Management of corrosive injuries of the esophagus

During a 5-year period from 1993 to 1998, 22 cases of caustic esophageal injuries were referred to our clinic, caused by acid consumption as suicidal intentions or as an accident. Four out of 10 cases where acute exploration was performed the corrosion was so extended that no further intervention could be done, and all of them died within 24 hours. In the remaining 6 cases acute esophagogastrectomy, or total gastrectomy with esophageal exclusion was performed. Three out of 6 patients survived primary surgery, who later underwent esophageal reconstruction with a colon substitute. In 12 patients no indication for acute surgery arose, but later during the follow-up in 5 of them dysphagia and corrosive stricture developed. All underwent successful esophageal reconstruction with colon substitute. Case reports, acute management, indications for surgery and prognostic factors are also discussed.