mohamed Aboulkacem Bourguiba, MD, Faten Souai, MD, Alaeddine Khemir, Marwa Gharbi, Yassine Ben Safta, Sofiene Sayari, Mounir Ben Moussa. Charles Nicolle hospital tunis tunisia
Introduction:The caustic ingestion is a serious surgical pathology that requires a multidisciplinary management. Its prognosis depends on the nature of the ingested agent, the early maturing of the lesions and late complications. Our Purpose is to identify diagnostic, therapeutic and prognostic features of this pathology
Methods: it is a retrospective study that included 100 patients whom were taken charge of at the General surgery department “A” at the Charles Nicolle Hospital of Tunis , Between 2005 and 2013 for a caustic injuries.
Results: The average age was 33, 11 years, the gender ratio was 1,2. The ingested agent was a strong base in 55.6% of the cases, a strong acid in 17.3% and an oxidizing in 27.2%. The found endoscopic lesions were a grade 4 both in esophagus and stomach in 1%, A third grade gastric in 33% and esophageal in 30% of cases. A grade 2a esophageal was found in 25% and gastric in 20%, and grade 2b was found in 26% in the esophagus and 19% in the stomach .A first grade oesohagual found in 18% and gastric in 27% of cases. 11% of patients had an emergency oesogastrectomy and 58.9% had a feeding jejunostomy .the risk factors of endoscopic severity in a univariate analysis were both strong base ingested agent and the oral lesions and only strong base ingested agent in multivariate analysis. The rate of mortality at the acute stage was 7, 1%.The risk factors of mortality in a univariate analysis were the advanced age, strong base ingested agent and elevated endoscopic grade, and both of advanced age, endoscopic grading in a multivariate analysis. In secondary outcomes esophageal and gastric strictures were found in 38.6% of cases. Endoscopic dilatation was attempt in 2.6% and 20% have a feeding jejunostomy. 66.6% esophageal and gastric strictures was found in the third outcomes endoscopic dilatation was attempted in 19% of cases. 73% of patients were operated:80% had coloplasty,13% gastroplasty .13% oesophagectomy and 6%gastrectomy. the risk factors of strictures was: the strong base ingested agent, elevated endoscopic grade and emergency surgery in univariate analysis.
Conclusion: The caustic injuries of the digestive tract have an important aftermath .The prevention and the education of the population has a primary role in the decrease of impact of this pathology.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80009
Program Number: P064
Presentation Session: Poster (Non CME)
Presentation Type: Poster