RESUMO
BACKGROUND/PURPOSE: Caustic esophageal burn is a serious problem in pediatric surgery. Even though many clinical and experimental studies had been performed, the complication rate could not be reduced to a satisfying level. In this study, the authors evaluated the effects of hyperbaric oxygen (HBO) therapy in caustic esophageal burn in rats. METHODS: Rats were divided into 4 groups, and caustic burn at the distal esophagus was created by applying 50% NaOH for 3 minutes in all groups. The first and third groups did not receive HBO therapy. HBO therapy was applied to the second group for 2 days and to the fourth group for 28 days. To evaluate the effects of short-term HBO therapy, the first 2 groups were compared for ulceration, inflammation, and submucosal vascular thrombosis after 2 days. The third and fourth groups were compared for the long-term effects of HBO therapy. Rats in these groups were killed after 28 days and compared for the collagen content, weight, and mortality rate. RESULTS: In the second group, which received 2 days of HBO therapy, ulcer depth and vascular thrombosis were significantly lower than these in the first group (P =.022 and P =.020, respectively). The fourth group, which received 4 weeks of HBO therapy, had a significantly reduced mortality rate, weight loss, and collagen score and hydroxyproline level if compared with the third group (P =.035; P =.016; P =.028; and P =.033, respectively). CONCLUSIONS: These results indicate that HBO therapy is useful in caustic esophageal burn both in short-term and long-term use.
Assuntos
Queimaduras Químicas/terapia , Esofagite/terapia , Esôfago/lesões , Oxigenoterapia Hiperbárica , Animais , Colágeno/análise , Espasmo Esofágico Difuso/etiologia , Espasmo Esofágico Difuso/terapia , Esofagite/induzido quimicamente , Esôfago/patologia , Fibrose , Hidroxiprolina/análise , Ratos , Ratos Wistar , Hidróxido de Sódio/toxicidade , Trombose/etiologia , Trombose/terapia , Fatores de Tempo , Úlcera/etiologia , Úlcera/terapia , Redução de PesoRESUMO
Perdiem is a bulk laxative (mostly psyllium) formulated as granules; these granules can adhere together and cause esophageal impaction and gastric bezoars. I have reported three cases of esophageal impaction caused by Perdiem. Although endoscopic manipulation is the currently favored treatment, bougienage relieved these impactions easily. One patient also had a gastric bezoar. Doctors and patients need to be aware of this potential complication from Perdiem.