon interposition. Recently, she presented with worsening dysphagia, weight loss, neck swelling and chest pain. After the diagnostic workup, an invasive squamous cell carcinoma of the esophagus was confirmed...
2016: International Journal of Surgery Case Reports
Rhonda F Souza
Reflux esophagitis causes Barrett's metaplasia, an abnormal esophageal mucosa predisposed to adenocarcinoma. Medical therapy for reflux esophagitis focuses on decreasing gastric acid production with proton pump inhibitors. We have reported that reflux esophagitis in a rat model develops from a cytokine-mediated inflammatory injury, not from a caustic chemical (acid) injury. In this model, refluxed acid and bile stimulate the release of inflammatory cytokines from esophageal squamous cells, recruiting lymphocytes first to the submucosa and later to the luminal surface...
2016: Digestive Diseases
Antonios I Vezakis, Eirini V Pantiora, Elissaios A Kontis, Vasileios Sakellariou, Dimitrios Theodorou, Georgios Gkiokas, Andreas A Polydorou, Georgios P Fragulidis
BACKGROUND: Ingestion of caustic substances is a medical emergency in both the adult and pediatric population and is associated with high morbidity and mortality. The extent of injuries after ingestion of caustic substances depends on the nature, amount, and concentration of the agent and on the exposure time. Acutely, caustic substances may cause massive hemorrhage and gastrointestinal tract perforation; the most markedly affected cases require urgent surgical treatment. Patients surviving the initial event may present with aorto-enteric or gastrocolic fistulae, esophageal strictures, dysphagia, and increased risk of esophageal cancer as long term sequelae...
2016: American Journal of Case Reports
Mircea Chirica, Matthieu Resche-Rigon, Anne Marie Zagdanski, Matthieu Bruzzi, Damien Bouda, Eric Roland, François Sabatier, Fatiha Bouhidel, Francine Bonnet, Nicolas Munoz-Bongrand, Jean Marc Gornet, Emile Sarfati, Pierre Cattan
BACKGROUND: Endoscopy is the standard of care for emergency patient evaluation after caustic ingestion. However, the inaccuracy of endoscopy in determining the depth of intramural necrosis may lead to inappropriate decision-making with devastating consequences. Our aim was to evaluate the use of computed tomography (CT) for the emergency diagnostic workup of patients with caustic injuries. METHODS: In a prospective study, we used a combined endoscopy-CT decision-making algorithm...
July 2016: Annals of Surgery
Fiona J Li, Elham Nili, Cora Lau, Neil A Richardson, Jennifer Walshe, Nigel L Barnett, Brendan G Cronin, Lawrence W Hirst, Ivan R Schwab, Traian V Chirila, Damien G Harkin
The New Zealand White rabbit has been widely used as a model of limbal stem cell deficiency (LSCD). Current techniques for experimental induction of LSCD utilize caustic chemicals, or organic solvents applied in conjunction with a surgical limbectomy. While generally successful in depleting epithelial progenitors, the depth and severity of injury is difficult to control using chemical-based methods. Moreover, the anterior chamber can be easily perforated while surgically excising the corneal limbus. In the interest of creating a safer and more defined LSCD model, we have therefore evaluated a mechanical debridement technique based upon use of the AlgerBrush II rotating burr...
June 2016: Experimental Eye Research
Rachel S Wightman, Kevin B Read, Robert S Hoffman
Caustics are common in household and industrial products, and, when ingested, they can pose a significant public health risk. Caustic exposures in adults typically present in the setting of occupational exposure or suicide attempt; exposures in children occur most often by unintentional ingestion. Caustics cause local damage upon contact with tissue surfaces and can lead to systemic toxicity. Endoscopy is recommended in all intentional ingestions (and many unintentional ingestions) to grade injury severity, determine treatment options, and assess prognosis; however, it is generally best performed within 24 hours post ingestion to avoid risk of perforation...
May 2016: Emergency Medicine Practice
M Colegrave, M G Rippon, C Richardson
Clinical studies suggest that dressings containing Ringer's solution, such as the TenderWet and HydroClean families, provide relief from wound pain. This report reviews the available evidence and possible mechanisms for the relief of wound pain by these dressings. The ability of dressings containing Ringer's solution to provide pain relief is likely to be through providing a moist environment that is favourable for wound healing; furthermore, the dressing augments the protective barrier function by having additional fluid under the dressing, which covers exposed nerve endings and protects against friction damage...
April 2016: Journal of Wound Care
K R Chandrakala, Bindu Nagaraj, D V Bhagya, Y R Chandrika
The loss of oesophageal length or obliteration of oesophageal lumen due to stricture acquired by accidental caustic ingestion is more common in children that may require major operative reconstruction. A number of procedures have been developed for anatomic replacement of oesophagus of which thoracoscopic assisted gastric transposition has shown the best outcome in children. This demands an extensive pre-operative evaluation, preparation and anaesthetic management since this is challenging and prolonged procedure done under one lung ventilation (OLV)...
February 2016: Indian Journal of Anaesthesia
Romain Ducoudray, Antoine Mariani, Helene Corte, Aurore Kraemer, Nicolas Munoz-Bongrand, Emile Sarfati, Pierre Cattan, Mircea Chirica
BACKGROUND: The mechanisms of damage to the gastrointestinal tract after caustic ingestion are conditioned by the nature of the ingested agent. Whether the nature of the ingested agent has a direct influence on patient outcomes is unknown. METHODS: From January 2013 to April 2015, 144 patients underwent emergency management for caustic injuries at the Saint Louis Hospital in Paris. There were 51 men (51 %) and the median age was 44 years [39, 48]. The ingested agents were soda-based strong alkali in 85 patients (59 %), strong acids in 36 patients (25 %), and bleach in 23 patients (16 %)...
July 2016: World Journal of Surgery
K Raynaud, D Seguy, M Rogosnitzky, F Saulnier, F R Pruvot, Philippe Zerbib
PURPOSE: Best clinical management of severe caustic injury is still a subject of debate. Most surgical teams consider severe caustic injury as an indication for emergency surgery. But, under certain circumstances, conservative management is feasible, avoids the need for gastrectomy, and has a low mortality rate. Postponed reconstructive surgery is usually performed several months after caustic ingestion to restore intestinal continuity or to treat stricture sequelae. This study aimed to investigate long-term nutritional and quality of life (QoL) outcomes after reconstructive surgery for high-grade esophageal and gastric caustic injury...
February 2016: Langenbeck's Archives of Surgery
Mark Tettey, Frank Edwin, Ernest Aniteye, Martin Tamatey, Ekow Entsua-Mensah, Ernest Offosu-Appiah, Innocent Adzamli
Extensive caustic stricture of the upper aero-digestive system (oro- and hypo-pharynx) is a severe injury with limited surgical options. We adopted augmentation of the cicatrized upper aero-digestive tract with colon as our preferred management option. The aim of this report is to describe our initial experience with the technique of colon-flap augmentation pharyngo-esophagoplasty (CFAP) for selected patients with severe pharyngo-esophageal stricture. Between October 2011 and June 2013, three male patients (aged 16, 4 and 18 years respectively) underwent CFAP following extensive pharyngo-esophageal stricture...
2015: Pan African Medical Journal
Luigi Bonavina, Mircea Chirica, Ognjan Skrobic, Yoram Kluger, Nelson A Andreollo, Sandro Contini, Aleksander Simic, Luca Ansaloni, Fausto Catena, Gustavo P Fraga, Carlo Locatelli, Osvaldo Chiara, Jeffry Kashuk, Federico Coccolini, Yuri Macchitella, Massimiliano Mutignani, Cesare Cutrone, Marco Dei Poli, Tino Valetti, Emanuele Asti, Michael Kelly, Predrag Pesko
INTRODUCTION: Lesions of the upper digestive tract due to ingestion of caustic agents still represent a major medical and surgical emergency worldwide. The work-up of these patients is poorly defined and no clear therapeutic guidelines are available. PURPOSE OF THE STUDY: The aim of this study was to provide an evidence-based international consensus on primary and secondary prevention, diagnosis, staging, and treatment of this life-threatening and potentially disabling condition...
2015: World Journal of Emergency Surgery: WJES
M Rollin, A Jaulim, F Vaz, G Sandhu, S Wood, M Birchall, K Dawas
Adult ingestion of caustic substances is an unusual but serious surgical problem, with injuries likely to be more extensive than those in the corresponding paediatric population. After initial stabilisation and airway management, clinicians are presented with a complex multisystemic problem, frequently requiring a multidisciplinary approach involving several surgical disciplines and associated therapies. A new multidisciplinary team was convened to discuss complex ingestion injury in adults and established techniques were used to bring forward a proposed treatment algorithm...
May 2015: Annals of the Royal College of Surgeons of England
Mitchell D Shub
PURPOSE OF REVIEW: This review will focus on therapeutic considerations and recent advances in treatment of caustic ingestion injuries. RECENT FINDINGS: A retrospective study suggests that it may be safe to advance the endoscope beyond the first circumferential burn to allow for a more complete assessment of extent of injury. A randomized controlled prospective study suggested that a 3-day course of high-dose methylprednisolone might reduce the occurrence of esophageal stricture formation...
October 2015: Current Opinion in Pediatrics
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