ABSTRACT
Se denominan agentes cáusticos aquellas sustancias que producen quemadura en el tejido con el cual se ponen en contacto. La frecuencia de lesiones por estas sustancias a nivel mundial aun no ha sido determinada, sin embargo estadísticas de países como Estados Unidos reportan 26.000 mil casos anuales, constituyéndose en un problema de salud publica por sus múltiples complicaciones, y ser asiento de lesiones que pudieran tornarse cancerígenas. Con el propósito de determinar la frecuencia y complicaciones de estas lesiones por ingestión de cáusticos en nuestro medio, se realizó en el Servicio de Gastroenterología del Hospital "Dr. Carlos Arvelo", un estudio retrospectivo longitudinal, que incluyó la revisión de historias de pacientes con diagnóstico de esofagitis cáusticas en el lapso comprendido entre los años 2005 al 2007, utilizando la clasificación de Zargar. En este estudio se reportaron 13 casos, clasificados 7 como esofagitis grado 3, 1 grado 2, y 5 grado 1. De las cuales las grado 2 y 3 se sometieron a dilataciones esofágicas con dilatadores de Savary y dilatadores de Balón.
Caustic agents are those substances capable of burning the tissue with which they come into contact. The frequency of worldwide caustic injuries has not been determined, nevertheless statistics of countries like The United States report 26.000 annual cases, thus becoming a public health problem due to their multiple complications, including esophageal cancer in the long term. With the intention of determining the frequency and complications of these injuries, a retrospective longitudinal study was done at the gastroenterology service , Hospital "Dr. Carlos Arvelo", We reviewed all the files of patients with diagnosis of caustic esophagitis, between the years 2005 and 2007, using ZargarÊs classification. In this study 13 cases were reported, 7 were classified as grade 3, 1 with grade 2, and 5 with grade 1 esophagitis. Patients with grade 2 and 3 esophagitis underwent esophagial dilations with Savary and balloon dilators.
ABSTRACT
BACKGROUND AND OBJECTIVES: The bilateral choanal atresia is a medical emergency for which surgery is the only and definite treatment. We performed an atretic bone perforation using Hagers dilators. The purpose of this study, then, is to evaluate the efficacy of this simple technique of perforation, dilation and stenting. MATERIAL AND METHODS: We studied five patients who underwent surgery for a complete bilateral bony atresia from 1994 to 2004. All the patients were newborn: two males and three females babies. The male female ratio was 1 : 1.5. Their age varied from 1 day to 4 days. The surgery was performed with Hagers dilators using the puncture and dilation technique. Stenting was carried out in all cases using a non cuffed endotracheal tube. RESULTS: The reestablishment of the nasal passage through a perforating atretic plate was considered a successful criteria of surgery. All the neonates had good nasal air passage after the perforation, dilation and stenting. Two of the patients who were with the CHARGE association died within 7 days due to causes unrelated to surgery. The other three patients had successful removal of stent after six weeks. There was no follow-up afterwards. CONCLUSION: The puncture, dilation and stenting technique by Hagers dilator is safe, quick and simple. It involves minimum blood loss and is without any complications. Stenting, therefore, is essential for preventing restenosis.