Risk Factors for Esophageal Stricture in Grade 2b and 3a Corrosive Esophageal Injuries

• Published in: Journal of gastrointestinal surgery 2018-10, Vol.22 (10), p.1659-1664
• Main Authors: Mahawongkajit, Prasit, Tomtitchong, Prakitpunthu, Boochangkool, Nuttorn, Limpavitayaporn, Palin, Kanlerd, Amonpon, Mingmalairak, Chatchai, Awsakulsutthi, Surajit, Havanond, Chittinad
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Body Height; Burns, Chemical - complications; Caustics - adverse effects; Child; Endoscopy, Gastrointestinal; Esophageal Stenosis - chemically induced; Esophageal Stenosis - diagnostic imaging; Esophagus; Esophagus - diagnostic imaging; Esophagus - injuries; Female; Gastroenterology; Gastrointestinal surgery; Humans; Injuries; Male; Medicine; Medicine & Public Health; Middle Aged; Omeprazole - therapeutic use; Original Article; Protective Factors; Proton Pump Inhibitors - therapeutic use; Retrospective Studies; Risk Factors; Severity of Illness Index; Surgery; Young Adult
• ISSN: 1091-255X; 1873-4626
• DOI: 10.1007/s11605-018-3822-x

Background and Purpose Publications document the risk of developing esophageal stricture as a sequential complication of esophageal injury grades 2b and 3a. Although there are studies describing the risk factors of post-corrosive stricture, there is limited literature on these factors. The aim of this study was to evaluate the different factors with post-corrosive esophageal stricture and non-stricture groups in endoscopic grades 2b and 3a of corrosive esophageal injuries. Methods Data were retrospectively analyzed in the patients with esophageal injury grades 2b and 3a between January 2011 and December 2017. Results One hundred ninety-six corrosive ingestion patients were admitted with 32 patients (15.8%) in grade 2b and 12 patients (6.1%) in grade 3a and stricture was developed in 19 patients (61.3%) with grade 2b and in 10 patients (83.3%) with grade 3a. The patients’ height of the non-stricture group was greater than that of stricture groups (2b stricture group, 1.58 ± 0.08 m; 2b non-stricture group, 1.66 ± 0.07 m; p <  0.004; 3a stricture group, 1.52 ± 0.09 m; 3a non-stricture group, 1.71 ± 0.02 m; p <  0.001). Omeprazole was more commonly used in the non-stricture than stricture group (26.3% in the 2b stricture group, 69.2% in the 2b non-stricture group, p =  0.017; 50% in the 3a stricture group, 100% in the 3a non-stricture group, 1.71 ± 0.02 m, p =  0.015). Conclusions The height of patients may help to predict the risks and the prescription of omeprazole may help to minimize the risks of 2b and 3a post-corrosive esophageal stricture.