Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “CAUSTICS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 127 records · Page 7Linked to original sources
PubMed1992

Colonic replacement for the treatment of caustic esophageal strictures in children.

Caustic esophageal stricture is one of the most common indications for esophageal replacement in children. During a 13-year period between 1976 and 1989, colonic replacement was performed in 50 patients for the treatment of caustic esophageal strictures at the Department of Pediatric Surgery of Hacettepe University Children's Hospital. A retrospective clinical study was undertaken to discuss the indications and results of colonic replacement. The 50 children, 34 of whom were male (68%) and 16 of whom were female (32%) with 27 patients (54%) under 6 years of age, were evaluated retrospectively. Indications for operation included 21 (42%) who could not swallow saliva and had total or nearly total obliteration of lumen involving more than 3 cm of an esophageal segment at admittance, and 16 (32%) who had difficulty in swallowing within a 1-month period following the last dilation after completion of a 1-year dilation program. A further 13 (26%) had bleeding and difficulties during dilations, after experiencing an esophageal perforation. The right colon was used in 48 and the left in the remaining 2 patients. Patients were followed for at least 1 year following replacement. Growth was excellent in all but one patient who had redundant colon and showed growth retardation. There was one postoperative late death because of massive bleeding from ulceration of the transplanted colon. The other 49 patients were available for accurate follow-up. The results were good, 46 (92%) were able to eat everything, while occasional dysphagia in 3 (6%) required dilation after operation. Colon conduit provides an excellent substitute for esophagus in pediatric patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Burns, Chemical↗
PubMed1981

Blunt transmediastinal total esophagectomy with simultaneous substernal colon interposition for esophageal caustic stricture in children.

The management of caustic strictures of the esophagus continues to be a challenge to the pediatric surgeon. Many of these patients develop refractory strictures and esophageal reconstruction becomes necessary. Most of the currently employed surgical techniques for this reconstruction leave the injured esophagus in situ and most surgeons have been unwilling to perform a secondary thoracotomy for removal. Many authors have suggested a vastly increased risk of development of esophageal carcinoma in the caustically injured esophagus. In the past five years, techniques for blunt transmediastinal esophagectomy have been developed for adult patients with carcinoma of the cervical region of the esophagus. The current report describes the use of these techniques in two pediatric patients for performing total esophagectomy with simultaneous substernal colon interposition, without the need for thoracotomy. With careful adherence to several technical aspects, this procedure safely allows for complete removal of the injured esophagus and alleviates the concerns of subsequent complications from this organ.

Burns, Chemical↗
PubMed1998

Gastric tubes in children with caustic esophageal injury: a 32-year review.

PURPOSE: Caustic injury to the upper aerodigestive system with scarring of the pharynx, hypopharynx, and esophagus is a challenging reconstructive problem. The author has used the gastric tube for this purpose for three decades. METHODS: During the last 32 years (1965 to 1996 inclusive) the author treated 11 patients who required esophageal replacement with a gastric tube conduit, which was anastomosed to the cervical esophagus. At the time of injury, ages ranged from 2 months to 13 years (mean, 3 years) in seven boys and four girls. Time from injury to esophageal replacement was 12 months to 14 years (mean, 5 years). All 11 had multiple dilations before the replacement. Two had injury and scarring of the epiglottis and larynx that required pharyngeal reconstruction and tracheostomy before replacement. Nine patients underwent reconstruction with a gastric tube anastomosed to the cervical esophagus, and the other two had an interposition with an intrathoracic anastomosis. Eight tubes were antiperistaltic and three isoperistaltic. Seven tubes were placed in the retrosternal space, three were transthoracic, and one was subcutaneous. Six tubes were completed in two stages and five in a single stage. RESULTS: Nontube complications were wound infection (n = 2), perforation (n = 2), paralyzed hemidiaphragm (n = 1), and recurrent laryngeal nerve injury requiring tracheostomy (n = 1). Tube complications were anastomotic leak (n = 9), stricture (n = 8), anastomotic resection (n = 3), ulcer (n = 1), and perforation (n = 1). Six required posttube multiple dilations for several years including self-bouginage (n = 2). All learned to swallow and eat initially with minimal aspiration; only one remains on tube feed supplements. Long-term follow-up (3 to 30 years) includes nine eating normally and not requiring dilations (the tracheostomy boy has chronic lung disease), one lost to follow-up after 1 year, and one death from tube hemorrhage 2 months after operation. CONCLUSION: Children with caustic injury to the upper aerodigestive system can undergo gastric tube replacement with good results. The majority of the problems relate to the esophagogastric tube anastomosis.

Adolescent↗
PubMed1985

Upper airway lesions in children after accidental ingestion of caustic substances.

Of 33 children admitted within 24 hours after accidental ingestion of a caustic substance, 14 (42.5%) had evidence of upper airway lesions on direct laryngoscopy. Three patients, 10 to 12 months old, needed endotracheal intubation for acute respiratory obstruction; four patients younger than 2 years had severe dyspnea without obstruction; seven patients had mild or no respiratory symptoms. All were discharged without respiratory sequelae, although esophageal stenosis developed in six patients. Nine of 13 patients younger than 2 years, compared to five of 20 patients older than 2 years, had upper airway lesions (P less than 0.01). The frequency of respiratory tract lesions was higher in patients with severe esophagitis. Eleven of 17 patients with severe esophagitis, compared to three of 16 with mild inflammation, had respiratory tract lesions (P less than 0.025). No specific caustic substance predisposed to upper airway lesions.

Ampicillin↗
PubMed2001

Caustic soda ingestion -- a case presentation and review of the literature.

We present a case report of a 2-year-old child with a hypopharyngeal stricture secondary to caustic soda ingestion. We discuss the initial and long-term management of caustic soda ingestion. In this case the hypopharynx was successfully reconstructed using a pedicled pectoralis major flap. We demonstrate the versatility of this flap, which is traditionally known for its use in adult head and neck surgery.

Administration, Oral↗
PubMed2000

Microsurgical reconstruction for caustic injuries of the oral cavity and esophagus.

Ingestion of caustic material often produces profound and irreversible pathologic changes that require reconstructive surgery of the organs damaged. This report describes the authors' successful experience with microsurgical techniques that allowed adequate reconstruction in three patients with cicatricial contracture of the oral cavity and esophagus following ingestion of caustic substances. All patients had attempted suicide by ingesting liquid alkali. Patients #1 and #2 complained of limited mouth opening and impaired tongue movement due to oral scar contracture. Contracture release in the first patient resulted in a defect from the anterior border of the mandible to the retromolar region. The defect was resurfaced with a 6 x 12 cm free forearm flap. Release of the scar contracture in the second patient resulted in a long, narrow, tortuous defect that was difficult to cover, even with a forearm flap, and a jejunal segment was microsurgically transferred as a patch graft to reconstruct the defect. Patient #3 had dysphagia due to stricture of the cervical portion of the esophagus. The defect after resection of the cervical portion was reconstructed by free jejunal interposition. Appropriately selected free-flap transfer in each case provided a satisfactory restoration of function of the oropharyngeal and digestive passages.

Adult↗
PubMed1990

[Esophageal caustic injury in childhood. A critical elucidation with indication for esophagoscopy].

From 1983 through 1988, esophagoscopies were performed in 41 children because of suspected caustic esophageal injury. Of these 41 children, 11 had endoscopically significant esophageal burns and were treated with steroids and antibiotics. Of these 11 patients, two had no chemical burns of the facial skin, mouth, or pharyngeal mucosa. The authors therefore believe that esophagoscopy must not be omitted in cases of suspected caustic ingestion.

Anti-Bacterial Agents↗
PubMed1994

Combined duodenal and colonic necrosis. An unusual sequela of caustic ingestion.

Two unusual cases of liquid caustic ingestion that resulted in gangrene of the duodenum and adjacent colon, and burns of the esophagus, stomach, and pancreas are presented. The routine evaluation of the oropharynx, esophagus, and stomach after liquid caustic ingestion can seriously underestimate the extent of injury to distal portions of the gastrointestinal (GI) tract, such as the colon and pancreas, that are not usually included in the initial evaluation of ingestion injuries. In stable patients managed nonoperatively, the entire upper GI tract, including the duodenum, must be visualized either by endoscopy or, less preferably, by barium series. Double-contrast computed tomography should be performed when significant duodenal injuries are present in order to inspect the colon, pancreas, and small bowel. With this approach, life-threatening, multi-organ, subdiaphragmatic ingestion injuries can be identified and treated early.

Adult↗
PubMed1997

Ingestion of caustic hair relaxer: is endoscopy necessary?

Hair relaxer, a commercially available alkaline product, is commonly the offending agent in caustic ingestion. These patients often experience oral cavity and facial burns; however, no clinically significant esophageal injuries have been reported. Therefore, we questioned the therapeutic and economic efficacy of the "standard treatment protocol" that includes hospitalization and endoscopic evaluation. Twenty-six patients over a 7-year period presented to our institution having ingested hair relaxer. Presenting signs and symptoms, esophageal findings, and cost of the standard treatment protocol were reviewed. Also, we analyzed the caustic potential and current packaging of hair relaxer. Our findings support modifications in the standard treatment protocol for hair relaxer ingestion including elimination of hospitalization and endoscopy in most patients. We also question compliance with childproof packaging laws and suggest avenues for prevention of hair relaxer ingestion.

Burns, Chemical↗
PubMed1990

Predictive value of visible lesions (cheeks, lips, oropharynx) in suspected caustic ingestion: may endoscopy reasonably be omitted in completely negative pediatric patients?

The relationship between absence or presence of grossly visible lesions in the cheeks, lips, and oropharynx (C.L.O. burns) and the incidence, site, and degree of visceral burns was evaluated in all children referred to our hospital for a suspected caustic ingestion during a 10-year period. All children underwent eso-gastro-duodenoscopy within 24 hours. Of the 156 children, 96 (61.6%) showed no visible signs of contact with the caustic substance; however, in 36/96 (37.5%), endoscopy revealed burns in one or more visceral sites. Eight of 36 children (22.2%) sustained potentially dangerous lesions (second to third degree). Sixty of 156 children (38.4%) showed visible lesions; in 30/60 (50%), endoscopy revealed other burns in one or more visceral sites. Fourteen of 30 patients (46.6%) sustained potentially dangerous lesions (second to third degree). A total of 50 esophageal burns have been recorded: first degree (E1), 32; second degree (E2), 12; third degree (E3), 6. Two of 12 patients with E2 lesions and 6/6 with E3 lesions developed esophageal stenosis. One patient in this latter group died because of complications related to a tracheostomy. A total of 31 gastric burns have been recorded: G1 (22), G2 (6), G3 (3). One gastric perforation was observed in the G3 group, whereas the remaining two lesions healed with residual asymptomatic scarring. Minimal scarring was observed in two of six patients with G2 burns. A total of eight lesions have been recorded in the larynx [L1 (3), L3 (1)] and in the duodenum [D1 (2), D2 (2)].(ABSTRACT TRUNCATED AT 250 WORDS)

Burns, Chemical↗
PubMed1987

Caustic ingestion and its sequelae in children.

Management of caustic ingestion in children remains a difficult challenge, with the outcome ranging from an asymptomatic state to intractable esophageal strictures. We reviewed the cases of 56 children ranging in age from 10 months to 5 years treated from 1973 to 1984 at the University of Florida. For children seen primarily at our institution, initial management consisted of prompt endoscopy and early institution of steroids and antibiotics. Esophageal burns were confirmed in 37 patients, 21 (56.75%) of whom subsequently had esophageal strictures of varying severity. In seven patients, limited esophageal strictures were managed successfully by dilation, but 14 children with multiple strictures required eventual esophageal replacement. Substernal right colonic interposition was tolerated well by these patients, with few complications, and their growth and development have been satisfactory over follow-up periods ranging from nine months to 13 years. A review of these cases suggests that the character of the ingested caustic material is the most important determinant of the severity of esophageal injury, with preparations containing lye being the most injurious; that in the presence of full-thickness esophageal injury, there is a high potential for stricture formation, regardless of the type of initial management, including early use of steroids; and that multiple esophageal strictures are refractory to dilation, and esophageal replacement should be an early consideration.

Black or African American↗
PubMed1994

Epidemiology and prevention of caustic ingestion in children.

A total of 102 children less than 16 years of age admitted for caustic ingestion in the period 1976-1991 were registered. The annual incidence rate of hospitalization was 10.8:100,000 for the city of Aarhus, Denmark. Esophageal burns occurred with a frequency of 5.0:100,000 per year. Ninety-four percent of the children were less than 5 years old. For this age group, the incidence rates of admission and esophageal burns were 34.6:100,000 and 15.8:100,000, respectively. All ingestions were accidental. The incidence rates of esophageal burns in children 0-4 years old (p = 0.019) decreased significantly during the period studied. The cause of this decrease is not clear, but a change in the spectrum of household products and the gradual introduction of child-proof caps are possible explanations. To minimize the frequency of accidents, an information campaign directed specifically at parents of toddlers is recommended. Information material should stress that caustics should always be inaccessible to children and stored separately, and should never be decanted.

Accident Prevention↗
PubMedDate not supplied

Pediatric caustic ingestion.

Accidental caustic ingestion in the pediatric age group continues to be a controversial and difficult problem. This retrospective study gives clinical support to treating this problem with early esophagoscopy, steroids, antibiotics and dilatation. Four hundred two patients were evaluated for possible caustic burn of the esophagus. Of the 70 patients who had esophageal burns demonstrated at esophagoscopy and who were treated with steroids, antibiotics and dilatation, none developed strictures. The two patients not treated in this fashion developed strictures.

Adrenal Cortex Hormones↗
PubMed1999

Local corticosteroid treatment of caustic injuries of the esophagus. A preliminary report.

So far, no therapy has been shown to reduce the incidence of strictures in the esophagus after ingestion of caustic agents. Two patients with pronounced caustic ingestion injuries were treated locally with solutions of corticosteroids normally used for inhalation therapy in lung diseases. Serious strictures did not appear, and their swallowing returned to normal. Further studies are needed.

Administration, Topical↗
PubMed1980

Caustic ingestion: controversies in management. A review of 214 cases.

Two hundred fourteen patients admitted with a history of caustic ingestion are reviewed. Sixty-five had mucosal penetrating burns. Children five years of age and under accounted for 39% of admissions, but only 8% of burns requiring treatment. Adults accounted for 48% of admissions and 81% of burns requiring treatment. Complications associated with mucosal penetrating burns occurred in 31 patients; all but one were due to lye or acids. A three year prospective study evaluating methylprednisolone in the management of caustic burns is reported. This included 24 patients with mucosal penetrating burns due to lye or acids. The results of this study, and this review as a whole, indicate that methylprednisolone is beneficial in moderately severe burns due to lye, but is not indicated for severe burns from liquid lye, or for acid burns.

Accidents, Home↗
PubMed1999

Combined use of steroid, antibiotics and early bougienage against stricture formation following caustic esophageal burns.

BACKGROUND: If an esophageal burn is diagnosed, the aim is to prevent stricture formation. The combined use of steroid, antibiotics and early bougienage (SAEB) is one of the currently used treatment protocols. The effect of SAEB treatment against stricture formation following caustic esophageal burn has been evaluated retrospectively. METHODS: Forty-nine children of 282 admitted with a history of caustic substance ingestion were found to have esophageal burns. Forty-nine children underwent treatment against stricture formation. SAEB was begun within 48 hours of ingestion. RESULTS: Eight children of 12 who ingested sodium hydroxide and five children of 20 who ingested acids developed strictures in spite of the therapy. Additionally two esophageal perforations were encountered in patients who ingested sodium hydroxide. CONCLUSIONS: This protocol has been found to carry a risk of perforation without preventing stricture formation after strong alkali ingestion. Therefore other treatment modalities for preventing strictures should be evaluated especially in children who have ingested products containing strong alkalis.

Anti-Bacterial Agents↗
PubMedDate not supplied

[Current trends in the surgical treatment of lesions caused by caustic ingestion].

During a twenty-six year period from 1973 to 1999 a total of 78 patients with severe esophago-gastric lesions after caustic ingestion were referred to and managed at our unit. Hydrochloric acid was the most frequently involved caustic agent and the lesions were located in the esophagus (52.6%), in the stomach (19.2%) and in both the esophagus and stomach (28.2%). Thirty-seven patients were managed by endoscopic dilation of esophageal stricture that gave permanent relief of dysphagia in 13 cases only. Twelve patients are still managed with endoscopic dilation and in another 12 we performed bypass surgery. Two perforations developed and spontaneously sealed after T.P.N. for 6-8 weeks. No death occurred. Fifty-three patients were operated on in emergency or during survey period or for stenotic lesions. Surgical procedures were: in esophageal strictures a substernal esophago or pharyngocologastroplasty without esophagectomy; in esophago-gastric strictures, after an esophago-gastrectomy, an esophago or pharyngocolojejunoplasty in one or two steps; in total gastric stenosis without esophageal involvement a total gastrectomy followed by a Roux-en-Y esophago-jejunal anastomosis and in antropyloric strictures a Billroth I or II partial gastrectomy. The morbidity rate was 32% with a 5.6% mortality rate.

Adolescent↗
PubMed2000

Caustic ingestion.

Caustic and corrosive injury of the upper gastrointestinal tract can lead to significant morbidity and mortality with the development of upper gastrointestinal stricture or perforation. Household products containing alkalis, acids, and detergents are responsible for most injuries, with each having varying histological injury patterns and anatomic distribution. Early signs and symptoms after caustic ingestion are not consistent with the extent of damage, and endoscopy is the only reliable method to assess injury. Medical and surgical treatments are controversial and include steroids, antibiotics, esophageal dilation, stenting, and surgical reconstruction and are centered around prevention of esophageal strictures. Early diagnosis and prompt and aggressive treatment can improve long-term outcomes in these patients.

Accidents, Home↗