Long term evolution of caustic induced esophagitis: A descriptive 20-years cohort.

Abstract

Introduction: Corrosive esophagitis following caustic agent ingestion remains a significant medical and social concern in Tunisia. Secondary stricture is the most challenging complication. The aim of this study is to determine the incidence of caustic esophageal injuries and to highlight the characteristics of the management. Methods: Over a 20 years period, we conducted a retrospective and descriptive study about 164 consecutive patients presented to our department following ingestion of caustic agents. Results: The mean age was 26 years (16-87) with a gender ratio of 0.2. The ingestion was accidental in 58% of cases and as a suicidal attempt in 42%. Bleach largely dominates ingested solutions in 78.3 % of cases. The delay of the consultation was less than 12 hours in 98.4% of cases. We noticed gravity signs in eight patients. Lesions in Esophagoscopy were recorded in 62 patients (37.8%). The esophageal injury assessed as grade I in 36 patients, grade IIa limited lesions in 10 patients, grade IIa extensive in 8 patients, grade IIb in 5 patients and grade III in 3 patients. During the follow-up, 26 patients (41.9%) had a second assessment during the secondary stage, only 4 patients (2.4%) presented esophageal strictures. Three patients underwent coloplasty for esophageal replacement. Conclusion: During a 20-year period, 164 cases of caustic ingestion were reported. Constituted esophagitis injuries were noted in 37.8% and strictures in 6.45% of all cases.