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Corrosive oesophageal strictures following acid ingestion: Clinical profile and results of endoscopic dilatation

 

作者: S. L. BROOR,   A. KUMAR. S. T. CHARI,   A. SINGAL,   S. P. MISRA,   N. KUMAR,   S. K. SARIN,   J. C. VIJ,  

 

期刊: Journal of Gastroenterology and Hepatology  (WILEY Available online 1989)
卷期: Volume 4, issue 1  

页码: 55-61

 

ISSN:0815-9319

 

年代: 1989

 

DOI:10.1111/j.1440-1746.1989.tb00807.x

 

出版商: Blackwell Publishing Ltd

 

关键词: acid ingestion;corrosive oesophageal strictures;dysphagia;Eder‐Puestow metal olives;endoscopic dilatation.

 

数据来源: WILEY

 

摘要:

AbstratThere are several reports on oesophageal strictures caused by alkali ingestion, but information on oesophageal strictures due to acid ingestion is scarce. Endoscopic dilatation, which has been found to be quite safe and effective in the treatment of benign oesophageal strictures of other aetiology, has also not been evaluated adequately in the treatment of these strictures. Over a period of 2 years, of 47 patients treated at this centre of benign oesophageal strictures, 17 (36.2%) patients had strictures following ingestion of corrosive agents. Thirteen patients had ingested acids and only four gave a history of alkali ingestion. The age range of these 13 patients was 14–50 years (mean = 25.5 years, s.d. = 2.6). The amount of acid ingested varied from 10 to 100 ml (median = 50 ml). The interval between acid ingestion and presentation to hospital ranged from 1 to 60 months (median = 2 months). Ten patients had multiple strictures, and the most common site of involvement was the upper third followed by the lower third of the oesophagus. Only five‐of these 13 patients had evidence of gastric involvement in the form of antral stricture (four) and hour glass deformity (one). Strictures were dilated using Eder‐Puestow metal olives passed over a guide wire. The total number of sittings required to achieve adequate dilation in this group ranged from 1 to 30 (median = 14). Most patients were managed successfully with dilatation (good response 63.6%, satisfactory response 18.2%). On follow‐up, recurrence of dysphagia was seen in a high number of patients (66%), but this could be managed easily with repeat dilatation. It is concluded that, in contrast to reports from the West, acid ingestion is a common cause of oesophageal strictures in India. These strictures are usually tight and multiple. The patients not only require several sittings to achieve adequate dilatation, but they also have a high recurren

 

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