Bär U, Coburg A J
Leber Magen Darm. 1978 Jun;8(3):130-5.
Case reports of 3 patients are given with severe corrosive lesions of the esophagus and stomach due to acid ingestion. All of them survived the initial phase and seemed to be expecting a favourable clinical course. In all of these cases however massive upper gastrointestinal bleeding, perforation, and death occurred in a later phase after an interval free of symptoms. Treatment of severe corrosions of the upper gastrointestinal tract differs significantly from treatment of less serious cases. In less severe cases care has to be taken to avoid later complications in the first place. If there are serious corrosions however vital indications are predominant in determining the course of treatment during the initial phase. An interval with no or rather few clinical symptoms of 3 weeks duration after severe corrosive lesions should not be considered to exclude the danger of later lethal complications, especially bleeding and perforation. In order to avoid such complications endoscopic and eventually surgical exploration after the acute initial phase is recommended.
本文报告了3例因吞服酸性物质导致食管和胃严重腐蚀性损伤的病例。所有患者均度过了初始阶段,似乎预期临床病程良好。然而,在所有这些病例中,在无症状间隔后的后期均发生了大量上消化道出血、穿孔和死亡。上消化道严重腐蚀的治疗与不太严重病例的治疗有显著差异。在不太严重的病例中,首先必须注意避免后期并发症。然而,如果存在严重腐蚀,在初始阶段确定治疗方案时,重要指征占主导地位。严重腐蚀性损伤后持续3周无临床症状或症状很少的间隔期,不应被视为排除后期致命并发症(尤其是出血和穿孔)的危险。为避免此类并发症,建议在急性初始阶段过后进行内镜检查,并最终进行手术探查。