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Author: search.filters.author.Vesna ChibishevaSubject: search.filters.subject.esophagogastroduodenoscopy

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    The Role of Urgent Esophagogastroduodenoscopy in Prognosis of Acute Caustic Poisonings
    (Academy of Medical Sciences of Bosnia and Herzegovina, 2011)
    Andon Chibishev
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    Vesna Chibisheva
    Introduction: Ingestion of corrosive substances causes severe lesions to the upper gastrointestinal tract. The aim of this paper was to present our clinical experience with the 4-grade endoscopic classification of post-corrosive injuries in prognosis of the outcome in acute caustic poisonings. Material and methods: This was a retrospective study comprising 33 patients with grade II B and III injury hospitalized at the University Clinic for Toxicology in Skopje, Republic of Macedonia in the period 2008-2009. The grade of injury was determined with urgent esophagogastroduodenoscopy performed in the first 12-24 hours. After treatment the patients were followed for a minimum of six months. Results: A total of 33 patients were analyzed. At the time of hospital admission post-corrosive injuries of grade III predominated (n=22, 66.67%) and post-corrosive injuries of grade II B (n=11, 33.33%). The most common late postcorrosive complications of the esophagus was stenosis esophagei (n=19, 57.58%). The most common post-corrosive damages of the stomach were: stenosis antropylori (n=10, 30.30%), stenosis pylori (n=6, 18.18%) and stenosis antri (n= 3, 9.09%). Conclusion: Urgent esophagogastroduodenoscopy has to be done in all acute caustic poisonings in the first 12-24 hours and they are to be classified according to Kikendall’s four-grade classification. The classification in four grades of post-corrosive injuries to the upper gastrointestinal tract might help in therapeutic approach and prognosis of the outcome
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    Corrosive poisonings in adults
    (ScopeMed Publishing, 2012)
    Andon Chibishev
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    Vesna Chibisheva
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    Ingestion of corrosive substances may cause severe to serious injuries of the upper gastrointestinal tract and the poisoning can even result in death. Acute corrosive intoxications pose a major problem in clinical toxicology since the most commonly affected population are the young with psychic disorders, suicidal intent and alcohol addiction. The golden standard for determination of the grade and extent of the lesion is esophagogastroduodenoscopy performed in the first 12-24 hours following corrosive ingestion. The most common late complications are esophageal stenosis, gastric stenosis of the antrum and pyloris, and rarely carcinoma of the upper gastrointestinal tract. Treatment of the acute corrosive intoxications include: neutralization of corrosive agents, antibiotics, anti-secretory therapy, nutritional support, collagen synthesis inhibitors, esophageal dilation and stent placement, and surgery.