摄入腐蚀性物质造成的胃肠道粘膜损伤:盐酸和氢氧化钠案例研究

Narra J Pub Date : 2023-12-25 DOI:10.52225/narra.v3i3.259
F. Yusuf, A. Abubakar, Desi Maghfirah, Mirza Heltomi, C. C. Isitua
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引用次数: 0

摘要

儿童摄入腐蚀性物质最为常见,而成人摄入腐蚀性物质则会造成更严重的伤害。如果处理不当,大量摄入腐蚀性物质会对胃肠道和口咽造成严重损害。pH值为12的腐蚀性物质可导致严重的食道损伤,出现胶凝性(碱性)或凝固性(酸性)坏死,同时各种胃肠道损伤可导致腐蚀后的晚期并发症。本病例研究旨在报告盐酸(HCl)和氢氧化钠(NaOH)摄入导致的胃肠道粘膜损伤。一名 55 岁的男性患者在入院前一小时以呕吐为主诉到急诊室就诊。持续呕吐,每次呕吐物量约为 10-20 毫升。呕吐物最初呈淡蓝色,随着时间的推移变成黑褐色。其他主诉还包括恶心、呼吸急促、胃灼热、口腔和喉咙灼痛,并伴有乏力和头晕。患者不小心喝了含有盐酸的地板清洁液。患者被诊断为因盐酸引起食管、胃和十二指肠粘膜溃疡而吐血。该患者后来出现气管食管瘘,这是一种长期并发症。另一名 22 岁的男性患者在入院前一小时因主诉恶心和呕吐被送入急诊室。同时还伴有头痛和轻微的紧绷感。患者口腔感觉太阳穴灼痛,唾液呈泡沫状。一小时前,患者因经济问题喝下两瓶地板清洁液试图自杀。患者被诊断为 NaOH 引起的食管胃十二指肠黏膜糜烂。这些病例突出表明,腐蚀性物质中毒可并发胃肠道黏膜损伤,损伤特征取决于物质浓度和腐蚀性物质的数量。
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Gastrointestinal mucosal damages caused by ingestion of corrosive substances: A case study of hydrochloric acid and sodium hydroxide
Ingestion of corrosive substances is most common in children, while in adults causes more severe damages. Massive ingestion of corrosive substances results in severe damage to the gastrointestinal tract and oropharynx if not treated properly. Corrosive substances with pH<2 or >12 can result in severe esophageal damage with either colliquative (alkaline) or coagulative (acidic) necrosis and, at the same time various gastrointestinal injuries could lead to late post-corrosive complications. The aim of the case study was to report the gastrointestinal mucosal damages due to hydrochloric acid (HCl) and sodium hydroxide (NaOH) ingestion. A 55-year-old male patient was presented to the emergency room with a chief complaint of vomiting an hour before admission. Continuous vomiting with a volume of approximately 10–20 cc per vomit. The vomit was initially bluish and turned in to blackish brown over time. Other complaints included nausea, rapid breathing, heartburn, and burning mouth and throat, and had weakness and dizziness. The patient accidentally drank floor cleaning liquid containing HCl. The patient was diagnosed with hematemesis due to ulceration of esophageal, gastric, and duodenal mucosa induced by HCl. Tracheoesophageal fistula developed later in the patient as a long-term complication. Another a 22-year-old male patient was presented to the emergency room with chief complaints of nausea and vomiting an hour before admission. Headache and slight tightness were also experienced. The patient mouth felt burned pain in the solar plexus and frothy saliva. An hour earlier, the patient attempted suicide by drinking two bottles of floor cleaning liquid due to economic problems. The patient was diagnosed with erosive mucosal esophagogastroduodenum induced by NaOH. These cases highlight that intoxication with corrosive substances can complicate damage to the gastrointestinal mucosal and damage features depend on the type of substance concentration and quantity of the corrosive substance.
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