Corrosive Stricture of both the Hypopharynx and the Esophagus after Swallowing Strong Hydroxide: Report of Two Cases Treated Surgically

Naoki Mori, Hiromasa Fujita, Susumu Sueyoshi, Toshiaki Tanaka, Yuichi Tanaka, Hiroko Sasahara, Satoru Matono, Mie Lee, Hideaki Yamana and Kazuo Shirouzu

Department of Surgery, Kurume University School of Medicine

We report two patients who underwent surgical treatment for corrosive stricture of both the hypopharynx and the esophagus. Case 1 was a 47-year-old man with schizophrenia who had drunk 10% KOH-a commonly available cleaning agent. He underwent cervical and mediastininal drainage due to esophageal perforation. On the 209^th day after swallowing the hydroxide, he underwent resection of the hypopharynx, larynx, and cervical esophagus followed by an esophageal bypass using the colon. The postoperative course was uneventful. He was able to take solid food and was discharged on the 95^th day after the operation. Case 2 was a 58-year-old woman with depression who had attempted suicide with KOH and NaOH cleaning fluid. We performed an esophageal bypass using the colon without laryngectomy on the 323^rd day after swallowing the hydroxide. Postoperatively, she could not take food orally due to repeated aspiration. We therefore performed laryngeal pull-up on the 181^st postoperative day. Aspiration was still not improved, so she underwent laryngectomy on the 219^th day after the 1^st operation. Finally, she could take solid food, and was discharged. In choosing the operative procedure to treat corrosive stricture of the hypopharynx and the esophagus, especially whether or not to preserve the larynx, required considerations include the extent of the hypopharyngeal injury, the will and consent of the patient and family, and the patient's background including who takes care of the patient, because such patients frequently have some mental illness.

Key words
esophageal bypass surgery, corrosive injury, stricture of the hypopharynx and the esophagus

Reprint requests
Naoki Mori Department of Surgery, Kurume University School of Medicine
67 Asahi-machi, Kurume, 830-0011 JAPAN

Accepted
April 27, 2005

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