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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Managementof Corrosive Injuries ofthe Upper Gastrointestinal Tract
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Managementof Corrosive Injuries ofthe Upper Gastrointestinal Tract

机译:上消化道腐蚀损伤的处理

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Introduction: A corrosive injury to the upper gastrointestinal tract is a common problem and has a wide spectrum of presentations. We have prospectively evaluated 16 patients who ingested corrosive substances for the location, extent and the severity of injury and its outcome. The best time to assess the injury is by 12-48 hours of ingestion of the corrosive substances. Upper gastrointestinal (GI) endoscopy is the single most important investigation which helps to grade the injury and to plan the further management.Materials and Methods: All the patients who presented to the Casualty and to the Out patients Department of the H S K hospital, Bagalkot, during August 2009 to July 2010, with a history of corrosive agent ingestion were admitted and resuscitated. In the indicated cases, upper GI endoscopy was done to assess the severity of the injury. The following grading system was used. Grade 0- Normal mucosa, Grade1(superficial)- Superficial hyperaemia and oedema, Grade2A (Transmucosal)- Haemorrhage, exudates, linear erosions, blisters, shallow ulcers involving the mucosa and the submucosa, Grade2B- Circumferential burn present, Grade3-Deep ulceration, eschar formation with necrosis, full thickness injury with and without perforation.Results: Out of the 16 patients, 10 were females and most were of the age group of 10-30 years.10 had consumed acid and 3 alkalis and in another 3 cases, the substance which was ingested was not elicitable. 15 patients had consumed the substances with suicidal intentions and in only one patient it was accidental. The predominant symptom was pain and most had oesophageal injuries. The grade 2 injury was the most common type of injury. 13 patients were managed conservatively and 3 required surgery. The most common complication was a stricture in the oesophagus.Conclusion: The corrosive injury is more common in females. Most of the patients were of younger ages. Acid ingestion was more common than alkali ingestion, and most had suicidal intentions. Early upper G.I. endoscopy has a definite role in diagnosing the severity of the injury and in planning the management. Most of the patients with corrosive injuries can be managed conservatively with follow up for the stricture, which is the most common complication that is often treated by dilatation.
机译:简介:对上消化道的腐蚀伤害是一个普遍的问题,涉及范围广泛。我们对16例摄入腐蚀性物质的患者进行了前瞻性评估,以评估其位置,程度,严重程度及其后果。评估伤害的最佳时间是摄入腐蚀性物质12-48小时。上消化道内窥镜检查是最重要的检查,它有助于对损伤进行分级并计划进一步的治疗。材料与方法:所有向HSK医院Bagalkot的伤亡和门诊部就诊的患者,在2009年8月至2010年7月期间,有腐蚀剂摄入史并被复苏。在所示病例中,进行了上消化道内镜检查以评估损伤的严重程度。使用了以下分级系统。 0级-正常粘膜,1级(浅表)-浅表充血和水肿,2A级(透粘膜)-出血,渗出液,线状糜烂,水疱,涉及粘膜和粘膜下层的浅溃疡,2B级-存在周围烧伤,3级深溃疡,结果:16例患者中,10例为女性,大多数年龄在10-30岁之间。10例患者食用酸和3种碱,另外3例,摄入的物质是无法引出的。 15名患者食用了具有自杀意图的物质,只有1名患者是偶然的。主要症状为疼痛,多数食道损伤。 2级伤害是最常见的伤害类型。保守治疗13例,需要手术3例。最常见的并发症是食管狭窄。结论:腐蚀损伤在女性中更为常见。大多数患者年龄较小。酸摄入比碱摄入更常见,并且大多数有自杀意图。早期的上G.I.内窥镜检查在诊断损伤的严重程度和计划治疗中具有明确的作用。大多数腐蚀性损伤患者可以通过狭窄的随访保守治疗,这是最常见的并发症,通常通过扩张术来治疗。

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