腐食性障害のZargar内視鏡分類
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Grade 0、1、2Aではほとんど狭窄を起こさないが、Grade 2B～3は高頻度（70～100%)に狭窄を来す。Grade 3では全身的な合併症を来すリスクがありICUでの加療を必要とし、また局所合併症として出血、穿孔を来すリスクもあり、注意深い観察が必要である。ほとんどの死亡例はGrade 3の症例である。
出典
1:
The role of fiberoptic endoscopy in the management of corrosive ingestion and modified endoscopic classification of burns.
著者:
S A Zargar, R Kochhar, S Mehta, S K Mehta
雑誌名:
Gastrointest Endosc. 1991 Mar-Apr;37(2):165-9.
Abstract/Text
We prospectively evaluated the role of fiberoptic esophagogastroduodenoscopy in the management of 81 patients with corrosive ingestion. A total of 381 endoscopic examinations were performed: 88 within 96 hours following corrosive ingestion, 108 between the third and ninth week, and 185 during the period of follow-up after bougie dilation of esophageal strictures. The customary endoscopic classification of burns (grades 0 to 3) was modified by subdividing grade 2 burns into 2a and 2b, and grade 3 burns into 3a and 3b for prognostic and therapeutic implications. There was no significant correlation between oropharyngeal and upper gastrointestinal tract injury. Early major complications and deaths were confined to patients with grade 3 burns. All patients with grade 0, 1, and 2a burns recovered without sequelae. The majority of patients (71.4%) with grade 2b injury and all survivors with grade 3 injury developed esophageal or gastric cicatrization, or both, which needed endoscopic or surgical treatment. There were no complications related to endoscopy. We conclude that early endoscopy is not only a safe, reliable, and accurate diagnostic tool in such patients, but also is of crucial importance in management and prognosis.
Gastrointest Endosc. 1991 Mar-Apr;37(2):･･･
