Anti-inflammatory agents? effect in esophageal alkali burn (Experimental study)

Corrosive burns of the esophagus results from the ingestion of a strong acid such as sulphuric acid and hydrochloric acid, or most commonly (75-90%) a strong alkali such as potassium hydroxyde (KOH), sodium hydroxyde (NaOH) and sodium hypochlorite. There are some reports demonstrating that the stricture ratio exceeds 50% in the case of a severe burn. The identification of the chemical material is the first and the most important step in the management of the corrosive burns of the esophagus. One should pay attention to maintain the airway open. The treatment modalities concerning of the antibiotics and steroids, which are the main options used nowadays, are based on the previous animal researches. In this experimental animal study of rats, we aimed to investigate the effects of the anti-inflammatory agents in esophageal alkali burns.Twenty-eigth Wistar albino rats, weighing from 220 to 250 gr, were used in the study. Following a starving period of 12 hours, a corrosive burn just like the corrosive esophagitis as described by Gehanno et al. was obtained under general anesthesia. Thereafter, the rats were divided into four groups (7 rats for each). The intraluminal area of 1 cm in the esophagus of the rats of the first group was washed using serum physiologic (1 ml). Group II rats received parenteral antibiotic treatment. Group III rats received antibiotic and dexamethason regiment, while the Group IV rats received antibiotic and prednisolone regiment as therapy. Each animal was sacrified on the 21th day, and their abdominal esophagus were resected for histopathological investigation.The submucosal increase in the collagen, the damage to the muscularis mucosa and the damage to the tunica muscularis were three parameters demosntrating the injury histopathologically. There was no injury in the Group I. There was injury in each parameter in the Group II, III, and IV compared with Group I. In the comparison between Group II and III, there was less injury in the Group III. In comparison with Group II there was also significant injury in the muscularis mucosa and the tunica muscularis in the Group IV.Prednisolon may decrease the new collagen synthesis that progresses up to muscularis mucosa, but the effect on the lowering the stricture formation is not better than dexamethasone.Key words: Corrosive burns of the esophagus, Collagen, Prednisolon, Dexamethasone.