Caustic injury: can CT grading system enable prediction of esophageal stricture?

Ryu, Hyun Ho; Jeung, Kyung Woon; Lee, Byung Kook; Uhm, Jun Hwan; Park, Young Hun; Shin, Min Ho; Kim, Hyun Lee; Heo, Tag; Min, Yong‐Ki

doi:10.3109/15563650903585929

Cited by 85 publications

(55 citation statements)

References 19 publications

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“…Computed tomography (CT) is an accurate and safe modality for the emergent assessment of the upper gastrointestinal tract [23,24]. However, few studies have assessed the role for CT after corrosive ingestion, and most of them focused on predicting late complications [25]. In 2006, we initiated a diagnostic study evaluating the ability of CT to detect full-thickness esophageal necrosis.…”

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confidence: 99%

Computed tomography evaluation of high-grade esophageal necrosis after corrosive ingestion to avoid unnecessary esophagectomy

et al. 2014

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Computed tomography evaluation of high-grade esophageal necrosis after corrosive ingestion to avoid unnecessary esophagectomy

et al. 2014

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“…However, endoscopy is not always feasible especially in developing countries where these events are common. The laboratory tests [6], computed tomography [7] and endoscopic ultrasound [8] were used for this purpose in different studies. White blood cell count (WBC), C-reactive protein (CRP), and arterial blood gas analysis are laboratory tests used in a few studies for prediction of degree of caustic injury and of late sequeles.…”

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confidence: 99%

Neutrophil to Lymphocyte Ratio as a Predictor of Endoscopic Damage in Caustic Injuries

Uyar¹,

Kök²

2017

J Clinic Toxicol

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Context: The endoscopic degree of injuries is the main finding for further management of caustic ingestions. However, if endoscopy cannot be performed quickly, clinicians decide on treatment and follow-up goals according to the signs and symptoms of the patient. The aim of this study was to determine the association of white blood cells (WBC), C-reactive protein (CRP) and neutrophil-lymphocyte ratio (NLR) with the degree of caustic injury and to evaluate whether NLR is able to predict the severity of injuries. Materials and methods:A retrospective evaluation was made of a total of 190 patients with a mean age of 38.6 years. WBC, neutrophil, lymphocyte and CRP values and endoscopic findings of all patients at hospital admission were retrieved from hospital files. The association between WBC, NLR, CRP and endoscopic findings was evaluated.Results: Endoscopy was normal in 28 of 119 patients (23.5%) and most patients (42 of 119 (35.3%) had only gastric involvement. NLR was significantly higher in patients with injuries than normal patients (p=0.010), whereas WBC and CRP not. NLR was also significantly higher in patients with both esophagus and gastric injuries compared to patients with no organ involvement (p<0.001). NLR, WBC and CRP were weakly correlated to the grade of involvement. In the ROC analysis, the AUC value was 0.914 (95% CI (0.85-0.96, p<0.001)) and the cut-off value for NLR was 8.71 with sensitivity of 90% and specificity of 91.7% for discriminating injuries as grade 0-1-2 from 3-4. Conclusions:Higher NLR values showed widespread and severe involvement of caustic ingestion. NLR also seems to be a more reliable method to make a distinction between severe and mild injuries. It is an easily derived and inexpensive marker of inflammation and might guide the management of patients before endoscopic evaluation in emergency departments.

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“…Injeksi ini dapat diberikan pada striktur yang kecil dan striktur yang berulang. 10 Ramage, dkk. 17 mengatakan bahwa hasil setelah follow up selama satu tahun pada pasien dengan striktur peptik berulang yang mereka teliti, didapatkan pasien dengan injeksi kortikosteroid lebih sedikit rekurensinya dibandingkan dengan dilatasi balon saja.…”

Section: Terapi Dengan Kortikosteroid Intralesiunclassified

“…, 10 Striktur simpel didefinisikan sebagai striktur yang bersifat fokal, simetris, dan memiliki diameter yang cukup untuk dilewati diameter normal dari endoskop (>12mm). Striktur simpel ini sering terjadi pada kasus injuri peptik (60-70% kasus) dan juga Schatzki's ring or web.…”

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Tata Laksana Endoskopik pada Striktur Esofagus

Hazim¹,

Abdullah²

2018

JPDI

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ABSTRAKPenatalaksanaan striktur esofagus memerlukan aspek medis yang komprehensif untuk pemenuhan kebutuhan nutrisi yang adekuat dengan terapi non bedah atau terapi bedah. Endoskopi memiliki peranan yang sangat penting pada striktur esofagus yaitu bermanfaat sebagai diagnostik dan terapi. Pilihan penatalaksaan striktur esofagus melalui bantuan endoskopi terdiri dari terapi dilatasi, pemberian kortikosteroid intralesi, pemakaian stents, dan pemandu untuk reseksi tumor. Pemilihan tindakan yang tepat sesuai dengan keadaan klinis pasien kasus per kasus merupakan hal yang penting untuk mencapai target perbaikan striktur pada esofagus, sehingga dapat membantu mengembalikan fungsinya sebagai saluran makanan dan perannya dalam proses menelan. Kata Kunci: Endoskopik, Striktur esofagus, Tata laksana ABSTRACT Management of esophageal stricture requires comprehensive medical aspect to fulfill adequate nutritional needs with non surgery or surgery therapy. Endoscopy has an important roles in diagnostic and

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Caustic injury: can CT grading system enable prediction of esophageal stricture?

Abstract: Assessment of the degree of esophageal damage using CT, a noninvasive modality, in patients who visit the emergency department following caustic ingestion should be useful in estimating the occurrence of complications including esophageal stricture.

Cited by 85 publications

References 19 publications

Computed tomography evaluation of high-grade esophageal necrosis after corrosive ingestion to avoid unnecessary esophagectomy

Computed tomography evaluation of high-grade esophageal necrosis after corrosive ingestion to avoid unnecessary esophagectomy

Neutrophil to Lymphocyte Ratio as a Predictor of Endoscopic Damage in Caustic Injuries

Tata Laksana Endoskopik pada Striktur Esofagus

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