Surgical management of esophageal stenosis due to ingestion of corrosive substances

Tustumi, Francisco; Seguro, Francisco Carlos Bernal da Costa; Szachnowicz, Sérgio; Bianchi, E; Morrell, André Luiz Gioia; Silva, Matheus Oliveira da; Duarte, Ana Filipa; Sousa, Jorge Henrique Bento de; Laureano, G; Rocha, Júlio Rafael Mariano da; Sallum, Rubens Antônio Aissar; Ivan, Cristina

doi:10.1016/j.jss.2021.03.009

Cited by 5 publications

(10 citation statements)

References 72 publications

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“…The first description in the literature of the association of esophageal cancer in a patient with ingestion of caustic product was made in the literature by Teleky, in 1904 (9,11,16,17). Since then, patients who have ingested caustic products, at some stage of life, continue to be a matter of concern, and several cases have been reported by the authors, over the years.…”

Section: Cancer Riskmentioning

confidence: 99%

“…The estimated risk in patients with a history of caustic ingestion is 1000-3000 times higher when compared to normal individuals of the same age group (1,9,(16)(17)(18). However, the occurrence of the disease has been recorded early.…”

Section: Cancer Riskmentioning

confidence: 99%

“…The occurrence of cancer is in the areas of narrowing and strictures in the esophagus, therefore, it is in these places that endoscopists, during the exams, need to focus their attention, in order to search for pre-neoplastic lesions (5,9,16) The survival rate of patients with esophageal squamous cell carcinoma depends on the staging at the time of diagnosis and oncological and surgical treatment options (13,19). However, the authors have reported a 5-year survival rate of 45-50% and a 10-year survival rate of approximately 15% in patients undergoing esophagectomy with neoplasms associated with caustic ingestion.…”

Section: Cancer Riskmentioning

confidence: 99%

“…The first treatment attempt to relieve dysphagia is esophageal dilatation with the aid of digestive endoscopy, which can be repeatedly performed (2,4,9). If there is no improvement in dysphagia, weight gain and the patient's ability to ingest food orally, the surgical treatment is indicated.…”

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confidence: 99%

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Caustic stenosis of the esophagus and malignant neoplasia: A dilemma

et al. 2022

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Caustic ingestion remains a complex public health issue worldwide, in adults and children. Caustic agent (acids and alkalis) is a product that causes tissue damage, and its ingestion will damage the mouth, pharynx, hypopharynx, esophagus, stomach, duodenum, and may reach the jejunum. Concomitant gastric and intestinal injuries can occur in 20 to 60% (1-3) Acid products, most of the times, cause coagulative necrosis of the mucosa, while alkalis cause a liquefaction/saponification effect on the mucosa, reaching the entire wall of the organ. The most accessible acids are hydrochloric, sulfuric and oxalic acid, widely used in civil construction and factories. Products that contain alkali are those used in household cleaning, containing sodium hydroxide, also known as caustic soda. Therefore, caustic stenosis of the esophagus depends on the product ingested, the amount that was ingested and its concentration (1, 4-6).Ingestion of these products damages the esophagus, in different extensions, and the final consequence is progression to stenosis and fibrosis of the organ. The most common symptom is dysphagia, and the intensity of dysphagia depends on the degree of stenosis. Odynophagia is also present. The nutritional status injury is evident, due to significant weight loss (1,2,4,7).Developing countries have a higher incidence of this kind of accident. In children under 10 years of age, ingestion is most often accidental, however, in adolescents and adults, the etiology of ingestion is due to attempted suicide. In the United States, despite the decline in caustic intake in children (5,000 to 15,000 per year), the incidence is 15.8 cases per 100,000 peoples (8).

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Section: Cancer Riskmentioning

confidence: 99%

Section: Cancer Riskmentioning

confidence: 99%

Section: Cancer Riskmentioning

confidence: 99%

mentioning

confidence: 99%

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Caustic stenosis of the esophagus and malignant neoplasia: A dilemma

et al. 2022

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“…Global data show corrosive poisoning o be a grievous but often under-reported public health issue 1 . The term encompasses a wide range of immediate and long-term complications arising from intake of household or commercially available chemicals 2 .…”

Section: Introductionmentioning

confidence: 99%

Implications of Social Factors and Management Outcomes Among Patients with Corrosive Ingestion

2022

PJMD

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Background: Corrosive poisoning is a growing concern in developing countries and although management options have improved over the years, preventive strategies have failed to provide results. The objective of this study was to determine social and epidemiological factors related to corrosive intake in patients and to assess the effect of these factors on management outcomes in terms of morbidity and mortality. Methods: A retrospective cross-sectional study was carried out in Surgical Unit-1 of Holy Family Hospital, Rawalpindi from February 2019 to June 2020. Each corrosive poisoning patient’s age, gender, residence, ethnicity, education, and financial status were recorded. Previous psychiatric illnesses were also recorded. Management outcomes in terms of wound infections, anastomotic leaks, weight gain, return to work and mortality were recorded. The correlation between social characteristics and the outcome of management was statistically analyzed using SPSS software. Results: Out of 70 patients, the majority were females 48(68.6%). Chief suicidal motives included low-income [49(70%)], marital discord [16(22.5%)] and domestic violence [21(29.5%). Education level was the only social factor that was significantly associated with major as well as minor complications after intervention (p=0.021). Only 10(14.3%) patients had an established past psychiatric history. At 6 months follow-up, 57(81.4%) never went back to their original weight and only 22(31.4%) were able to return to work. Conclusion: Domestic violence was found to be major cause of suicidal intent [21(29.5%)] followed by marital discord [16(22.5%)]. In managing such patients, a multidisciplinary approach including a surgical and gastroenterology team, psychologist and social workers must be employed. Keywords: Corrosive; Demography; Epidemiology; Jejunostomy.

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Upper Esophageal Dysphagia

Chheda

2022

Surgical Clinics of North America

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Surgical management of esophageal stenosis due to ingestion of corrosive substances

Cited by 5 publications

References 72 publications

Caustic stenosis of the esophagus and malignant neoplasia: A dilemma

Caustic stenosis of the esophagus and malignant neoplasia: A dilemma

Implications of Social Factors and Management Outcomes Among Patients with Corrosive Ingestion

Upper Esophageal Dysphagia

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