Ingestão Cáustica e Estenose Cáustica de Esôfago: Diagnóstico e Tratamento / Caustic Ingestion and Caustic Stenosis of the Esophagus: Diagnosis and Treatment

Yago Correa Peres, Andressa de Souza Abi-Rachid Moraes, Rodrigo Pantoja Moraes, Einar Afonso Fried dos Santos, Yan Tavares bandeira Lopes, Enzo Sá Pantoja da Silva da Silva, Murilo Brandão Pimenta, Bruno Rodrigues Salvador, Amanda Chagas Barreto, Ana Paula Santos Oliveira Brito

Abstract


A ocorrência da ingesta de substâncias cáusticas é considerada emergência médica que pode ocorrer em adultos e crianças e acarretar sequelas e agravos como a estenose cáustica de esfôfago. O diagnóstico e o manejo adequados são de extrema importância para a diminuição da mortalidade e para traçar o prognóstico desses pacientes. A diagnose se dará pela somatória de características clínicas, laboratoriais, radiológicas e endoscópicas, sendo fundamental e necessário a endoscopia digestiva alta somada à radiografia contrastada de esôfago, estomago e duodeno, para avaliar o grau da lesão e a estenose esofágica. A terapêutica inicial será realizada de acordo com grau estabelecido e posteriormente pode necessitar de condutas especificas para a dilatação esofágica, sendo o método mais indicado através de expansores endoscópicos associados a fármacos, principalmente a mitomicina C. Em casos recidivantes, ou não responsivos à terapêutica precoce, pode ser realizada, tardiamente, a intervenção cirúrgica que possui a sua eficiência bem descrita.


Keywords


Estenose Esofágica, Estenose Cáustica, Cáusticos, Endoscopia, Diagnóstico, Tratamento.

References


-Vezakis AI, Pantiora EV,Kontis EA, Sakellariou V, Theodorou D, Gkiokas G, et al. Clinical Spectrum and Management of Caustic Ingestion: a case series presenting tree opposing outcomes. Am J Case Rep. 2016; 17: 340–346.

-Contini S, Scarpignato C. Caustic injury of the upper gastrointestinal tract: A comprehensive review. World J Gastroenterol. 2013; 19(25): 3918–3930

-Mowry JB, Spyker DA, Cantilena LR, McMillan N, Ford M. 2013 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 31st Annual Report. Clin Toxicol (Phila). 2014; 52(10): 1032-283.

-Silva AAR, Rezende ALF, Silva MJO, Passos RS, Falluh R, Gois WAF. Diretriz Interprofissional de Atenção à Criança e ao Adolescente com Ingestão de Substâncias Cáusticas. Hospital da Criança de Brasília José Alencar. 2016.

-Bonavina L, Chirica M, Skrobic O, et al. Foregut caustic injuries: Results of the world society of emergency surgery consensus conference. World J Emerg Surg. 2015;10:44.

-Bosnali O, Moralioglu S, Celayir A, Pektas OZ. Is rigid endoscopy necessary with childhood corrosive ingestion? A retrospective comparative analysis of 458 cases. Diseases of the Esophagus. 2017; 30:1–7.

- Boskovic A, Stankovic I. Predictability of gastroesophageal caustic injury from clinical findings: is endoscopy mandatory in children? European Journal of Gastroenterology & Hepatology. 2014; 26(5):499–503.

-Vargas BOR, Salgado EM, Teves PM, Ventura SS, Calderon EG. Lesiones por cáusticos del tracto digestivo superior: características clínicas y endoscópicas. Rev gastroenterol Perú. 2016; 36.

-Seydou T, Abdoulaye OM, Xing L, Zimogo S, Sekou K, Wen YS, et al. Apport des moyens endoscopiques dans la dilatation des sténoses caustiques de l’œsophage. The Pan African Medical Journal. 2016;23:24.

-Losada M, Rubio M, Blanca JA, Pérez C. Ingesta de cáusticos en niños, experiencia de 3 años. Rev. chil. pediatr. 2015; 86.

-Reddy RY, Gupta P, Sinha SK, Kochhar R. A novel method of evaluating corrosive stricture during endoscopy. Gastrointestinal Endoscopy. 2015; 81(2): 486-487.

-Kuehn F, Klar E, Schwandner F, Alsfasser G, Gock M, Schiffmann L. Endoscopic continuity-preserving therapy for esophageal stenosis and perforation following colliquative necrosis. Endoscopy 2014; 46(01): 361-362

-Kucuk G, Assist P, Gollu G, Ates U, Cakmak ZA, Kologlu M, et al. Evaluación de lesiones esofágicas secundarias a la ingesta de sustancias cáusticas no rotuladas: Serie de casos pediátricos. Arch. argent. pediatr. 2017; 115 (2)

- Gonçalves MEP, Cardoso SR, Cereda D, Diamari CRC. Endoscopia digestiva pediátrica. Manual do residente em endoscopia digestiva. 2014

-Gschossmann JM, Schroeder R, Wyler F, Scheurer U, Schiemann U. Wann sollte eine frühe endoskopische Inspektion bei Verletzungen des oberen Gastrointestinaltrakts nach Ingestion von potenziell ätzenden Substanzen und anderen Noxen erfolgen? – Eine retrospektive 13-Jahres-Analyse in einem tertiären Haus der Maximalversorgung. Z Gastroenterol. 2016; 54(06): 548-555.

-Gupta V, Kurdia KC, Sharma A, Mishra AK, Yadav TD, Kochhar R. Tracheoesophageal fistula in adults due to corrosive ingestion: challenges in management. Updates in surgery. 2015; 67(1):75-81

-El-Asmar KM, Hassan MA, Abdelkader HM, Hamza AF. Topical mitomycin C can effectively alleviate dysphagia in children with long-segment caustic esophageal strictures. Diseases of the Esophagus. 2015; 28(5): 422-427.

-Bartel MJ, Seeger K, Raimondo M, Wallace MB, Woodward TA. Mitomycin C application improves the outcome of highly refractory and recurrent benign esophageal strictures. Gastrointestinal endoscopy. 2014; 79 (5): 410.

-Usta M, Erkan T, Cokugras FC, Urganci N, Onal Z, Gulcan M, Kutlu T. High doses of methylprednisolone in the management of caustic esophageal burns. Pediatrics. 2014; 133 (6): 1518-1524.

-Sweed AS, Fawaz SA, Ezzat WF, Sabri SM. A prospective controlled study to assess the use of mitomycin C in improving the results of esophageal dilatation in post corrosive esophageal stricture in children. 2015; 79 (1): 23-25.

-Julca AJO. Uso de corticoides sistémicos en esofagitis caustica. Rev gastroenterol Perú. 2016; 36.

-Shub MD. Therapy of caustic ingestion: new treatment considerations. Current Opinion in Pediatrics. 2015; 27 (5): 609-613.

-Nijhawan S, Udawat HP, Nagar P. Aggressive bougie dilatation and intralesional steroids is effective in refractory benign esophageal strictures secondary to corrosive ingestion. Diseases of the Esophagus. 2017; 30 (6): 1–5.

-Mendez CM, Mondragon FZ, Mayans JR, Flores MF. Mitomicina C tópica contra triamcinolona intralesional en el manejo de la estenosis esofágica por cáusticos. Revista de Gastroenterologia de México. 2015; 80 (4): 248-254.

-Bartel MJ, Seeger K, Jeffers K, Clayton D, Wallace MB, Raimondo M, et al. Topical Mitomycin C application in the treatment of refractory benign esophageal strictures in adults and comprehensive literature review. Digestive and Live Disease. 2016; 48 (9): 1058-1065.

-Shahi AS, Behdad B, Esmaeili A, Moztarzadeh M, Peyvandi H. Esophageal stenting in caustic injuries: a modified technique to avoid laparotomy. General Thoracic and Cardiovascular Surgery. 2015; 63 (7): 406-412.

-Uygun I. Caustic oesophagitis in children: prevalence, the corrosiveagents involved, and management from primary care through to surgery. Otolaryngology & Head and Neck Surgery. 2015; 23 (6): 423-432.

-Venkatachalapathy SV, Burr N, Subramanian V, Everett S. Systematic review and meta-analysis on complications following oesophageal dilatation for benign oesophageal stricturespreliminary results. BMJ Publishing Group. 2016; 65.

-Woynarowski M, Dądalski M, Wojno V, Teisseyre M, Hurkała L, Ptowiecki E. Novel, double-lumen removable stent to treat caustic esophageal stenosis. Endoscopy. 2014; 46 (1): 378-379.

-Chirica M, Brette MD, Faron M, Bongrand MN, Halimi B, Laborde C, et al. Upper Digestive Tract Reconstruction for Caustic Injuries. Annals of Surgery. 2015; 261 (5): 894-901.

-Harlak A, Yigit T, Coskun K, Ozer T, Mentes O, Gulec B, et al. Surgical treatment of caustic esophageal strictures in adults. International journal of surgery. 2013; 11 (2): 164-168.

-Ezemba N, Eze JC, Nwafor IA, Etukokwu KC, Orakwe O. Colon Interposition Graft for Corrosive Esophageal Stricture: Midterm Functional Outcome. World Journal of Surgery. 2014; 38 (9): 2352-2357.

-Seong YW, Kang CH, Chang H, Park IK, Kim YT. Fasciocutaneous Flap in Esophageal Stricture With Ventriculoperitoneal Shunt. The annals of thoracic surgery. 2014; 97 (1): 340-342.

-Banerjee JK, Bharathi RS. Minimally invasive substernal colonic transposition for corrosive strictures of the upper aerodigestive tract. Diseases of the Esophagus. 2017; 30 (4): 1–11.




DOI: https://doi.org/10.34119/bjhrv4n1-152

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