Rodríguez Vargas Briny Omar, Monge Salgado Eduardo, Montes Teves Pedro, Salazar Ventura Sonia, Guzmán Calderón Edson
Hospital Daniel Alcides Carrión. Lima, Perú.
Edgardo Rebagliati Martins. Lima, Perú.
Rev Gastroenterol Peru. 2016 Apr-Jun;36(2):135-42.
To describe the clinical and endoscopic features of caustics injuries in the upper gastrointestinal tract in patients of the National Hospital Daniel Alcides Carrión.
A descriptive study was conducted; the study populations were patients diagnosed with caustic ingestion who were admitted into the Gastroenterology service of the HNDAC to perform an upper endoscopy during the period of January 2009 to December 2012. We documented the type of caustic substance ingested, cause of intake, amount ingested, intake mode, signs or symptoms present, endoscopic findings as classified by Zargar, presence of complications and treatment performed. Analysis was performed comparing them based on the ingested caustic type: acid or alkali.
We obtained 91 patients; the average age was 30.6±16.3 years. Caustic substances ingested were: bleach (sodium hypochlorite) in 71 (78%) patients, muriatic acid (hydrochloric acid) in 18 (20%) patients, caustic soda in 2 (2%) patients. The average intake was 136ml (30-500 ml). The most frequent signs and symptoms were vomiting, abdominal pain, nausea and sore throat. The 46% of patients had injuries. 100% of patients who ingested acid and 33% who ingested alkali had lesions. Five (5%) patients had oropharyngeal lesions, 24 (26%) in the esophagus, 36 (40%) in the stomach and 12 (13%) in the duodenum. Grade I lesions were found in 10 (11%) patients, 16 (18%) patients with grade II lesions and 15 (16%) of patients with grade III, 12 patients who toke acid had lesions of grade III. Esophageal stricture was found in 2 (2%) patients, gastric stenosis in 7 (8%) patients and esophageal and gastric stenosis in 3 (3%) patients. Two patients required pneumatic dilation and 10 surgical treatments.
Most injuries were found in the stomach. Acidic injuries occur more frequently and with greater severity than alkaline. Acidic substances produce esophageal or gastric stenosis more frequently than alkaline.
描述丹尼尔·阿尔西德斯·卡里翁国立医院患者上消化道腐蚀性损伤的临床和内镜特征。
进行了一项描述性研究；研究对象为2009年1月至2012年12月期间因诊断为腐蚀性物质摄入而入住HNDAC胃肠病科接受上消化道内镜检查的患者。我们记录了摄入的腐蚀性物质类型、摄入原因、摄入量、摄入方式、出现的体征或症状、按照扎尔加分类的内镜检查结果、并发症的存在情况以及所进行的治疗。根据摄入的腐蚀性物质类型（酸或碱）对他们进行比较分析。
我们纳入了91例患者；平均年龄为30.6±16.3岁。摄入的腐蚀性物质为：71例（78%）患者摄入漂白剂（次氯酸钠），18例（20%）患者摄入盐酸，2例（2%）患者摄入苛性钠。平均摄入量为136毫升（30 - 500毫升）。最常见的体征和症状为呕吐、腹痛、恶心和咽痛。46%的患者有损伤。摄入酸的患者中有100%有损伤，摄入碱的患者中有33%有损伤。5例（5%）患者有口咽损伤，24例（26%）有食管损伤，36例（40%）有胃损伤，12例（13%）有十二指肠损伤。10例（11%）患者为I级损伤，16例（18%）患者为II级损伤，15例（16%）患者为III级损伤，12例摄入酸的患者有III级损伤。2例（2%）患者发现食管狭窄，7例（8%）患者发现胃狭窄，3例（3%）患者发现食管和胃狭窄。2例患者需要进行气囊扩张，10例患者需要手术治疗。
大多数损伤发生在胃。酸性损伤比碱性损伤更频繁且更严重。酸性物质比碱性物质更频繁地导致食管或胃狭窄。
