Gumaste V V, Dave P B
Department of Medicine, Mount Sinai Services-City Hospital Center, Elmhurst, New York.
Am J Gastroenterol. 1992 Jan;87(1):1-5.
Compared with the ingestion of corrosive substances in children, this problem tends to be more serious, in adults, because its intent is often suicidal, rather than accidental. The severity and extent of damage produced to the gastrointestinal tract depends on the morphological form of the caustic agent. In the acute stage, perforation and necrosis may occur. Long-term complications include esophageal stricture, antral stenosis, and the development of esophageal carcinoma. X-rays of the abdomen and chest should be done initially to detect any evidence of perforation. Endoscopy should be performed as soon as possible in all cases to evaluate the extent and severity of damage, unless there is evidence of perforation. A complete examination is feasible in most cases. Stricture formation is more common in patients with second- and third-degree burns. Measures to prevent stricture formation, including the use of steroids, have not been successful. Esophageal carcinoma usually occurs 40 yr after the time of injury.
与儿童摄入腐蚀性物质相比，这个问题在成年人中往往更严重，因为其意图通常是自杀性的，而非意外。对胃肠道造成损害的严重程度和范围取决于苛性剂的形态。在急性期，可能会发生穿孔和坏死。长期并发症包括食管狭窄、胃窦狭窄以及食管癌的发生。最初应进行腹部和胸部X线检查以检测是否有穿孔迹象。除非有穿孔证据，否则所有病例都应尽快进行内镜检查以评估损伤的程度和严重性。在大多数情况下，完整的检查是可行的。二度和三度烧伤患者中狭窄形成更为常见。包括使用类固醇在内的预防狭窄形成的措施尚未成功。食管癌通常在受伤后40年发生。
