PRISE EN CHARGE DES INGESTIONS CAUSTIQUES: EXPERIENCE DU CHU HASSAN II DE FES MANAGEMENT OF CAUSTIC INGESTION: UNIVERSITYHOSPITAL HASSAN II EXPERIENCE

The ingestion of causticproductsconstitutes a frequent and serious emergency, whichinvolves the vital and functionalprognosis. The delaybetween ingestion and patient management is a major prognostic factor. Uppergastrointestinalendoscopyis the diagnostic elementused to determine the prognosis and guide therapeutic management. Patients and Methods: This isaretrospectivestudyinvolving 83 patients over a period of 9 years (2000-2009). All patients underwentuppergastrointestinalendoscopy in the acute phase. Results: Our studyincluded 83 patients. The averageageis 35 yearsold.Wenoted a femalepredominancewithsex ratio (M / F) at 0.8.The ingestion of causticproductwas for the purpose of autolysisin 87% of cases.The mostfrequentlyoccurringcausticwasdominated by hydrochloricacid, foundin 40% of cases.The initial digestive endoscopywasperformed in all patients with an averagedelay of 17 h (6h -7d). Wenotedthatat the esophagus, 23.6% of patients had a stage III lesion. In the stomach, the lesionswere more severe, 27.7% of patients had a stage III lesion. Early control (48h -1 week) wasperformedin 23 patients (27.7%) objectifying in the majority of cases a clearimprovement (In 17 cases). Thirteen patients (15.6%) wereoperated on in the acute phase. the lateendoscopic control (21 days) wascarried out in 14 patients (16.8%) objectifyingstenosis in seven patients, including four in the esophagus. In ourseries, 12 patients died (14.4%) including six aftersurgery. Conclusion: The ingestion of causticproductsis a diagnostic and therapeutic emergency requiringmultidisciplinary PEC. Endoscopyis the key examination to guide management.The risk in the acute phase isrelated to the occurrence of shock or surgical complications thatmayindicate urgent surgery. Causticstrictures come secondary must be as soon as possible for possible PEC.In ourseries 15.6% of patients wereoperated on in the acute phase, causticstenosisoccurredin 8.4% of cases and 14.4% of deaths.