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. 2024 Jan 8;24(1):20-26.
doi: 10.4103/tjem.tjem_134_23. eCollection 2024 Jan-Mar.

Role of high-dose methylprednisolone in Zargar Grade IIB corrosive esophageal burns: A randomized control study

Irtiqa Sheikh  1 , Nayer Jamshed  1 , Akhil Neseem  1 , Praveen Aggarwal  1 , Saurabh Kedia  2 , Maroof Ahmad Khan  3 , Chandan J Das  4 , Ankit Kumar Sahu  1
Affiliations

Role of high-dose methylprednisolone in Zargar Grade IIB corrosive esophageal burns: A randomized control study

Irtiqa Sheikh et al. Turk J Emerg Med. .

Abstract

Objective: The objective of the study is to test the efficacy of high-dose methylprednisolone in the prevention of esophageal stricture after corrosive ingestion.

Methods: This study was a single-center, randomized controlled single-blinded study. Simple randomization was done with 15 adult patients (>18 years) in each arm, who presented with a history of corrosive ingestion within the past 24 h and had esophageal injury of Zargar Grade IIB on endoscopy. Intravenous methylprednisolone 1 g/day for 3 days was given to the intervention arm while 100 mL of normal saline was given as placebo in control arm. Follow-up to diagnose esophageal stricture was done at 8 weeks.

Results: Thirty patients (15 in each arm) were recruited for the study. As per the intention to treat analysis, 33% and 46.6% developed stricture in the intervention and control arm, respectively (relative risk [RR] = 0.714; 95% confidence interval 0.29-1.75; P = 0.462). 40% patients in control group and 7.7% in intervention group had undergone feeding jejunostomy, which was statistically significant with a p-value of 0.048. Airway injury showed significant clinical improvement in the intervention arm but the difference was nonsignificant statistically (P = 0.674). There was no increased incidence of hypertension, hyperglycemia, hyponatremia, hyperkalemia, or infections in intervention arm.

Conclusion: Methylprednisolone does not help in the prevention of stricture formation in corrosive esophageal injury, but it significantly reduces the requirement of feeding jejunostomy and has a beneficial role in treating airway injury.

Keywords: Airway injury; Zargar classification; corrosive ingestion; esophageal burns; steroids; stricture.

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Conflict of interest statement

None Declared.

Figures

Figure 1
Figure 1
Consolidated Standards of Reporting Trials diagram showing progress through the phases of trial. ED: Emergency department, n: Frequency, Inj.: Injection, NS: Normal saline, OD: Once a day, BD: Twice a day, IV: Intravenous, UGIE: Upper gastrointestinal endoscopy
See this image and copyright information in PMC

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