AI Article Synopsis
- Surgical intervention is often necessary for patients with acute corrosive injuries, but it comes with high risks of complications and mortality, as shown in a study of 170 patients where 14% required emergency surgery.
- The most common reasons for surgery were peritonitis and mediastinitis, with patients experiencing high post-operative mortality rates.
- Despite the initial dangers, a significant number of survivors (72%) were able to undergo successful reconstructive surgeries during follow-up after the acute phase had passed.*
Article Abstract
Background: Surgical intervention for acute corrosive injury is often required. It is associated with considerable morbidity and mortality. Sparce data is available on the types and timing of surgery after acute corrosive ingestion and complications associated with the same.
Methods: This is a retrospective single-center study from a tertiary care center in India. All patients who underwent surgical exploration after acute corrosive intake between January 2003 and June 2014 were enrolled in the study. Data on patients' presentation, their endoscopic findings, indications of surgery, type of surgery and post-operative follow-up was retrieved.
Results: Out of 170 patients who presented with acute corrosive ingestion, 24 patients (14.11%) required emergency surgery. The mean interval between ingestion and surgery was 9.92 ± 9.03 days. Presence of peritonitis was the most common indication for surgery (n = 10; 41.7%) followed by mediastinitis (n = 7; 29.2%). A total of 17 resectional and 7 non-resectional procedures were performed. Thirteen (54%) patients succumbed to their illness post-operatively due to multi-organ failure (n = 9), refractory shock (n = 3) or pulmonary thromboembolism (n = 1). Patients with early surgery (≤7 days) after corrosive ingestion had similar mortality compared to patients with late surgery (>7 days) (50% versus 67%; P = 0.30). Of the 11 surviving patients, eight patients (72%) underwent successful reconstructive surgery on follow-up.
Conclusions: Emergency surgery after corrosive ingestion carries high morbidity and mortality. However, after the initial stormy acute phase, majority of patients can undergo successful reconstructive surgery on follow-up.
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| http://dx.doi.org/10.1111/ans.18576 | DOI Listing |
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