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Tracheobronchial Necrosis After Caustic Ingestion.

Barak Benjamin1, Rafika Agueb, Helene Vuarnesson

  • 1Department of General, Endocrine and Digestive Surgery, Saint-Louis Hospital, APHP, Université Paris 7 Diderot, Paris, France.

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|March 17, 2015
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Summary

Tracheobronchial necrosis (TBN) following caustic ingestion is a severe complication with high mortality. Pulmonary patch repair offers a lifesaving intervention in these critical cases.

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Area of Science:

  • Medical research
  • Surgical outcomes
  • Gastroenterology

Background:

  • Caustic ingestion can lead to severe tracheobronchial necrosis (TBN).
  • Emergency pulmonary patch repair has shown life-saving potential in managing caustic TBN.

Purpose of the Study:

  • To describe the management and outcomes of tracheobronchial necrosis (TBN) after caustic ingestion.
  • To evaluate the effectiveness of pulmonary patch repair in patients with caustic TBN.

Main Methods:

  • Retrospective review of patients managed for caustic TBN between 1989 and 2013.
  • Comparison of outcomes between patients with and without TBN who underwent esophagectomy for caustic injuries.
  • Definition of early TBN (on admission) and late TBN (occurring after admission).

Main Results:

  • Twenty patients with caustic TBN were analyzed; 14 had early TBN and 7 had late TBN.
  • Pulmonary patch repair was performed in 80% of patients; 45% died, and morbidity was 100%.
  • Late TBN and acid ingestion were significant predictors of mortality; survival and functional success rates were significantly impaired.

Conclusions:

  • Tracheobronchial necrosis (TBN) is a devastating complication of caustic ingestion.
  • Pulmonary patch repair is a technically simple and potentially lifesaving procedure for caustic TBN.