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首页> 外文期刊>Surgical Endoscopy >Caustic acid burn of the upper gastrointestinal tract: first use of endosonography to evaluate the severity of the injury.
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Caustic acid burn of the upper gastrointestinal tract: first use of endosonography to evaluate the severity of the injury.

机译：上消化道的苛性酸烧伤：首先使用超声检查评估损伤的严重程度。

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摘要

Judging the severity of an injury after erosions of the upper gastrointestinal tract has been exclusively based on endoscopic inspection. For the first time, we used minimal probe endosonography during initial endoscopy and endoscopical progress observations to improve assessment of injury depth determining the therapy. Nine hours after admitting a patient after acid ingestion, the initial endoscopy and simultaneous endosonography with a 12-MHz minimal endosonographical probe took place. The affected wall sections with macroscopical coagulation necrosis regularly showed a richer echo, broadened first layer, and a low-echo wall edema that had developed under the necrosis. Differences existed between the breadth of the first echo-rich layer and the breadth of the edema below it. The indiscriminability of single wall layers correlated with the intensity of the edema. The initial injury depth was defined based on the depth extension of the wall edema and the discriminability of the layers. In the control examinations, a complete wall edema with limited assessability developed independently of the injury's initial severity. The assessment of injury depth was only possible during a short time span. Differences existed in the regression time of the wall edema. The initial endosonography and diagnostic findings over time showed differences between superficial and deep wall injuries after erosion. In this way, the injury depth could be correctly estimated, thus directly influencing therapy planning.
机译：仅根据内窥镜检查来判断上消化道侵蚀后的损伤严重程度。首次，我们在初始内窥镜检查和内窥镜检查过程中使用了最小限度的探头超声检查，以改善对确定治疗深度的损伤深度的评估。酸摄入后允许患者入院9小时后，进行了初始内窥镜检查和同时用12 MHz最小内窥镜探头进行内窥镜检查。伴有宏观凝固性坏死的受影响的壁部分通常显示出较厚的回声，第一层变宽以及在坏死下发展的低回声壁水肿。第一富含回波的层的宽度和其下方的浮肿的宽度之间存在差异。单壁层的不可区分性与浮肿的强度有关。初始损伤深度是根据壁水肿的深度扩展和各层的可分辨性定义的。在对照检查中，与损伤的初始严重程度无关，可评估性有限的完整壁水肿发生。只能在很短的时间内评估损伤深度。壁水肿消退时间存在差异。最初的超声检查和诊断结果表明，侵蚀后浅表和深壁损伤之间存在差异。这样，可以正确估计损伤深度，从而直接影响治疗计划。

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