PDF(Pubmed)
Abstract：
Despite being one of the most debilitating conditions encountered in the field of toxicology, there is a lack of neutralization measures for the toxins involved in acute corrosive poisoning, and this promotes progressive contact injury of deep tissues after poisoning has occurred. Multiple controversies still surround management strategies during the acute phase of poisoning and the long-term follow-up of the patient. Here, we report a severe case of intentional poisoning with nitric acid complicated by extensive injury of the upper digestive tract, multiple stricture formation, and complete dysphagia. Serial endoscopic dilation and insertion of a jejunostomy feeding tube were necessary, and underlying psychiatric illness negatively affected the outcome of the patient. We conclude that an interdisciplinary approach is necessary to properly reduce the extent of lesions and sequelae induced by corrosion. Early endoscopic mapping of injuries is of major importance to better predict the evolution and possible complications of poisoning. Interventional and reconstructive surgical procedures may significantly improve the life expectancy and quality of life of patients following intoxication with corrosive substances.
摘要：
尽管是毒理学领域中遇到的最衰弱的条件之一，对急性腐蚀性中毒的毒素缺乏中和措施，这促进了中毒后深部组织的进行性接触损伤。在中毒的急性期和患者的长期随访期间，仍然存在许多争议。这里,我们报告了一例严重的硝酸故意中毒并发上消化道大面积损伤的病例，多重狭窄形成，和完全吞咽困难.连续的内窥镜扩张和空肠造口术饲管的插入是必要的，和潜在的精神疾病对患者的预后产生负面影响。我们得出的结论是，需要采用跨学科的方法来适当减少腐蚀引起的病变和后遗症的程度。损伤的早期内镜标测对于更好地预测中毒的演变和可能的并发症至关重要。介入和重建外科手术可以显着提高腐蚀性物质中毒后患者的预期寿命和生活质量。
