Mustafa KAPLAN, Bülent ÖDEMİŞ, Selçuk DİŞİBEYAZ, Erkan PARLAK, Volkan GÖKBULUT, Adem AKSOY, Orhan COŞKUN, Muhammet AKPINAR

Kostik madde içimi sonrası gastrointestinal darlık gelişen hastalarda endoskopi tecrübemiz

Giriş ve Amaç: Bu çalışmada gastrointestinal kostik yaralanma sonrası endoskopik tedavi uygulanan hastaların etiyolojik nedenlerini, darlık yerlerini ve uygulanan tedavileri araştırdık. Gereç ve Yöntem: Bu çalışma 2005-2015 yılları arasında kostik hasara bağlı darlık nedeniyle endoskopik olarak tedavi edilen 41 hasta ile retrospektif olarak yapılmıştır. Hastaların demografik özellikleri, ameliyat bilgileri, ne içtikleri ve darlık yerleri dosyalarından kaydedilmiştir. Bulgular: Bu çalışma 41 hasta ile yapılmıştır. Hastaların ortalama yaşı 32±9.2 idi. Hastaların 25’i erkek (%61), 16’sı ise kadındı (%39). Hastaların median işlem sayısı 9 olup, işlem sayısı 1 ile 32 arasında değişmekteydi. Kostik hasarın en sık sebebi ozon suyu (%19), yağ çözücü (%15) ve kireç çözücü (%15) idi. Endoskopik incelemede darlıklar en sık orta özofagusta (%41) görülmekle birlikte daha az sıklıkla proksimal özofagus (%19), distal özofagus (%19), anastomoz (%10) ve tüm özofagusta (%7) görülmekteydi. 6 hastanın darlıklar nedeniyle opere edildiği görüldü (%15). Hastalara yapılan terapötik işlemler incelendiğinde en sık buji ve balon dilatasyonu uygulandığı görüldü. İki hastaya lokal steroid enjeksiyonu ve iki hastaya da stent takıldığı görüldü. Sonuç: Kostik madde içimine bağlı özofagus darlığı en sık olarak temizlik maddelerinin içimine bağlı olarak gelişmekte, en sık özofagus orta kısmını tutmakta ve tedavide en sık balon ve buji dilatasyon tedavisi kullanılmaktadır.

Anahtar Kelimeler:

Özofagus darlıkları, Savary-Gilliard dilatasyonu, balon dilatasyonu

Experience of endoscopy in patients with gastrointestinal stenosis after caustic ingestion

Background and Aims: This study investigated the etiologic causes, stenosis locations, and endoscopic treatment options of caustic gastrointestinal injury. Material and Methods: This study was performed retrospectively, with 41 patients who were treated endoscopically for stenosis caused by caustic damage between 2005 and 2015. Data such as patients’ demographic characteristics, surgical information, ingested material, and stenosis locations were obtained from their medical records. Results: This study comprised 41 patients. The mean age of patients was 32±9.2 years. Of these, 25 patients were males (61%), and 16 were females (39%). The median number of endoscopy procedures was 9 and ranged from 1 to 32. The most common cause of caustic damage was ozone water (19%), degreasers (15%), and descaling agents (15%). Endoscopic examination revealed stenosis in the middle esophagus (41%), but less frequently in the proximal esophagus (19%), distal esophagus (19%), anastomosis (10%), and the entire esophagus (7%). Six patients were operated for strictures (15%). Savary-Gilliard and balloon dilatation were the most frequently applied treatments. Two patients had local steroid injections, and two had stents. Conclusion: Esophageal stenosis because of caustic ingestion develops most frequently by ingesting cleaning agents and most commonly involves the middle part of the esophagus, with the most commonly used treatment options being balloon and Savary-Gilliard dilatation.

Keywords:

Esophageal stenoses, Savary-Gilliard dilatation, balloon dilatation,

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