Corrosive Stricture esophagus

Q) Which has no part in management of corrosive injury of esophagus?

a) Repeated Endoscopies routinely

b) Esophagectomy in some cases

c) Early emergency surgery routinely

d) Steroid use routinely

c

Other than the need for emergency surgery for bleeding or perforation, elective oesophageal resection should be deferred for at least 3 months until the fibrotic phase has been established.

Oesophageal replacement is usually required for very long or multiple strictures. Resection can be difficult because of perioesophageal inflammation in these patients.

Regular endoscopic examinations are the best way to assess stricture development (Figure 62.12). Significant stricture formation occurs in about 50% of patients with extensive mucosal damage

corrosives, can cause significant pharyngolaryngeal oedema

In unusual circumstances, e.g. with extensive necrosis after corrosive ingestion, emergency oesophagectomy may be necessary.

Bailey 27th page 1075

Pseudo achalasia

Q) Most common cause of  pseudo achalasia is ?

(a) Benign tumors of esophagus
(b) Chagas disease
(c) Caustic injury
(d) Adenocarcinoma of cardia

Answer free for all 

d

Pseudoachalasia is an achalasia-like disorder that is usually produced by adenocarcinoma of the cardia
Other uncommon causes are
 1.benign tumours at this level.
2, Tumors of bronchus, pancreas
Ref Bailey page 1097

Caustic Injury to esophagus

Q ) False regarding Caustic injury to Esophagus

a) Gastric lavage not done as it increases the chances of more injury

b) Neutralising  agents not given as it produces more injury than preventing it

c) Milk and albumin not given as it causes more damage

d) Activated charcoal not given as it doesn’t effectively absorb alkali

Check one more question on caustic injuries to esophagus here


Answer 

In  caustic injuries to the esophagus, early decisions have to be taken. The involvement of surgeon should be done early and patient should be placed under close monitoring.

Blind nasogastric and orogastric tubes should not be inserted and initially CT of chest and abdomen with contrast should be done to guide the subsequent procedures. Read on