ISSN: 1305-3876
Dil: Türkçe
Hakkında: Özel sayılar şeklinde yayınlanır.
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Esophageal Emergencies
Dr. Şevval ERENa
aGöğüs Cerrahisi AD, Dicle Üniversitesi Tıp Fakültesi, DİYARBAKIR
Emergencies of the oesaphagus may cause oesaphagial perforation leading to mediastinitis and death. Foreign bodies in the oesophagus more common in the first three years of life. Metal coins are the most frequently encountered foreign bodies in this age group. More recently, chemical burns due to the ingestion of flat alkaline batteries are among the frequent causes of oesaphagial perforation. Fleshy bones, chicken and fish bones are among the frequently encountered oesaphagial foreign bodies in adults, especially in the elderly. The underlying cause in some cases may be inadequate chewing, while in some patients an underlying oesaphagial disease, neurogenic and psychiatric disorders may lead to repeat presentations of a foreign body. After the extirpation of the foreign body by adequate techniques, the possibility of an oesaphagial perforation must be kept in mind especially in delayed cases or in those managed with difficulty.
Iatrogenic manipulations and external traumas are the most common causes of oesaphagial injuries. The morbidity and mortality rates are higher in thoracic oesaphagial injuries than in cervical injuries. Early diagnosis and treatment is the major factor in reducing mortality rates. Suspect of oesaphagial injury by the physician is probably the most important factor leading to prompt diagnosis. Oesophagography using a water soluble contrast meduma, endoscopy and computed tomography (CT) are the techniques used for the diagnosis of perforation. Early surgical treatment is the most effective treatment modality in traumatic oesaphagial perforations. Primary closure in the first 24 hours and supporting by a pedicled flap gives the best results. Alternative treatment techniques are required in delayed cases.
Chemical burns of the oesaphagus caused by corrosive materials may be due to acidic or alkaline agents. Alkaline agents used in household cleaning are the most frequent causes and their possibility of injuring the oesaphagus is greater tha acidic agents. Urgent surgical intervention is necessary in case of a perforation. In those cases of chemical burns without a perforation, medical treatment and subsequent dilating procedures are required.Keywords: Esophagus, foreign bodiesTurkiye Klinikleri J Surg Med Sci 2007, 3(3):54-62
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