Abstract
Background
Most of the patients with caustic injury can be successfully manage with conservative treatment. However, some patients with high severity required surgery. In this study, we assess failure rate, outcome and predictors of failure of conservative treatment in patients with acute caustic foregut injuries.
Methods
We retrospectively reviewed clinical records of patients with acute caustic foregut injuries who were hospitalized and treated at the Bhumibol Adulyadej Hospital from January2008 – December 2015. Analysis the data included the clinical factor, laboratory result, failure rate and outcome of management.
Results
Out of the 190 patients with caustic foregut injuries, 7.4%(14 patients) were failed to treat with conservative treatment and underwent to emergency surgery. 2 deaths were found in this study. Factors that associated with failure of conservative treatment were epigastrium tenderness (OR 22.2, 2.8–173.6 95% CI), Heart rate > 100 (OR 7, 2.2- 22.6 95% CI), WBC count > 10,000 (OR 4.9, 1.3–18.3 95% CI), Band form positive (OR 9.2, 2.6–32.7 95% CI), Blood PH < 7.2 (OR 16, 3.6–70.9 95% CI).
Conclusion
We consider epigastrium tenderness, Heart rate > 100 bpm, WBC count > 10,000 cell/ul, positive band form and blood pH < 7.2 to be the significant factor associating with failure of conservative management in patients with acute caustic foregut injuries. Intensive evaluation and early surgery should be considered in this group of patients.
Disclosure
All authors have declared no conflicts of interest.
Eosinophil Band Form Count
