Clinical Studies Of Intramural Oesophageal Dissection Associated With Acute Paraquat Poisoning

Background:Background:Paraquat poison have high toxicity to human body, can cause serious damage to the multiple system organs of the body, almost all oral poisoning have different degrees of digestive system damage, producing the corresponding clinical symptoms and further affect patients’ diet and treatment.Paraquat is not only to have obvious corrosion damage of the oral mucosa, but also cause a certain degree of damage to the esophagus, severe cases can lead to esophageal mucosal surface stripped. At home and abroad have not yet seen the systematic research of acute paraquat poisoning cause esophageal mucosal surface stripped,we did systematically research to the related cases admitted in our department.Objective:Through the retrospective analysis of9cases of oral paraquat lead to esophageal mucosal surface stripped disease in patients with clinical data and histopathological changes admitted in our department, understanding the special form of paraquat to esophageal mucosal surface stripped esophageal lesions,and for paraquat lead to esophageal injury provide reference for the prevention and treatment.Methods:A retrospective analysis of9cases of treated oral paraquat to esophageal mucosal epidermal stripping patients clinical data poisoning admitted in occupational medicine in Qilu Hospital of Shandong University, in Jan.2011-Feb.2014, and did the histopathological examination for the emergence of abnormal tissue and damage in some patients with chest HRCT esophageal reconstruction.Results:oral paraquat to esophageal mucosal epidermal peeling disease occurs mainly in3-8days after drugs initiation, upper gastrointestinal paragraphs are may occur, especially stripped on esophageal tube type. Pathological changes by hemorrhage, necrosis and edema, inflammatory cells infiltration, the mucosa and submucosa, muscularis can emerge even in vitro; Develops in amount of poison is between60and100ml, early gastric lavage is not timely and frequent vomiting before gastric lavage, at the same time with a certain degree of damage to the lungs, liver, kidney and other organs of patients, most patients after eat it would result in poor prognosis. Except for one case of paraquat to esophageal mucosal surface stripped survived, other patients died from the esophageal mucosa surface stripped disease occurred for several hours to ten days; When did the routine chest HRCT inspections in some patients, obvious esophageal lesions can be seen, the esophagus suspended material membrane peeling in the esophageal lumen even can be found.Conclusion:Acute paraquat poisoning has certain damage to the esophagus, serious patients may with esophageal lining exfoliation syndrome, once happened prompt the patients overall poor prognosis; HRCT in diagnosis of paraquat to severe esophageal injury has certain reference value.