Early operation for severe corrosive injury of the upper gastrointestinal tract.

OBJECTIVE

To describe our experience of treating severe corrosive burns of the upper gastrointestinal (GI) tract.

DESIGN

Open study.

SETTING

Teaching hospital, France.

SUBJECTS

18 patients who had swallowed an alkaline substance (caustic soda in 10 cases) and 4 who had swallowed either hydrochloric or sulphuric acid.

INTERVENTIONS

Endoscopy was done a mean of 4 hours after the substance had been swallowed. 10 patients underwent oesophagogastrectomy without thoracotomy.

MAIN OUTCOME MEASURES

Morbidity and mortality.

RESULTS

4 of the 10 patients died and 3 developed postoperative complications. Of the 12 patients treated by feeding jejunostomy 7 developed stenosis that required operation and 3 developed stenosis that responded to dilatation. None of the 12 died.

CONCLUSIONS

Early oesophagoscopy allowed optimal management. Patients died if they swallowed more than 60 ml of a strong alkaline substance. When patients are treated conservatively about half will develop stenoses that require operation.