Munoz-Bongrand N, Gornet J M, Sarfati E
Service de Chirurgie Générale, Digestive, Endocrinienne et Thoracique, Hôpital Saint-Louis, F 75010 Paris.
J Chir (Paris). 2002 Apr;139(2):72-6.
Caustic burns of the upper gastrointestinal tract are a common emergency. Outcome is generally favorable. Endoscopic fiberoptic examination is the most accurate exam for evaluation of the extent of corrosive injuries. In case of severe caustic burns, surgical intervention allows removal of necrotic tissues, and prevent the extent of burns to the adjacent organs. Blunt esophageal stripping, combined with total gastrectomy is then the intervention of choice. Superficial burns usually recover without sequela, or with esophageal or gastric stenosis. Secondary coloplasty is advocated for treatment of failure of endoscopic dilatations, and for digestive reconstruction after initial esophagogastrectomy.
上消化道腐蚀性烧伤是一种常见的急症。预后通常良好。内镜纤维光学检查是评估腐蚀性损伤程度最准确的检查方法。对于严重的腐蚀性烧伤,手术干预可清除坏死组织,并防止烧伤蔓延至邻近器官。钝性食管剥脱术联合全胃切除术是首选的干预措施。浅表烧伤通常可痊愈且无后遗症,或仅出现食管或胃狭窄。对于内镜扩张失败以及初次食管胃切除术后的消化重建,提倡进行二期结肠成形术。