Surgical management and outcomes of corrosive esophageal injuries: a prospective study from Sana'a, Yemen.

BACKGROUND

Corrosive esophageal injuries pose a significant health burden in resource-limited settings like Yemen. This study evaluated the demographic patterns, clinical presentations, management strategies, and outcomes of patients with corrosive esophageal injuries at a tertiary hospital in Sana’a, Yemen.

METHODS

This prospective single-center study at Al-Thawra Modern General Hospital, Sana’a, Yemen (January 2021–June 2024) enrolled 22 patients with corrosive esophageal injuries. Data on demographics, corrosive agents, clinical features, endoscopic findings, management, and outcomes were analyzed using chi-square tests and ANOVA (p < 0.05).

RESULTS

The mean patient age was 24.7 ± 17.0 years, with 40.9% (n = 9) under 20 years. Accidental ingestion, primarily acidic agents (68.2%, n = 15), accounted for 90.9% (n = 20) of the cases. Dysphagia was the most common symptom (90.9%, n = 20). Endoscopy revealed Grade 2B injuries in 59.1% (n = 13), using the endoscope unable to pass in 13.6% (n = 3). Strictures developed in 36.4% (n = 8) of patients. Endoscopic dilation (ED) was attempted in 77.3% (n = 17), achieving durable symptomatic improvement in 58.8% (n = 10/17). Surgical interventions, including colonic conduit (n = 6) and gastric pull-up (n = 2), were performed in 36.4% (n = 8). Complications occurred in 45.5% (n = 10), and mortality was 13.6% (n = 3), significantly associated with suicidal ingestion (p = 0.001).

CONCLUSION

Corrosive esophageal injuries in Yemen, mostly accidental, affect younger patients and result in high morbidity (45.5%). ED is effective for single strictures, but severe cases often require surgery. Gastric pull-up appeared to have lower complications than colonic conduit in this small cohort, although larger studies are needed to confirm this trend. The elevated mortality rate among suicidal cases highlights the need for mental health support. The small sample size (n = 22) and single-center design limit generalizability, necessitating larger multicenter studies to optimize management strategies.