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Copyright of Médicas UIS is the property of Universidad Industrial de Santander and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Chemical substances are important causes of gastrointestinal tract injuries and usually affect two groups of patients: children under 5 years of age and adults who attempt suicide. Its effects can range from necrosis to perforation of the digestive tract, which can affect the mouth, pharynx, esophagus and stomach. The main complication of accidental caustic ingestion is esophageal stricture. The frequency with which esophageal strictures appear ranges from 15% to 35% and is related to the degree of injury induced by the ingested agent. They may become symptomatic by the second or third week after a latent repair phase or, in other cases, months or years after ingestion. Different forms of treatment have been applied to treat caustic esophageal strictures, and endoscopic dilation is the first line, with successful results in 60% to 80% of patients. If these are not effective, surgical treatment for esophageal replacement is indicated. Clinical Case: A clinical case of a 48-year-old male patient with no chronic degenerative history is presented, who began suffering after accidental ingestion of caustic substance 4 months ago with dysphagia to liquids and solids, for which he is protocolized in our unit for definitive surgical resolution by gastric pull-up. Conclusions: Although associated with high rates of anastomotic stricture, transhiatal esophagectomy and gastric pull-up with cervical anastomosis are safe procedures for the treatment of caustic esophageal strictures. [ABSTRACT FROM AUTHOR]

Aim: To describe the results of esophageal replacement surgery with an inverted gastric tube via retrosternal ascent in two pediatric hospitals during the period March 2015 to March 2018. Materials and Method: an observational, cross-sectional study with retrospective data collection that included all the records of patients with esophageal discontinuity due to acquired or congenital causes who underwent esophageal replacement surgery with an inverted gastric tube in two pediatric hospitals for 3 years. Results: We found 29 children undergoing esophageal replacement, of which 27 met inclusion criteria. The age between 2 to 17 years. 63% corresponds to the female sex. The most frequent cause of esophageal replacement is esophageal stricture due to caustic ingestion (92.59%). 70% presented some type of complication after surgery. The esophagocutaneous fistula is the main complication with 33.33%. The stay in the intensive care unit is less than 24 hours in 74% of children. The oral route is started in almost half of cases between 10-12 days after surgery; the hospital stay is on average 18.5 days. Mortality is 3.70%. Conclusion: The esophageal substitution by inverted gastric tube via retrosternal ascent is a technique comparable in results to the interposition of the colon. For the authors, the stomach is an ideal organ to perform esophageal reconstruction, and its complications are manageable. [ABSTRACT FROM AUTHOR]

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Knowledge about triamcinolone utility for esophagitis in children is limited. Objective: To compare the therapeutic treatment of the intralesional use of triamcinolone in pediatric patients with recurrent or refractory esophageal stenosis. Patients, materials and methods: Analysis of nine pediatric cases. Patients under 18 years of age with a diagnosis of recurrent or refractory esophageal stricture were included. Triamcinolone was applied through endoscopy in the four quadrants of the lesion every two to four weeks, in three sessions, and with six months of follow-up. Frequency of dilations was assessed before and after the administration of the drug. Statistical analysis: the Wilcoxon test was applied to compare the periodic rate of dilations. Results: Median age of four years were included. There was a statistical difference between the RPD before and after the triamcinolone (0.81 vs. zero, p < 0.05). Conclusions: Periodic dilation, along with the application of intralesional triamcinolone, was effective in pediatric patients with refractory/recurrent and complex esophageal strictures, with a maximum follow-up of six months. [ABSTRACT FROM AUTHOR]

The congenital esophageal stenosis is defined as an intrinsic stenosis of the esophagus caused by one of the three histologically groups: 1) tracheobronchial remnants, 2) fibromuscular thickening and 3) membranous webbing. The following anomalies can be associated in up to 17 to 33%: atresia esophageal, cardiac anomalies, intestinal atresia, cardiac anomalies, anorectal malformations and chromosomal anomalies. The main clinically significant symptoms, vomiting and disphagia, represent a challenge for the variety of diferential diagnostic like achalasia or peptic stricture recondary to reflux esophagitis. The surgical treatment consisted of resecting the stenotic segment and then performing a primary anastomosis whith the possibility of an antireflux procedure in those cases where the stenosis is close to the esophageal-gastric union. [ABSTRACT FROM AUTHOR]

Introduction: Restore the continuity of the digestive tract in caustic esophageal stenosis is a surgical challenge. Preserve the native esophagus trough the prolonged use of dilatation therapy can present complications such as esophageal disorders in feeding, dysphagia, jaw problems, joint and dental disease. The best substitute of esophagus is the colon, but it carries a high morbidity such as anastomotic leakage, fistula, necrosis, perforation, stenosis, redundancy of interposed colon, bleeding, gastrocolonic reflux and others. The esophageal myotomy have been described for the management of achalasia, but we found not reports if it's use in caustic esophageal stenosis. Case report: The case report a child with two esophageal caustic stenosis who not responded to the dilatation program therapy, a double myotomy was performed through right posterolateral thoracotomy with videoendoscopy esophagic transillumination to locate the two stenosis areas, during the procedure. The clinical and endoscopic follow up with adequate response. Discusión: Esophageal rescue by this procedure improves the quality of life and has no the morbidity of colonic transposition. The patient monitoring by endoscopic control could effort the diagnosis of esophageal cancer risk. We think that clinical, radiographic and endoscopic response was adequate so, need more cases to asses whether this may be part of a new therapeutic option. [ABSTRACT FROM AUTHOR]

The caustic ingestion in the pediatric population is a serious problem because produce a progressive and devastating injury to the esophagus and stomach. methods: Retrospective and descriptive study of 421 patients with age from 2 months to 14 years who ingested caustic between 1.992 to 2.008 evaluated at the hospital universitario de maracaibo. results: The 60.09 per cent were pre-school and 62.23 per cent were male. The substance type alkali was swallowed by 90.73 per cent of cases and the caustics were stored in its original packaging by 3.8% and decanted in 96.2 per cent of cases. Intake was accidental source in 99.53 per cent. All patients showed some symptoms as oropharyngeal lesions, vomiting and drooling. Endoscopy evaluation was performed by 89.31% of cases and revealed gastrointestinal tract injuries in 60.63%. Patients with grade 3 Esophagitis and esophageal stricture were admitted in the dilatation program with a good success in 35.91% of them. conclusions: The caustic ingestion is a common and serious problem, mostly from accidental origin, mainly affects children under 6 years and the alkali is the principal agent involved. The Esophagoscopy is the ideal mean for evaluate these patients. The esophageal dilatations are moderately successful. The best treatment is the prevention. [ABSTRACT FROM AUTHOR]