Corrosive acid injury of the stomach

Abstract

Ingestion of corrosives with accidental or suicidal intent is a common problem in Sri Lanka. Management options and outcomes of corrosive injuries on stomach are not well documented in our setting. The clinical presentation, complications and management outcomes of nine patients with corrosive injury to stomach are presented. Gastric outlet obstruction seen in majority, was managed with bypass procedure (n=5) or resection (n=4). The outcomes of management were successful with both methods.

Protective effects of total flavonoids from Alpinia officinarum rhizoma against ethanol-induced gastric ulcer in vivo and in vitro

“…As generally known, gastric acid is one of the key factors that play an important role in the development of gastric ulcer (Wijeratne et al 2015). GAS can promote the synthesis of gastric acid and pepsin, stimulate the vagus nerve, and enhance the physiological function of gastric motility.…”

“…At present, gastric ulcer has become a common digestive disease encountered clinically. There are several pathogenic and aggravating factors contributing to gastric ulcers, such as Helicobacter pylori infection (Peterson 1991), long-term use of non-steroidal anti-inflammatory drugs (Matsui et al 2011), stressful mental states (Zhao et al 2018), excessive gastric acid secretion (Wijeratne et al 2015) and genetic predisposition (Tahara et al 2007). The type of gastric ulcer induced by ethanol tends to erode the gastric tissue, causing extreme damage to the gastric mucosa, including haemorrhagic damage to the gastric mucosal lesions and mucosal oedema (Park et al 2008), inflammatory cell infiltration (Xie et al 2017) and diffuse ulcers (Al-Sayed and El-Naga 2015).…”

Corrosive substances ingestion: a review

“…Predictors for mortality in these patients were associated with: requirement for endotracheal intubation (p ¼ 0.012), abnormal CT-scan findings (p ¼ 0.001), necessity for tracheostomy (p ¼ 0.048), higher Zargar scores on endoscopy (p ¼ 0.006), and requirement for emergent surgical intervention (p ¼ 0.005) (Struck et al 2016). Wijeratna et al (2015) described 9 adult cases of acid ingestion (sulfuric acid, n ¼ 5; acetic acid, n ¼ 1; unknown acid, n ¼ 2) in Sri Lanka. The acute stage management was not specified except in 1 case where gastric perforation and peritonitis occurred.…”

“…The acute stage management was not specified except in 1 case where gastric perforation and peritonitis occurred. All patients presented with gastric outlet obstruction (Wijeratna et al 2015).…”

“…Surgical interventions included the following: repair of the damaged stomach and loops of small bowel in the one fatal acute case; retro-colic iso-peristaltic gastro-jejunostomy; gastric resection with sparing of an uninjured fundus area and iso-peristalic jejunal loop reconstruction; gastric outlet junction injury with fistula closure, distal stomach resection, and proximal gastro-jejunostomy followed by right colonic transposition due to first surgical failure (fatal case); gastrectomy with retro-colic jejunal anastomosis; distal stomach strictures resection and retro-colic loop gastro-jejunostomy; ante-colic iso-peristaltic proximal gastrojejunostomy; esophageal dilation and pyloroplasty; proximal gastrojejunostomy; balloon dilation of the esophagus and proximal anticolic gastrojejunostomy (fatal case) (Wijeratna et al 2015).…”