EVOLUTION OF CAUSTIC INJURY OF THE UPPER GASTROINTESTINAL TRACT: ABOUT 38 CASES

Aims The aim of this work is to report our experience of caustic injure of the upper gastrointestinal tract and to analyze the evolution of the lesions.

Methods We performed a descriptive retrospective study over 3 years ( 2018-2020) where all patients who underwent upper GI endoscopy in the acute phase were included and esophageal and gastric caustic lesions were classified according to their severity and extent according to the Savary and Miller score.

Results 38 patients were included, the average age was 24 years (17- 49). The most frequently ingested corrosive substances were alkalis in 52.63% and acids in 31.57% of cas; ingestion was accidental in 57.89%. The super gastro-intestinal endoscopy was often performed on average after 48h-72h post ingestion, it showed different stages of lesions: from a stage I in 23.68% to diffuse necrosis lesions in 15.78% of cases. The evolution was marked by a clinical improvement without complications with a 3 year follow-up in 55.26%, while in 44.7% of the patients we noted: 3 cases of death following a perforation or infectious complications, 31.57% presented an esophageal stenosis at different levels which was clinically manifested by dysphagia and treated by dilatation with candles or pneumatics and 2 patients presented an antro-pyloric stenosis treated by dilatation sessions.

Conclusions Caustic ingestion is an urgent situation requiring an early multidisciplinary management likely to complications in the short, medium and long term and for which uppercut endoscopy represents a capital examination of first intention but also a tool in the therapeutic management of this pathology.

Publication History

Article published online:
14 April 2022