Pharyngeal burns
Introduction
Introduction to pharyngeal burns The pharynx is the only way to swallow and breathe. The pharyngeal burns involve the throat at the same time. The esophagus burns when entering the esophagus. In addition to local symptoms, it can also cause complex pathological changes and symptoms of poisoning. It should be diagnosed early and treated in time. . basic knowledge The proportion of illness: 0.03% Susceptible people: no special people Mode of infection: non-infectious Complications: laryngeal edema
Cause
Causes of pharyngeal burns
Cause of disease:
Ingestion of boiling water or chemical corrosive agents can cause damage to the oral mucosa and pharyngeal mucosa, and severe cases of severe systemic poisoning. Burns are more common in young children. Commonly used corrosive agents are strong acids, strong bases, toluene, carbolic acid, and the like. If a etchant enters the esophagus, an esophageal burn will occur at the same time.
Throat burns can be divided into thermal burns and chemical burns. Most of the pharyngeal burns occur in children, mostly for the care of children, accidentally drinking boiling water or eating hot food. Adults are more likely to be injured by fire, high heat vapor or other high temperature liquids. Therefore, it is often accompanied by severe burns on the head, face and neck. Chemical burns are often caused by accidental exposure to caustic chemicals such as strong acids, strong alkalis, heavy metal salts, ammonia, etc., and often burns of the mouth and esophagus. After the mucous membrane is exposed to the alkaline corrosive agent, the fat is saponified, the protein is dissolved, and the tissue is liquefied and necrotic, and the lesion has strong penetrability and is easy to develop into the deep layer. After the mucous membrane is exposed to the acidic corrosive agent, the pathological changes are mainly water absorption, protein coagulation, local tissue showing coagulative necrosis, penetrating power is weak, and high concentration can also cause serious damage.
Pathophysiology:
Ingestion of boiling water or chemical corrosive agents can cause damage to the oral mucosa and pharyngeal mucosa, and severe cases of severe systemic poisoning. Burns are more common in young children. Commonly used corrosive agents are strong acids, strong bases, toluene, carbolic acid, and the like. If a etchant enters the esophagus, an esophageal burn will occur at the same time.
Pathological changes:
The extent of damage to the throat tissue depends on the temperature of the wound (thermal burn) and the nature of the corrosive agent, the attempted capacity, the volume of entry, and the time of residence. The wounds stay in the throat stenosis area for a long time, so the damage is more serious in the tongue arch, uvula, epiglottis, cartilage and wrinkles, and the junction of the pharyngeal tube. Throat burns are divided into three degrees according to the degree of damage: one degree of burn is more common, which is characterized by diffuse hyperemia of the pharyngeal mucosa, followed by edema, which is more serious in the throat, and no scar formation after wound healing. Second degree burns affect the mucosal layer and muscle layer, mucosal edema is more pronounced, and the mucosal surface is covered with necrotizing pseudomembrane or suede, which may be white, yellow or gray depending on the cause of the disease. Third-degree burns are most severe and are common in chemical burns (such as ammonia and caustic soda). Caustic sodium burn can cause deep mucosal necrosis, long-lasting inflammation, and the necrotic pseudomembrane will disappear after 3 to 4 weeks. Light can be recovered, but severe burns, after the formation of dislocation and necrotic tissue, the scar tissue of the scars grows, causing various deformities.
Prevention
Pharyngeal burn prevention
1, the vast majority of pharyngeal scald occurred in children, mostly for the care of children, drinking water or eating hot food. Adults are more common in flames, high heat steam or other high temperature liquids.
2, keep the mouth clean, spray the surface of the wound with bismuth carbonate or coated gentian violet, or swallow olive oil, paraffin oil, make the wound dry, and have antiseptic, lubrication and protection. Oral administration of 1% procaine 15 mL before meals can alleviate dysphagia and is beneficial for increasing nutrient water and improving systemic conditions.
3, throat burns caused by strong acid and alkali, in the case of 3 to 4 hours after the injury, patients should be given depending on the poison they are given. Those who take strong alkali can use neutralization of vinegar, orange juice, lemon juice, milk, egg white, etc. Neutralizing the acid with an aluminum hydroxide gel, soapy water or a dilute magnesium oxide emulsion. However, avoid using sodium bicarbonate and calcium carbonate to prevent carbon dioxide from rupturing the injured esophagus and stomach. Those who have more oral poisons can use gastric lavage with caution. Many scholars believe that acid-base corrosion and gastric lavage are taboo.
Complication
Pharyngeal burn complications Complications laryngeal edema
The main symptoms after injury are pain, swallowing pain, difficulty in swallowing, drooling, etc. If accompanied by laryngeal edema, dyspnea will occur, and severe burns often have symptoms of fever or poisoning.
Symptom
Symptoms of pharyngeal burns Common symptoms Tongue and pharyngeal burning sensation Dysphagia Throat pain Swallowing pain Irritability Speech disorder Scalding High heat dyspnea bleeding tendency
The main symptoms after injury are oral cavity, sore throat, swallowing pain, difficulty in swallowing, drooling, etc., followed by high fever, runny, cough, dysphonia, wheezing or difficulty breathing. Chemical damage may be due to the toxicity of the compound. Drowsiness, loss of water, high fever, shock, etc., can lead to death, children with difficulty in sucking and irritability, in addition, there may be lack of energy, lethargy, poor appetite, increased body temperature, and varying symptoms of poisoning, Difficulty breathing is caused by laryngeal edema and secretion of throat, which is caused by blockage of respiratory tract. It is the main cause of death from throat burns. Most of the dyspnea is seen in 5 to 10 hours after injury. During this period, close observation should be made. No breathing difficulties occur after 24 hours. It can be considered as a dangerous period of difficulty in breathing.
Check the visible soft palate, uvula, pharyngeal wall, epiglottis, etc. mucosal blistering, erosion or covered with white film, the mucosa after chemical burn has a typical performance, the pharyngeal substance is sticky , greasy, contains mucosal debris, caustic acts on the tissue, dissolves and destroys the protein, becomes a gel-like mass, the skin is soft and deep, it is a turbid gray film, and the burnt knot of nitric acid is often yellow, brown or brown. The sulfuric acid caused by black sputum, acetic acid and carbonated sputum are white, iodine, ammonia, acetic acid poisoning patients often exhale a distinct smell.
Many poisons can cause damage to the kidneys, liver, central nervous system, and electrolyte disorders, including renal dysfunction, failure, and bleeding tendency.
Patients with severe pharyngeal burns may cause scarring, adhesion, and respiratory and swallowing disorders in the corresponding organs in the advanced stage.
Examine
Examination of pharyngeal burns
The remaining poisons and containers of chemical corrosion damage should be kept for inspection. Sometimes the vomit and urine and the poison in the stool must be tested to assist in the diagnosis.
Diagnosis
Diagnosis and diagnosis of pharyngeal burns
The diagnosis should be differentiated from throat contusion, diphtheria, throat tracheal foreign body, acute laryngeal obstruction.
