日本救急医学会雑誌
Online ISSN : 1883-3772
Print ISSN : 0915-924X
ISSN-L : 0915-924X
塩酸服用による重症腐蝕性上部消化管炎の1救命例
山口 浩司茶木 良猪股 英俊丹野 克俊佐々木 盛土田 芳彦浅井 康文
著者情報
キーワード: 腐蝕剤摂取, 塩酸, 早期手術
ジャーナル フリー

2000 年 11 巻 9 号 p. 456-461

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A 28-year-old man attempted suicide by drinking a glass of dilute solution of caustic hydrochloric acid and was admitted to the Sapporo Medical University Hospital 3 hours later. Laboratory examination on admission showed metabolic acidosis, BE -8.9mEq/l. Endoscopic examination showed corrosive changes indicating injury to the deep layer of the upper gastrointestinal tract. The patient underwent surgery for severe caustic ingestion injury of the esophagus, stomach and duodenum to prevent perforative complications. After 84 days, esophageal reconstruction using the right colon with the terminal ileum was conducted, with excellent results were obtained. He was transferred to another hospital without further complication. Diagnosis and surgical treatment of caustic ingestion injuries remain controversial. After severe caustic injuries, patient survival is closely related to the delay between ingestion and surgical treatment. Our experience indicated that the decision for early operative intervention played a basic role in preventing of perforative complications.
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