A CASE OF CORROSIVE ESOPHAGITIS DUE TO INTENTIONAL INGESTION OF STRONG ACID IN WHOM CONSERVATIVE TREATMENT ACHIEVED IMPROVEMENT

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  • 保存的治療により改善した酸性洗浄剤による腐食性食道炎の１例

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Abstract

A man in his twenties who was diagnosed as schizophrenic drank a few gulps of hydrochloric acid (toilet-bowl cleaner) and surface acting agent in a suicide attempt, then rushed to a nearby hospital. On admission, he vomited and showed hoarseness. An endoscopic examination revealed Grade IIb laryngitis, esophagitis and gastritis : circumferential erosions and liner ulcerations in these areas. He was transferred to the intensive care unit and got through the acute period with a conservative treatment. After improvement of his psychiatric manifestation and an enterostomy, he was referred to the Department of Surgery in our hospital. Fortunately, stenosis of the thoracic esophagus was mild and improved gradually, adequate nutrition was provided from the tube feeding and oral intake, and neither endoscopic dilatation nor surgery were required. The patient was discharged 153 days after the prolonged treatment of mental disorder. The enterostomy tube was removed at 122 days after the incident. The patient did not have any digestive symptoms at 15 months after the incident. Enterostomy is a minimally invasive surgery and is very useful in these patients with corrosive esophagitis/gastritis made in early period after ingestion.

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