Short-term and long-term management of caustic-induced gastrointestinal injury: An evidence-based practice guidelines.

IF 2 Q3 GASTROENTEROLOGY & HEPATOLOGY
Anupam Kumar Singh, Deepak Gunjan, Nihar Ranjan Dash, Ujjal Poddar, Pankaj Gupta, Ajay Kumar Jain, Deepak Lahoti, Jamshed Nayer, Mahesh Goenka, Mathew Philip, Rakesh Chadda, Rajneesh Kumar Singh, Sreekanth Appasani, Showkat Ali Zargar, Sohan Lal Broor, Sandeep Nijhawan, Siddharth Shukla, Vikas Gupta, Vikram Kate, Govind Makharia, Rakesh Kochhar
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引用次数: 0

Abstract

The Indian Society of Gastroenterology has developed an evidence-based practice guideline for the management of caustic ingestion-related gastrointestinal (GI) injuries. A modified Delphi process was used to arrive at this consensus containing 41 statements. These statements were generated after two rounds of electronic voting, one round of physical meeting, and extensive review of the available literature. The exact prevalence of caustic injury and ingestion in developing countries is not known, though it appears to be of significant magnitude to pose a public health problem. The extent and severity of this preventable injury to the GI tract determine the short and long-term outcomes. Esophagogastroduodenoscopy is the preferred initial approach for the evaluation of injury and contrast-enhanced computed tomography is reserved only for specific situations. Low-grade injuries (Zargar grade ≤ 2a) have shown better outcomes with early oral feeding and discharge from hospital. However, patients with high-grade injury (Zargar grade ≥ 2b) require hospitalization as they are at a higher risk for both short and long-term complications, including luminal narrowing. These strictures can be managed endoscopically or surgically depending on the anatomy and extent of stricture, expertise available and patients' preferences. Nutritional support all along is crucial for all these patients until nutritional autonomy is established.

烧碱性胃肠道损伤的短期和长期管理:循证实践指南。
印度胃肠病学会已经制定了一个以证据为基础的实践指南,用于管理腐蚀性摄入相关的胃肠道(GI)损伤。一个修改的德尔菲过程是用来达到这一共识包含41个语句。这些声明是经过两轮电子投票、一轮实体会议和对现有文献的广泛审查后产生的。在发展中国家,烧损和误食的确切流行率尚不清楚,但似乎严重到足以构成公共卫生问题。这种可预防的胃肠道损伤的程度和严重程度决定了短期和长期的结果。食管胃十二指肠镜检查是评估损伤的首选初始方法,而增强计算机断层扫描仅用于特定情况。轻度损伤(Zargar分级≤2a)在早期口服喂养和出院后表现出更好的预后。然而,高度损伤(Zargar分级≥2b)的患者需要住院治疗,因为他们出现短期和长期并发症(包括管腔狭窄)的风险更高。这些狭窄可以通过内窥镜或手术治疗,这取决于解剖结构和狭窄程度、可用的专业知识和患者的偏好。营养支持一直对所有这些患者至关重要,直到建立营养自主。
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来源期刊
Indian Journal of Gastroenterology
Indian Journal of Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
3.90
自引率
10.00%
发文量
73
期刊介绍: The Indian Journal of Gastroenterology aims to help doctors everywhere practise better medicine and to influence the debate on gastroenterology. To achieve these aims, we publish original scientific studies, state-of -the-art special articles, reports and papers commenting on the clinical, scientific and public health factors affecting aspects of gastroenterology. We shall be delighted to receive articles for publication in all of these categories and letters commenting on the contents of the Journal or on issues of interest to our readers.
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