Esophageal burn is an extremely common pathological condition in which esophageal tissues are damaged as a result of aggressive exposure to thermal, chemical or radiation factors. The clinical picture of this disease is quite specific. It includes pain spreading along the esophagus, swelling, vomiting attacks and much more. Often there is a violation of the general condition of a sick person. The prognosis for this pathology will be determined by the nature of the influencing factor, the severity of morphological changes in tissues, the timeliness of medical care provided, and many others. In the vast majority of cases, properly selected therapy avoids serious complications, as a result of which the functional activity of the esophagus is restored in full.
Esophageal burn is a serious condition that threatens the life of the affected person. Approximately seventy percent of all patients are children from one to ten years old with chemical damage to the walls of the esophagus. At the same time, in the vast majority of cases, the intake of chemicals does not occur intentionally, but through negligence due to non-compliance by adults with the rules for storing such substances. In adulthood, especially among the elderly, there are also cases of accidental use of alkalis or acids. However, in about forty-five percent of cases, these actions are suicidal in nature.
The prognosis for this pathological process will be directly determined by the degree of burn. We will talk about them in more detail below. In addition, it is worth noting that with thermal or chemical damage to the esophageal wall, scar structures often form. In the event that the correction of strictures was not performed in the required time, the probability of the formation of persistent scars is about seventy percent. Subsequently, such scars lead to esophageal stenosis and its obstruction.
Causes and degrees of esophageal burn
As we have already said, the most common cause of esophageal burns are chemicals used inadvertently or intentionally. To date, more than half of all cases are caused by the ingestion of concentrated acetic acid into the esophagus. Other types of acids, for example, sulfuric acid, alkalis, as well as many other substances can also have a damaging effect on the wall of the esophagus. Thermal and radiation burns of the esophagus are much less common.
Esophageal burn is characterized by initial damage to the surface epithelium under the influence of caustic substances. With further progression, deeper-lying tissues may also be involved in the pathological process. It is noteworthy that acids provoke more pronounced changes in the mucous membrane of the esophagus. Alkalis have a more adverse effect on the stomach, which is often affected after the esophagus. In severe cases, such a disease is accompanied by secondary bacterial infection with the appearance of purulent foci, rupture of the esophagus, damage to the mediastinal fiber and many other dangerous complications.
As we have already said, the prognosis for this pathological process will directly depend on the degree of burns. At the moment, there are three of them. In the first degree, only the superficial epithelium is affected. The second degree is established when the changes have already spread to the muscle layer. The third degree is the most unfavorable. The mortality rate in this group of patients is about sixty percent. It is characterized by damage to the entire wall of the esophagus, as well as surrounding tissues.
Symptoms of esophageal burn: pain, swelling and other
The primary symptom in this condition is extremely pronounced pain that spreads along the esophagus. In the event that the chemical has entered the stomach, the pain syndrome begins to be determined in the epigastric region. Often, with severe damage, there is an increase in edema, accompanied by a violation of swallowing. Subsequently, the clinical picture is often supplemented by vomiting. Bloody clots are present directly in the vomit.
With the third degree of burns, as a rule, there are pronounced breathing problems. In addition, such a pathological process is often accompanied by profuse bleeding. A violation of the general condition is mandatory: complaints of weakness and malaise, an increase in body temperature, nausea, and so on may be added. The more deeply located tissues were damaged, the worse the patient’s condition.
At first, because of the pain, a person refuses to eat or drink. Subsequently, the damaged tissues are replaced by granulation tissue, due to which the clinical manifestations gradually subside. However, after some time due to the formation of scar structures, problems with swallowing may occur again.
Diagnosis and treatment of esophageal burn
It is possible to diagnose a burn of the esophagus already on the basis of available data on the intake of a chemical substance in conjunction with concomitant complaints. Additional studies are conducted no earlier than three days later. These include radiography of the esophagus, as well as esophagogastroduodenoscopy.
First of all, when receiving a burn, it is necessary to rinse the oral cavity with a large amount of water. After the patient is admitted to the hospital, a gastric tube is installed for him, with the help of which inactivating substances are injected. Neutralization of acids is carried out using soda solution, and alkalis — dilute acetic acid. To prevent secondary infection, antibiotics are prescribed, detoxification and analgesic measures are carried out. After some time, it is necessary to carry out the buging of the esophagus to restore its patency.
Principles of prevention
The principles of prevention are reduced to storing chemicals only in special places away from medicines and food, the presence of markings on them, and so on.