Endoscopic ultrasonography in diagnosis of chemical esophageal burn and prediction of cicatricial stenosis

Makarov AV, Petrikov SS, Zhirkova EA, et al. . Endoscopic ultrasonography in diagnosis of chemical esophageal burn and prediction of cicatricial stenosis. Pirogov Russian Journal of Surgery. 2024;(11):30‑37. (In Russ., In Engl.)
https://doi.org/10.17116/hirurgia202411130

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)

Использование инфографики авторами научных работ

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OBJECTIVE

To analyze the role of endoscopic ultrasonography (EUS) in predicting the risk of cicatricial stenosis after chemical esophageal burn.

MATERIAL AND METHODS

A retrospective study included 56 patients with chemical esophageal burn grade III/IV. Primary endoscopy was performed upon admission. To estimate lesion of muscular layer of esophageal wall, we performed EUS using mini-sensor 20 MHz in 3—5 days after injury. To assess severity of chemical esophageal burn, we used the classification proposed by Volkov S.V. (1997) and supplemented by Pesnya-Prasolova E.A. (2006): grade I — catarrhal damage, grade II — erosive, grade III — ulcerative, grade IV — ulcerative-necrotic damage.

RESULTS

To predict the risk of cicatricial esophageal stenosis, we identified 4 grades (a, b, c, d) of damage to muscular layer of esophageal wall considering EUS data. There was no esophageal stenosis in chemical esophageal burn grade III/IVa and acetic essence poisoning with esophageal burn grade IVb. Cicatricial stenosis occurred in 22 (78.6%) out of 28 patients with chemical esophageal burn grade IV (chemical burn grade IVb following alkalis poisoning and in all patients with chemical burn grade IVc/IVd). The risk of cicatricial stenosis was 9.4 times higher after alkalis burn compared to acetic acid burn.

CONCLUSION

EUS in chemical esophageal burn grade IV made it possible to identify additional grades (a, b, c, d) of damage to muscular layer of esophageal wall. This increased the effectiveness of endoscopic diagnostics and assessment of the risk of cicatricial esophageal stenosis.

Keywords:

chemical esophageal burn

poisoning with corrosive substances

esophagogastroduodenoscopy

endoscopic ultrasonography

cicatricial esophageal stenosis

Authors:

Makarov A.V.

Sklifosovsky Research Institute for Emergency Care

ORCID: 0000-0001-7388-7077

Petrikov S.S.

Sklifosovsky Research Institute for Emergency Care

ORCID: 0000-0003-3292-8789

Zhirkova E.A.

Sklifosovsky Research Institute for Emergency Care

ORCID: 0000-0002-9862-0229

Teterin Yu.S.

Sklifosovsky Research Institute for Emergency Care

SPIN RSCI: 8888-5490
Scopus AuthorID: 57194386231
ORCID: 0000-0003-2222-3152

Yartsev P.A.

Sklifosovsky Research Institute for Emergency Care

SPIN RSCI: 4044-9661
Scopus AuthorID: 55970485700
ResearcherID: P-9151-2017
ORCID: 0000-0003-1270-5414

Tatarinova E.V.

Sklifosovsky Research Institute for Emergency Care

ORCID: 0000-0001-5287-850X

Mironov A.V.

Sklifosovsky Research Institute for Emergency Care

ORCID: 0000-0002-6997-3420

Potskhveriya M.M.

Sklifosovsky Research Institute for Emergency Care

ORCID: 0000-0003-0117-8663

Received:

19.06.2024

Accepted:

10.07.2024

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