AN UPDATE ON CAUSTIC GASTROINTESTINAL INJURY WITH MINIMALLY INVASIVE TREATMENT OPTIONS
Abstract
Author(s): David M. Schwartzberg, Sathyaprasad C. Burjonrappa, Paresh C. Shah.
Caustic injury of the gastrointestinal tract (GI) has remained a costly and devastating problem to the bi-modal population affected, however it has seen encouraging evolutions in its care. Caustic i njury is defined as an ingested acid or base that results in a wide range of pathology in the upper GI tract, mainly the upper airway, esophagus and stomach. To yield an update on caustic injuries with succinct recent innovations in care, previously published articles, with an emphasis on more recent articles were searched for using Pubmed and MEDLINE. Major advancements in technology have improved the treatment of the acute phase of injury leading to a more uniform methodology in diagnosis, less morbid acute temporizing measures and improved staging of acute injury with the help of advancements in computed tomography and endoscopic interventions. With the advancement of endoscopy and laparoscopy, acute treatment and chronic complications of caustic injury have been reassuringly improved. Endoscopy and laparoscopy have also aided in therapeutic advancements with the implementation of endoscopic dilation of strictures and minimally invasive techniques for gastro esophageal bypasses and resections. Emerging are biochemical platforms such as bioscaffolds to promote esophageal healing and topical anti-cytotoxic agents to treat esophageal strictures. Treating caustic injury has seen recent advancements with the aid of minimally invasive diagnostic and therapeutic modalities to help in the acute and chronic phases of care as improvements in clinical outcomes with novel biocellular techniques emerging. Key Words: Gastrointestinal tract, cytotoxic agents, Endoscopy and laparoscopy
