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2.1
Esophageal Burn
Esophagus Burn

Presentation

When ulcerations start to occur, the bacteria, which is already present, starts infecting the wound and aggravating the process. [rawlsmd.com]

A 72-year-old woman presented with episodic melena of three weeks' duration associated with chest and epigastric discomfort. Both patients underwent initial and follow-up upper endoscopic studies along with multiple mucosal biopsies. [nejm.org]

Esophageal Injuries- Iatrogenic and others Presented By- Dr Sachin Katyal PG Student,Department of Gen.Surgery, M.K.C.G.MCH,Brahmapur 1 2. [slideshare.net]

Laryngopharyngeal reflux should be suspected in patients who present with any of these symptoms. [aafp.org]

Patients can also present with drooling, retrosternal or abdominal pain, nausea, vomiting, hematemesis, and odynophagia. If upper airway injury is present, patients may exhibit stridor, hoarseness, nasal flaring and retractions. [pedclerk.bsd.uchicago.edu]

Respiratoric

  • Non-Cardiac Chest Pain

    […] similar to the feeling of a heart attack, a.k.a. non-cardiac chest pain). [digestivedistress.com]

Gastrointestinal

  • Dysphagia

    Dysphagia and chest or back pain may occur in any esophageal disorder, the most serious of which is esophageal cancer. [merckmanuals.com]

    Often, a narrowing of the esophagus (esophageal stricture) leads to trouble swallowing or dysphagia. Bleeding. A person may vomit red blood or blood that looks like coffee grounds, or your stools may be black, tarry or bloody. [medicalnewstoday.com]

    This symptom is different from dysphagia (difficulty swallowing). Dysphagia too may be a "tight feeling" in the throat, but dysphagia is only elicited with swallowing food and is not a persistent feeling. Nor does stress make it worse. [digestivedistress.com]

    Gastroenterology consultation; endoscopy Consider surgery (Persistent daily and nightly regurgitation, odynophagia, dysphagia, poor response to drugs) Maximum dosage of PPI Possible surgery (same symptoms as severe or recalcitrant GERD) Maximum dosage [thedoctorwillseeyounow.com]

    Difficulty swallowing (dysphagia) You may feel pain or a burning sensation when you swallow, or your food may stick in your throat or chest. This is the most common symptom of oesophageal cancer. [cancerresearchuk.org]

  • Odynophagia

    As esophagitis worsens and becomes chronic, producing a narrowing of the esophagus, in addition to heartburn-like symptoms, such as a sour taste in the mouth or a feeling of pressure in the chest area, sufferers may feel pain when swallowing food (odynophagia [thedoctorwillseeyounow.com]

    […] abnormalities in the esophagus were indicative of reversible thermal injury.A 66-year-old man with a history of coronary artery disease presented to the emergency room for the second time in one month with retrosternal chest pain, mild dysphagia, and odynophagia [nejm.org]

    […] and upper GI series Chest x-ray Esophageal pH monitoring (measures acid in the esophagus) Esophageal manometry (measures pressure in the esophagus) Esophagogastroduodenoscopy (EGD) HIV testing Neck x-ray Throat culture Swallowing - pain or burning; Odynophagia [medlineplus.gov]

    Patients in both groups were also monitored through the outpatient clinic for complaints including abdominal pain, dysphagia, odynophagia, vomiting, or food impaction. [pediatrics.aappublications.org]

    Sometimes, when swallowing hurts, the condition is called odynophagia. This type of GERD is often referred to as silent reflux. [healthofchildren.com]

  • Hematemesis

    […] impaction Constipation Diarrhea Infectious Intestinal adhesions Rectum Proctitis Radiation proctitis Proctalgia fugax Rectal prolapse Anismus Anal canal Anal fissure / Anal fistula Anal abscess Hemorrhoid Anal dysplasia Pruritus ani GI bleeding / BIS Upper Hematemesis [en.wikipedia.org]

    Local complications: (1) bleeding: a few days after taking poison can occur a small amount of hematemesis, but a large number of bleeding caused by necrotic tissue shedding, often appear in 1 to 2 weeks, generally more than 10 days or so suddenly a large [healthfrom.com]

    Patients can also present with drooling, retrosternal or abdominal pain, nausea, vomiting, hematemesis, and odynophagia. If upper airway injury is present, patients may exhibit stridor, hoarseness, nasal flaring and retractions. [pedclerk.bsd.uchicago.edu]

  • Gagging

    This results in choking and gagging which may lead to aspiration of the caustic material and airway compromise. Acids cause tissue damage through coagulative necrosis that forms an eschar. [pedclerk.bsd.uchicago.edu]

    A third group of children report having trouble swallowing; they choke or gag whenever they eat, no matter what foods are served. [healthofchildren.com]

Cardiovascular

  • Chest Pain

    Pain in the chest should never be ignored. Heartburn may be mistaken for a heart attack and vice versa -- if in doubt, check it out. Know your risk factors for heart disease, and call for emergency help if chest pain is persistent. [livestrong.com]

    Moderate or severe chest pain that may worsen upon breathing or swallowing following an episode of retching or vomiting Fever Rapid, shallow breathing, difficulty breathing (dyspnea) Excessive sweating Subcutaneous emphysema Abdominal or back pain Difficulty [healthcommunities.com]

    The medical report, entitled "Esophageal Rupture After Ghost Pepper Ingestion," tells the tale of an unnamed man showing up at the ER with severe abdominal and chest pain following an episode of "violent retching and vomiting." [munchies.vice.com]

    Get immediate medical attention if you have any chest pain, pressure, or burning that doesn’t go away (even with medications and lifestyle changes). These can also be signs of a heart attack. [webmd.com]

    Reflux “Gastroesophageal reflux tops the list and is responsible for causing chest discomfort in upwards of 30% of patients complaining of chest pain at baseline. [scarysymptoms.com]

  • Retrosternal Chest Pain

    chest pain, mild dysphagia, and odynophagia. [nejm.org]

Workup

Diagnostic Workup and Initial Treatment It is important to gather as much information about the specific agent ingested as well as the time, nature of the exposure and duration of contact. [pedclerk.bsd.uchicago.edu]

Treatment

Treatment Treatment of esophageal chemical burn treatment Department of Surgery: Surgical thoracic surgery Treatment: rehabilitation treatment supportive treatment Treatment cycle: 2-4 weeks Cure rate: 70% (A) treatment Immediately terminate the exposure [healthfrom.com]

Then, we tried endoscopic steroid injection three months following the first treatment. Approximately 2mg of dexamethasone was injected into stenotic site in four directions. [jstage.jst.go.jp]

I also had a burned esophagus after just 15 radiation treatments for lung cancer. [inspire.com]

Treatment of cicatricial stenosis of the esophagus spend long bagirovym, which is the primary method of treatment of stenosis of the esophagus in children; when the failure resort to esophagoplasty - operation is the creation of artificial esophagus with [medicalency.com]

Among the treatment modalities to prevent stricture formation, esophageal dilation and stenting were most common. [academic.oup.com]

Prognosis

Prognosis for Esophageal Cancer Because symptoms often do not appear until esophageal cancer has advanced and has often spread to other organs, the prognosis for people with esophageal cancer is often poor. [everydayhealth.com]

What This Study Adds: High doses of methylprednisolone therapy lead to less frequent stricture formation in grade IIb esophageal burns in children who ingested caustic substances and may improve prognosis. [pediatrics.aappublications.org]

Prognosis The prognosis for people who get heartburn only occasionally or people without esophageal damage is excellent. [medical-dictionary.thefreedictionary.com]

Long-term Treatment and Prognosis Any patient with a Grade 2 burn or higher should be followed up with an upper GI (UGI) series 2-3 weeks after ingestion. [pedclerk.bsd.uchicago.edu]

This can be a very painful problem, but the prognosis is good. Doxycycline is notorious for causing burning of the food pipe called esophagitis. avoid foods which are hot, spicy. Also take Pepcid. Should resolve within a week to 10 days. [doctorbase.com]

Etiology

Etiology Etiology of esophageal chemical burns (A) the cause of the disease Esophageal chemical burns are clinically classified into acidic and alkaline corrosion, acidic chemicals, such as strong acid (sulfuric acid, nitric acid, hydrochloric acid, carbolic [healthfrom.com]

Studies 3 – 5 have shown that in 23 to 60 percent of patients presenting with globus sensation, GERD is the etiologic factor. [aafp.org]

[…] a thin tube is placed in the esophagus, through the mouth, to measure acid levels and the pH [5] Esophageal manometry ~ a procedure where a thin tube is placed in the esophagus, through the mouth or nose, to measure the pressure of the esophagus [5] Etiology [physio-pedia.com]

The etiology of esophageal cancer has not been fully studied. However, there are several factors, mostly due to lifestyle choices, that seem to play a role in disease pathogenesis. [news-medical.net]

Epidemiology

Current opinion in pediatrics 2009;21:651- Lakshmi CP, Vijayahari R, Kate V, et al: A hospital-based epidemiological study of corrosive alimentary injuries with particular reference to the Indian experience. [journals.sbmu.ac.ir]

Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review. El-Serag HB1,http://www.ncbi.nlm.nih.gov/pubmed/23853213?dopt=Abstract 8. Minerva Pediatr. 2012 Feb;64(1):101-19. [passeportsante.net]

Pathophysiology

DIFFERENCES IN GASTROINTESTINAL AND HEAD AND NECK SYMPTOMS The pathophysiology of GERD in patients with gastrointestinal symptoms differs from that in patients with head and neck symptoms. [aafp.org]

Moore W.P., Caustic ingestion: Pathophysiology, diagnosis, and treatment. Clin. Pediatr., 25 192-196 1986. 2. Kennedy A.P., et al, Colon patch esophagoplasty for caustic esophageal stricture. J. Pediatr. Surg., 30(8); 1242-1245,1995. 3. [ispub.com]

Pathophysiology and surgical implications. J Chir (Paris) 146(5): 499–502 Google Scholar de Lutio di Castelguidone E, Merola, Pinto A et al (2006) Esophageal in juries: spectrum of multidetector row CT findings. [link.springer.com]

Haller JA Jr, Andrews HG, White JJ, Tamer MA, Cleveland WW (1971) Pathophysiology and management of acute corrosive burns of the esophagus: results of treatment in 285 children. J Pediatr Surg 6: 578-584. [omicsonline.org]

Prevention

This splint was in place for three weeks and prevented stricture effectively. [academic.oup.com]

Prevention Prevention of esophageal chemical burns 1. Strict management, to prevent eating of strong acid, alkali and caused by esophageal injury. 2. [healthfrom.com]

First, sue, you should be using some sort of preventive agent, not one BEFORE rads but AFTER. [csn.cancer.org]

The role of corticosteroids in preventing corrosive-induced strictures is controversial. Our aim was to study the influence of high doses of corticosteroids in preventing esophageal strictures. [pediatrics.aappublications.org]

Normally, this regurgitation is prevented by the esophageal sphincter, a sort of one-way valve that allows food and drink to pass down the esophagus to the stomach while preventing gastric acid and other stomach contents from traveling in the opposite [thedoctorwillseeyounow.com]

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