Esophageal Replacement for Caustic Stricture-A

Digestive injury and complications resulting from caustic ingestion is the most challenging clinical situations encountered in gastroenterology. The commonest chemicals implicated in gastrointestinal caustic injury are alkaline and acid agents. The caustic ingestion is voluntarily and in suicidal intent in the most situations in adult .In fact, successful management of these patients requires multidisciplinary therapeutic approach including psychiatric support. Early diagnosis and adequate treatment are the keys of success particularly in severe injury which can lead to death resulted from complications [1,2]. Ct scan abdomino-thoracic has an important value to diagnose and precise the trans-mural character of the esophageal lesion thus reducing excessive esophageal excision and digestive complications. Stricture formation is inevitable in some cases and the first treatment of this stricture is the dilations. Every effort should be made to retain the native esophagus and reconstructive surgery is required for ineffectiveness, complications or lack of the dilations. The objective of surgery is to establish both digestive continuity and swallowing function. Establish the gut continuity needs the use of an abdominal digestive organ. The time of surgery for caustic stricture is still under controversy. However authors suggest that the most beneficial time for surgery is not less than 3 months for the esophagus and 6 months for the pharynx [3]. Despite the reduction in operative mortality, the morbidity rate is still high. The accuracy of the surgical technique and the experiences of surgeon are the most important factors that may impact outcome in esophageal reconstructive surgery.