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부식제에 의한 상부 소화관 손상에 대한 내시경적 연속추적검사에 관한 고찰
박충기(Choong Kee Park),김학양(Hak Yang Kim),신호균(Ho Kyun shin),정인구(In Goo Jung),전성국(Sung Gook Jun),유재영(Jae Young Yu) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.2
The ingestion of caustic agents can initiate a progressive and devastating injury to the esophagus and stomach. Since the introduction of concentrated alkaline cleansers in the 1960s, the incidence of seveve injury has increased. If the patient survives the acute effects of caustic ingestion, the reparative response can result in esophageal and gastric stenosis and an increased incidence of esophageal cancer. There are little reports in the case of the strong acid was ingested, and especially no reports about the periodic gastrofiberscopic examination. We have done the periodic gastrofiberscopic examination every a week for four times to whom ingested the caustic agents. The results obtained were as follows: 1) Male to female ratio was 7:6. The mean age was 33.6 years. (range: 18 to 59) 2) Amount of acid ingested was about 30 to 100 cc. 3) The motive of ingestion was accidental in 2 patients, suicidal attempt in 11 patients, and 4 patients of whom was major depression patients. 4) Patients with ulcer had more severe and many symptoms than patients with gastritis and esophagitis. 5) Of the 13 patients, stricture developed in 5 patients, esophageal stricture in 3 patients, and gastric antral stricture in 2 patients. 6) The esophageal injury was more severe than the gastric injury, probably that is due to ingestion of highly concentrated acid. 7) In 3 patients, serial fiberoptic gastroscopy demonstrated nodular regeneration at 2 weeks after ingesting caustics, esophageal or gastric antral stricture 3 or 4 weeks later. 8) In 5 patients with stricture, 4 patients required operation. Remaining patients without stricture were treated conservatively with antacid or H2 antagonist without subsequent complication.9) None of 13 patients expired. 10) 9 patients had followed-up from 3 months to 15 months after ingestion, 8 patients of whom were free of symptoms, only 1 patient persisted anorexia and dysphagia.