Department of Digestive and Emergency Surgery, University Hospital of Grenoble, Grenoble Alpes University, Grenoble, France.
University of Milan Medical School, Division of General Surgery, IRCCS Policlinico San Donato, Milan, Italy.
Lancet. 2017 May 20;389(10083):2041-2052. doi: 10.1016/S0140-6736(16)30313-0. Epub 2016 Oct 26.
Corrosive ingestion is a rare but potentially devastating event and, despite the availability of effective preventive public health strategies, injuries continue to occur. Most clinicians have limited personal experience and rely on guidelines; however, uncertainty persists about best clinical practice. Ingestions range from mild cases with no injury to severe cases with full thickness necrosis of the oesophagus and stomach. CT scan is superior to traditional endoscopy for stratification of patients to emergency resection or observation. Oesophageal stricture is a common consequence of ingestion and newer stents show some promise; however, the place of endoscopic stenting for corrosive strictures is yet to be defined. We summarise the evidence to provide a plan for managing these potentially life-threatening injuries and discuss the areas where further research is required to improve outcomes.
腐蚀性摄入是一种罕见但潜在破坏性的事件，尽管有有效的预防性公共卫生策略，但伤害仍在继续发生。大多数临床医生的个人经验有限，依赖于指南；然而，对于最佳临床实践仍然存在不确定性。摄入的情况从没有损伤的轻度病例到食管和胃全层坏死的严重病例不等。CT 扫描优于传统内窥镜检查，可对患者进行分层，以决定是否进行紧急切除或观察。食管狭窄是摄入的常见后果，新型支架显示出一定的前景；然而，腐蚀性狭窄的内镜支架放置的位置尚未确定。我们总结了证据，提供了一种管理这些潜在危及生命的损伤的方案，并讨论了需要进一步研究以改善结果的领域。
