Management of Corrosive Injuries of Upper GI Tract: Case Series

Abstract

Ingestion of corrosive substances results in severe damage of the upper aerodigestive system and is a major cause of concern in India. Corrosive ingestion may result in perforation and death in acute phase, Stricture formation is a debilitating long term complication. Retrospective study of all corrosive injury patients admitted in our hospital, both early and late presentations. A total of 29 cases were admitted from Jan 2010 to June 2014 of which 6 were Acute presentations and 23 Delayed presentations. In the Acute phase 2 were managed conservatively; there was 1 preoperative and 2 post operative deaths. 1 patient survived post surgery (cervical esophagostomy + total gastrectomy with feeding jejunostomy) of the 23 patients with late presentation, 2 underwent definitive surgery, 1 patient underwent Feeding Jejunostomy. The remaining 20 patients were managed with endoscopic dilatations. In this group 13 patients were followed up with repeated dilatations. 5 had endoscopic failure and 2 developed complications due to endoscopy. Surgery in the acute phase depends on the site and extent of injury. Choice depends on extent of cicatrisation and involvement of esophagus. In the late phase endoscopic dilatation of strictures is the mainstay of management. Maintenance of nutrition is essential for good outcome. Corrosive injury of the upper GI tract is a complex condition requiring intensive approach and multidisciplinary management.