Corrozive treatment of esophageal burns, treatment effect of corticosteroids applied to the inside wall of the esophagus (Experimental study)

ABSTRACT ALKALINE TREATMENT OF ESOPHAGEAL BURNS, TREATMENT EFFECT OF CORTICOSTEROIDS APPLIED TO THE INSIDE WALL OF THE ESOPHAGUS (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 (NaClO). 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 (2 rat grup I -8 rats grup II-III-IV). 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 paranteral antibiotic and intramural dexamethason regiment, while the Group IV rats received paranteral antibiotic and intramural 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. As a result of steroid substances applied to the inside wall of the esophagus can reduce both collagen synthesis, structure formation and reduce inflammation prednisolone steroid substance muscularis mucosa compared with two progressing to the formation of new collagen synthesis, reducing the effect of narrowing dexamethasone significantly applied to the inside wall of the esophagus. Key words: Corrosive burns of the esophagus, Alkaline substance, Collagen, Prednisolon, Dexamethasone.