Cases reported "Burns, Chemical"

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1/17. Alkaline esophagitis evaluated by endoscopic ultrasound.

    Case Report: Two patients with corrosive esophagitis caused by alkaline household agents were examined with endoscopic ultrasound using a 20-MHz probe. In the first case, endoscopic ultrasound revealed circumferentially thickened mucosa and muscularis propria, and lack of differentiation between the mucosa and submucosa. However, esophageal stricture did not develop during 3 months of follow-up, suggesting that the deep lesion may have involved a narrow section of esophagus only. In the second case, a markedly thickened mucosa was seen, resulting in no sequelae. Endoscopic ultrasound offers a more accurate evaluation of the depth of the lesions in alkaline esophagitis compared to standard endoscopy or computed tomography. longitudinal studies are needed to identify lesions at greatest risk for progression to stricture.
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keywords = esophagitis
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2/17. Esophageal replacement using a reversed gastric tube for lye stricture in a child: report of a case.

    A 5-year-old girl ingested lye, a detergent used in electric dishwashers. She was transferred to our hospital after balloon dilatation, performed for stenosis resulting from corrosive esophagitis, was complicated by esophageal perforation causing mediastinitis. Although the mediastinitis resolved with conservative treatment, the stenosis did not improve. Therefore, we performed esophageal replacement using a reversed gastric tube, which successfully relieved the obstruction, although she still had slight gastroesophageal reflux 6 months postoperatively.
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ranking = 0.16677836357188
keywords = esophagitis, reflux
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3/17. Gastric antral patch esophagoplasty for extensive corrosive stricture of the esophagus.

    A case is reported of a patient with a 9-cm stricture of the esophagus caused by ingestion of sodium hydroxide, who was treated by gastric antral patch esophagoplasty. In this procedure, a full-thickness pedicled patch of gastric antrum, based on the left gastroepiploic artery, was used to enlarge the esophageal lumen, thus allowing preservation of esophageal continuity and utilization of a functioning lower esophageal sphincter. The patient ate normally after the operation, and radiological, manometric, and esophageal ph monitoring studies indicated satisfactory esophageal function. Gastric antral patch esophagoplasty avoids the complications associated with esophageal bypass or resection. Previous long-term results of this procedure in patients with reflux-induced esophageal stricture have been good, and the technique merits consideration in the treatment of severe corrosive strictures.
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ranking = 0.00011169690521697
keywords = reflux
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4/17. sucralfate therapy for lye-induced esophagitis.

    sucralfate is a recently introduced drug that has received acceptance as a nonsystemic, locally active antiulcer agent used in the treatment of duodenal ulcer disease. In addition, sucralfate has been used for the treatment of gastric ulcer and a variety of other gastrointestinal diseases. However, the use of sucralfate to treat caustic esophagitis has not been clinically investigated, and a review of the literature yielded scant information (1). Herein, we report our experience with sucralfate in the treatment of a case of lye-induced esophagitis.
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5/17. Corrosive injury to the stomach: the natural history and role of fiberoptic endoscopy.

    Most physicians recognize that the ingestion of lye is associated with severe esophageal damage. It is much less widely known that gastric injury is the predominant finding when acid is ingested. We are reporting on five patients who had severe gastric damage after ingestion of diluted sulfuric acid (three cases), capsules of potassium hydroxide, and Clinitest tablets (one case each). Fiberoptic endoscopy was used to localize the extent and severity of injury and to follow the evolution of the damage. The extent and location of injury varied with the amount and type of agent ingested. Acid ingestion resulted in severe gastritis, which eventually led to antral stenosis and gastric outlet obstruction requiring operative intervention in two cases. potassium hydroxide capsules produced diffuse esophagitis, gastritis, and a non-healing large gastric ulcer. Clinitest tablets produced distal esophagitis and stricture and antral damage leading to gastric outlet obstruction which required operative intervention. These cases demonstrate the natural history of corrosive injury to the stomach and the value of fiberoptic endoscopy in the management of this problem.
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keywords = esophagitis
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6/17. Canidida infection of the upper gastrointestinal tract superadded upon chemical injury with acids.

    Two male patients, who presented with candida albicans infection of the upper gastrointestinal tract, superadded over local mucosal injury due to corrosive chemical agents and chronic alcoholism have been described. Such an association of prior local injury with this type of fungal infection has not been hitherto documented. One of these patients had a gastric antral stricture due to ingestion of concentrated sulfuric acid and Candida esophagitis, whereas the other had severe erosive gastritis and Candida gastritis following ingestion of thiocyanates.
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ranking = 0.16666666666667
keywords = esophagitis
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7/17. lye ingestion. Clinical patterns and therapeutic implications.

    Conventional treatment of caustic esophagitis consists of early endoscopy to the first site of injury followed by antibiotic and steroid therapy, with early mechanical dilatation to prevent stricture formation. The failure of this approach in two recent patients led us to review our overall experience with the management of patients who had ingested lye or other caustic substances. Of 42 patients treated at the Santa Clara Valley Medical Center between 1970 and 1980, seven sustained severe esophageal burns. All had intractable strictures despite steroids, antibiotics, and, in three cases, attempts at dilatation. We conclude that patient survival should not be jeopardized by overly aggressive attempts to salvage an extensively damaged esophagus. Such attempts will probably prove both futile and dangerous, and effective re-establishment of oral-intestinal continuity is now possible by a variety of techniques.
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ranking = 0.16666666666667
keywords = esophagitis
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8/17. Drug-induced corrosive injury of the oesophagus.

    Five patients are described who had retrosternal pains following the consumption of CetiprinR tablets. The pains increased so markedly within a few days that, initially, solid foods and, subsequently liquid foods also were impossible to swallow. Typically the history was of the comsumption of a tablet in the evening or night without fluids and the pains lasted 2--3 weeks. A marked corrosive injury of the middle third of the oesophagus was shown at oesophagoscopy in each case, but the mucosa of the lower one-third of the oseophagus was normal. Gastro-oesophageal reflux was not demonstrated radiologically in any of the patients. None of the patients developed a stricture of the oesophagus. The most likely alternative in the differential diagnosis was a foreign body. Oesophagoscopy should be performed on any patient in whom such pains persist for more than 4--5 days, even if the x-rays are normal. The physician should advise his patients to take tablets or capsules with fluids. This is especially important if the drug is taken in the evening or at night. CetiprinR tablets should be taken in the evening while the patient is still upright, and should be taken with fluids. If a corrosive injury does develop, we suggest that treatment should be with cortisone and with agents which protect the oesophageal mucous membranes.
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ranking = 0.00011169690521697
keywords = reflux
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9/17. Barrett's epithelium complicating lye ingestion with sparing of the distal esophagus.

    We report a patient with a history of lye ingestion in whom a band of ectopic gastric mucosa is associated with a stricture of the mid-esophagus. Specialized columnar epithelium (a type of Barrett's epithelium) developed along the edges of this band. This specialized columnar epithelium is separated from the mucosa of the stomach by a continuous sheet of normal stratified squamous epithelium. Heretofore, Barrett's epithelium involving the middle esophagus has been reported only as the proximal extension of a sheet of columnar mucosa lining the entire distal esophagus. The development of specialized columnar epithelium in this setting suggests that local factors besides gastroesophageal reflux may be involved in the pathogenesis of Barrett's epithelium.
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ranking = 0.00011169690521697
keywords = reflux
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10/17. Pericardial complications of peptic ulceration.

    Intrathoracic perforated peptic ulceration is uncommon. Two patients are reported with pericardial fistulization secondary to peptic ulceration. These occurred following colonic bypass surgery as a consequence of peptic esophagitis and hiatus hernia.
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keywords = esophagitis
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