Wu M H, Lai W W
Department of Surgery, National Cheng-Kung University Hospital, Taiwan, Republic of China.
Surg Gynecol Obstet. 1993 Jul;177(1):12-6.
To evaluate the surgical results of extensive corrosive injuries of the alimentary tract, 28 patients underwent emergency operations after ingestion of massive amount of caustics. The intent to commit suicide was the motivation for all these adults. Hydrochloride acid was the most frequently ingested agent--ingested by 22 patients. Among these 28 patients, 22 underwent cervical esophagostomy, esophagogastrectomy and feeding jejunostomy or concomitant splenectomy (n = 13), or both, resulting in the morbidity rate of 18 percent and mortality rate of 9 percent; the remaining six patients additionally underwent duodenectomy, segmental jejunectomy, pancreaticojejunostomy and concomitant resections of the adjacent organs, resulting in a morbidity rate of 100 percent and mortality rate of 50 percent. Extensive corrosive injuries of the alimentary tract usually caused an uncontrollable infection. The complicated surgical interventions resulted in extensive physiologic disturbances. However, appropriate surgical management could save the lives of most of these patients, even the damage of alimentary tract extended beyond the pylorus to the jejunum.
为评估广泛腐蚀性消化道损伤的手术效果，28例因大量摄入苛性碱而接受急诊手术的患者。所有这些成年患者的动机均为自杀。盐酸是最常摄入的腐蚀性物质，有22例患者摄入。在这28例患者中，22例行颈部食管造口术、食管胃切除术和空肠造口术或同时行脾切除术（n = 13），或两者同时进行，发病率为18%，死亡率为9%；其余6例患者还接受了十二指肠切除术、节段性空肠切除术、胰空肠吻合术及相邻器官的联合切除术，发病率为100%，死亡率为50%。广泛腐蚀性消化道损伤通常会导致难以控制的感染。复杂的手术干预会导致广泛的生理紊乱。然而，适当的手术处理能够挽救大多数此类患者的生命，即便消化道损伤已延伸至幽门以外直至空肠。
