Predicting full-thickness necrosis in adult acute corrosive ingestion injuries in a sub-Saharan African setting

Table 4 Overview of acute management

Management
Median (IQR) time from ingestion to first healthcare assessment	6 (2-13) hours
Emergency resuscitation	n	%
Required emergency resuscitation	23	23.0
Specified
Endotracheal intubation	19	19.0
Chest compressions	1	1.0
Inotropes	3	3.0
Other1	2	2.0
Other management initiated in the emergency department
Proton pump inhibitor therapy	35	35.0
Prophylactic antibiotics	7	7.0
Therapeutic antibiotics	4	4.0
Nasogastric tube insertion (for drainage, not feeding)	4	4.0
Activated charcoal administration	4	4.0
Steroids	1	1.0
Neutralizing agent	0	0.0
Surgery
Required acute surgery	20	20.0
Decision for needing surgery (n = 20)
Based on endoscopy findings	13	65.0
Based on CT findings	5	25.0
Based on clinical findings only	2	10.0
Type of surgery (n = 20)
Emergency resection performed	11	55.0
Oesophagectomy only	1
Oesophagogastrectomy	5
Gastrectomy only	5
Extended resections2	2
Exploration only - decision for palliation	6	30.0
Feeding jejunostomy (only)	1	5.0
Gastrojejunostomy & gastrostomy	1	5.0
Negative laparotomy	1	5.0

¹Other emergency resuscitation: Atropine with methylene blue administration for bradycardia & methaemoglobinaemia and recurrent emergency potassium shifting for refractory hyperkalaemia.

²Extended resections: Oesophagogastrectomy/total gastrectomy with additional pancreas-preserving duodenectomy and proximal jejunal resection in two patients. CT: Computed tomography.