Chronic Corrosive Injuries of the Stomach—A Single Unit Experience of 109 Patients Over Thirty Years

Abstract

The management of chronic corrosive gastric injury depends on the type of gastric involvement, the presence of co-existent esophageal stricture, and the general condition of the patient. A limited resection of the affected stomach is the ideal procedure for the common type of gastric injury. In patients whose general condition prohibits major resection or where the stricture extends to the antrum the best treatment is a loop gastroenterostomy. Type III, IV, V strictures require individualized treatment. Delayed gastric outlet obstruction affects the treatment plan of combined gastric and esophageal injuries.

Gastric outlet obstruction as a sequel of hydrochloric acid ingestion

“…It is of five types. 10 Short ring stricture of the stomach within 1 to 2 cm of the pylorus is type I. Stricture extending proximally up to the antrum is type II. Mid-gastric stricture involving the body and sparing the proximal and distal parts of the stomach is classified as type III.…”

Corrosive Injury of the Upper Gastrointestinal Tract: A Review

“…Type I: short ring stricture of the stomach within one or two centimeters of the pylorus; type II: stricture extending proximally up to the antrum; type III: mid gastric stricture involving the body of the stomach and sparing the proximal and distal parts of the stomach; type IV: diffuse gastric involvement producing a linitis plastica like appearance; and type V: gastric stricture associated with a stricture of the first part of the duodenum [69]. The ideal time for surgical intervention for a chronic corrosive gastric injury is debatable.…”

“…This period also enables the mucosal lesions to heal, so that surgical anastomosis can be carried out with greater safety. The preferred operation depends on several factors: (1) the general condition of the patient, (2) the need for a concomitant esophageal reconstruction, and (3) the type of chronic gastric injury [69][70][71]. In type I gastric injury, a limited resection with a gastroduodenal reconstruction is performed.…”

“…However, besides seriously compromising the general condition of the patient, they are almost always associated with severe esophageal injuries. These strictures are hence treated with a colonic bypass for the esophagus and anastomosing the distal end of the colon end-toside to the proximal jejunum, leaving the stomach in situ [4,16,[69][70][71].…”

Severe Renal Function Impairment in Adult Patients Acutely Poisoned with Concentrated Acetic Acid

“…In contrast to the European Union and the USA, where the production and use of acetic acid is strictly controlled, in the Balkan countries, Middle East, China, Thailand, and Russia, it is produced and used in higher concentrations and its abuse, mainly in suicidal attempts, is more frequent (5,6).…”