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ORIGINAL ARTICLE
Year : 2014  |  Volume : 22  |  Issue : 1  |  Page : 72-78

Upper gastrointestinal lesions and bleed in burn injuries: An endoscopic evaluation


1 Department of Burns and Plastic Surgery, Gandhi Medical College, Hyderabad, Andhra Pradesh, India
2 Department of Burns and Plastic Surgery, Osmania Medical College, Hyderabad, Andhra Pradesh, India

Correspondence Address:
Arige Subodh Kumar
13-6-457/29, Gayatri Nagar, Shivbagh, Gudi Malkapur, Hyderabad, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-653X.147012

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Upper gastrointestinal lesions are a known complication in burn injuries and are considered to be caused by acid-peptic digestion of gastric mucosa. Antacids and H2- receptor blockers are administered to neutralize the gastric secretions. The study aims to observe the incidence of upper gastrointestinal lesions, their natural course, the influence of the early oral feeds, oral Sucralfate and parenteral Ranitidine, the clinical and endoscopic incidence of the bleed. This study was undertaken on 92 patients having burns varying between 10% and 70% of body surface area and admitted within 24 h of the injury. Patients were divided randomly into three groups. Group I: Ranitidine at a dose of 50 mg intravenously twice a day was commenced from the time of admission and oral feeds after 24 h. Group II: Oral feeds, and sucralfate, 2 g at four hourly interval were administered from the time of admission. Group III: Oral feeds alone were given from the time of admission. Endoscopy was done at weekly interval, starting after 3 rd postburn day, after stabilization of the patient. Upper Gastrointestinal lesions were seen in 46% of patients, and they lasted up to 6 weeks while only 8% developed bleed. The lesions showed a direct proportionate relationship to the percentage of burn. Both Group I and Group III patients developed bleed, the incidence of which was more on endoscopy than the clinical manifestation. Group II patients did not have any bleed.


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