Esophageal emergencies

A state-of-the-art review of esophageal trauma: where do we stand?

The esophagus provides a diagnostic and therapeutic pathway not only for gastroenterologists but for surgeons, radiologists, cardiologists, and other specialists. Unfortunately, this procedural traffic occasionally leads to iatrogenic injury. As well, though reasonably well protected anatomically, frank esophageal injuries due to non-iatrogenic causes are not uncommon. We present a review of the literature on this subject covering anatomy, etiology, diagnostics, therapeutics, and management generally.

The effect of halofuginone, a specific inhibitor of collagen type 1 synthesis, in the prevention of esophageal strictures related to caustic injury

BACKGROUND

To assess the effects of halofuginone, a specific inhibitor of synthesis of collagen type 1, which is the major constituent of fibrosis, on esophageal stricture formation due to caustic ingestion.

METHODS

Sixty rats were divided into four equal groups: control group; sham laparotomy group; caustic injury without treatment group; caustic injury with halofuginone treatment group. Caustic injuries were done by 50% sodium hydroxide. Halofuginone was administered by the first postoperative day. All animals were sacrificed on day 21; and the results were evaluated by hydroxyproline levels, stenosis index, lumen diameter, histopathological evaluation, wall thickness, and animal weights.

RESULTS

Mortality differences were significant comparing group 3 with group 1 and 2 (P = 0.006) and group 4 (P = 0.03). According to hydroxyproline levels, the differences are significantly higher (P <0.001) comparing group 3 with group 1, 2, and 4. The P value was considered significant in all other parameters (P <0.001) for all the groups but group 1 versus group 2 (P >0.05).

CONCLUSIONS

Halofuginone, a specific inhibitor of collagen type 1 synthesis, significantly reduced esophageal stricture occurrence.