Valencia Carla, Prieto Jose, Jara Javier, Pesantez Priscila
Internal Medicine, Facultad de Medicina-Universidad del Azuay, Cuenca, ECU.
Internal Medicine, Loyola Medicine, MacNeal Hospital, Berwyn, USA.
Cureus. 2022 Jul 11;14(7):e26762. doi: 10.7759/cureus.26762. eCollection 2022 Jul.
Ingestion of corrosive agents is a well-known factor in extensive GI tract injury. Either acids or alkalis can lead to significant immediate and long-term complications throughout the GI system. The ingestion of these substances in children is often accidental, however, it is typical that in adults is due to suicidal attempts. A 25-year-old male with a history of suicidal attempt one month ago comes to the GI clinic due to unintentional weight loss of 19%, dysphagia of solids, emesis, and regurgitation. Evaluation with an upper gastrointestinal endoscopy was done which showed severe esophageal stenosis (90%), esophagitis Zargar 3a, and total pyloric stenosis. A dilation procedure was attempted, but complicated by severe bleeding; thus, the patient was hospitalized for a new attempt. During the second endoscopy, an esophageal dilation was successfully performed, but the pyloric dilation could not be completed. For that reason, a hepato-pancreato-biliary surgeon was consulted and a jejunostomy was performed for enteral nutrition. Caustic agent ingestion can cause different types of injuries including laryngospasms, perforations, necrosis, and mediastinitis in the short term. On the other hand, esophageal stenosis (ES), gastric outlet obstruction (GOO), and esophageal cancer can appear in the long term. In this case, we highlighted the importance of prompt recognition, identification, and grading of the lesions to determine a better outcome and prognosis for the patient.
摄入腐蚀性物质是导致广泛胃肠道损伤的一个众所周知的因素。酸或碱都可在整个胃肠道系统引发严重的即刻和长期并发症。儿童摄入这些物质通常是意外，但在成年人中，典型情况是由于自杀企图。一名有一个月前自杀未遂史的25岁男性因意外体重减轻19%、固体食物吞咽困难、呕吐和反流来到胃肠诊所。进行了上消化道内镜检查，结果显示严重食管狭窄（90%）、Zargar 3a级食管炎和完全性幽门狭窄。尝试进行扩张手术，但出现严重出血并发症；因此，患者住院准备再次尝试。在第二次内镜检查时，成功进行了食管扩张，但幽门扩张未能完成。因此，咨询了肝胰胆外科医生，并进行了空肠造口术以进行肠内营养。腐蚀性物质摄入在短期内可导致不同类型的损伤，包括喉痉挛、穿孔、坏死和纵隔炎。另一方面，长期可能出现食管狭窄（ES）、胃出口梗阻（GOO）和食管癌。在这种情况下，我们强调了对病变进行迅速识别、鉴定和分级以确定患者更好的结局和预后的重要性。
