Corrosive Injury of the Upper Gastrointestinal Tract: Review of Surgical Management and Outcome in 14 Adult Cases

Introduction: caustic ingestion is responsible for a spectrum of upper gastrointestinal tract injury from self-limited to perforation. this study conducted to evaluate clinical characteristics as well as surgical outcomes in patients with caustic ingestion.   materials and methods: between nov1993 to march 2011, 14 adults with a clinical evidence of corrosive ingestion were admitted into our institutions (omid and ghaem hospitals). patients evaluated for etiology of erosion, location, type of surgery, morbidity and mortality after surgery.   results: 14 patients (10men and 4 women) with a age range between18-53 years were evaluated. in 6 patients, the injury was accidental and in 8 patients ingestion was a suicide attempt. ingested agent included nitric acid in 4 patients, hydrochloric acid in 7 patients, sulfuric acid in 2 patients and strong alkali in one patient. the location and extent of lesion varied included esophagus in 13 cases, stomach in 7 cases and the pharynx in 3 cases. acute abdomen was developed in 2 patients and a procedure of total gasterectomy and blunt esophagectomy was performed. in the remaining patients, substernal esophageal bypass in 2 patients, esophageal resection and replacement surgery in 9 patients and gastroenterostomy in one patient performed to relieve esophageal stricture. two patients died of mediastinitis after esophageal replacement surgery. postoperative strictures were developed in 2 survived patients with hypopharyngeal reconstruction that was managed by per oral bougienage in one patient and ktp laser and stenting in the other patient.   conclusion:  esophageal resection with replacement was safe and good technique for severe corrosive esophageal stricture with low mortality and morbidity.