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The Journal of Cardiovascular Surgery 1999 April;40(2):307-10

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: English

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

Karnak I., Tanyel F. C., Büyükpamukçu N., Hiçsönmez A.

From the Department of Pediatric Surgery Hacettepe University Faculty of Medicine Ankara, Turkey


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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.

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