Adedeji Taiwo Olugbemiga, Tobih James Enajero, Olaosun Adedayo Olugbenga, Sogebi Olusola Ayodele
Department of Ear Nose and Throat, LAUTECH Teaching Hospital, Osogbo, Osun state, Nigeria.
Pan Afr Med J. 2013 May 6;15:11. doi: 10.11604/pamj.2013.15.11.2495. Print 2013.
Potentially catastrophic presentations and lifelong complications resulting from corrosive ingestions in humans is one of the most challenging situations encountered in clinical medical practice. This study reviewed pattern, mechanisms and associated socio-medical challenges with ingestion of corrosive agents as seen in a tertiary health institution in South-western Nigeria.
A retrospective review of all patients that were managed for corrosive ingestion at Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Osun State, Nigeria, over a seven year period.
A total of 28 patients M:F: 1.6:1. There were 7 children and 21 adults. Majority (78.6%) of the patients ingested alkaline substances. Accidental ingestion occurred in 28.6% while 71.4% resulted from deliberate self harm especially among adults (66.7%). Almost two thirds (64.3%) of the patients presented after 48hrs of ingestion. Patients who presented early were managed conservatively. Most patients (64.3%) who presented late had nutritional and fluid rehabilitation. Two patients died from oesophageal perforation and resulting septicaemia. Psychiatric evaluation revealed that seven adults (25%) had psychotic illness while (42.9%) of the patients developed oesophageal strictures. Short segment strictures were managed with oesophageal dilatation with good outcome while long and multiple segment strictures were referred to cardiothoracic surgeons for management.
Corrosive oesophageal injuries remain a prevalent and preventable condition in the developing countries. Preventive strategies should include regulation and packaging of corrosive substances, organization of psychiatric services, and education of the population on corrosive ingestion.
人类因腐蚀性物质摄入导致的潜在灾难性表现和终身并发症是临床医学实践中遇到的最具挑战性的情况之一。本研究回顾了在尼日利亚西南部一家三级医疗机构中，腐蚀性物质摄入的模式、机制及相关社会医学挑战。
对尼日利亚奥孙州奥索博市拉多克·阿金托拉科技大学教学医院七年间收治的所有腐蚀性物质摄入患者进行回顾性研究。
共有28例患者，男女比例为1.6:1。其中儿童7例，成人21例。大多数患者（78.6%）摄入的是碱性物质。28.6%的摄入为意外，而71.4%是故意自伤，尤其是在成人中（66.7%）。近三分之二（64.3%）的患者在摄入48小时后就诊。早期就诊的患者采用保守治疗。大多数晚期就诊的患者（64.3%）接受了营养和液体康复治疗。两名患者死于食管穿孔及由此引发的败血症。精神科评估显示，7名成人（25%）患有精神疾病，而42.9%的患者出现了食管狭窄。短段狭窄通过食管扩张治疗，效果良好，而长段和多段狭窄则转诊至心胸外科医生处进行治疗。
在发展中国家，腐蚀性食管损伤仍然是一种普遍且可预防的疾病。预防策略应包括对腐蚀性物质的监管和包装、精神科服务的组织以及对公众进行腐蚀性物质摄入方面的教育。
