CORROSIVE INJURY OF THE UPPER GASTROINTES TINAL-TRACT - TREATMENT ANDNATURAL-HISTORY

We report a retrospective analysis of 61 patients admitted during the years 1974 to 1992 after having recently swallowed a corrosive agent. Within 24 hours, the localisation, severity and extent of the injury h ad been determined by endoscopy. In 13 patients the injury was restric ted to the oropharynx, and in 48 it involved esophagus, stomach and du odenum. Fourteen had sustained a second degree injury, and 16 a third degree injury. Out of five patients with third degree injuries who wer e treated by operation within the first three days, two survived. Two patients operated upon for complications after 10 days of conservative treatment died. The total mortality was 21 %, but 56 % for those who had received a third degree injury. Thirteen patients developed a sten osis (27 % of those with gastroesophageal lesions). Esophageal strictu res were dilatated with bougies, but stomach stenoses were treated by resection. Of the 12 patients treated by dilatation, 4 sustained perfo rations and 4 of them were free of symptoms for a considerable period of time (more than 4 years).