Guzmán-Chávez OR, Bautista-González S, Ramírez-Solís A, Sandoval Virgen FG, López-Taylor JG

Language: Spanish
References: 31
Page: 211-216
PDF size: 534.34 Kb.

ABSTRACT

The caustics are substances with a pH lower to four or higher to 12 which when ingested may cause devastating effects in the digestive tract or even death. 80% of cases of ingestion are accidental; 58% occur in minors under six years of age. In adults, most of the cases are related to suicidal attempts. In the disease’s natural history, there is an acute phase where esophageal perforation and hemorrhage may present. Subsequently, the appearance of esophageal and gastric stricture predisposes esophageal squamous-type cancer. Fibroesophagogastroscopy must be performed between 12-48 hours after ingestion of the caustic in order to determine the damage. The most sensitive study to detect esophageal or gastric perforation is the computerized axial tomography (CT) with contrast medium. The treatment afterwards to the acute phase consists of performing esophageal dilatations following the third week after burning, and then a weekly dilatation during 3-4 weeks in a row, and finishing the continuity will depend on the degree of dysphagia. The ultimate handling is the surgical; the two most used techniques for esophagealreconstruction are, the right transthoracic esophagectomy (Ivor, Lewis) and thetranshiatal esophagectomy originally propitiated by Orringer, Moreno Gonzalez and Peracchia.

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