Corrosive-Induced Gastric Outlet Obstruction

Abstract

Ten patients with gastric scarring and an outlet obstruction secondary to ingestion of corrosive substances were referred to our department for surgical management, between May 1999 and April 2003. Hydrochloric acid was the most common corrosive ingested (4 cases), although many were not aware of the nature of the ingested substance. An associated esophageal stricture was present in 5 cases (50%). All the patients initially underwent feeding jejunostomy, with definitive surgery performed at a later date. A partial gastrectomy was found to be the most satisfactory procedure, and was performed in 90% of the cases (9 patients).

A complicated hospitalization following dilute ammonium chloride ingestion

“…Acid ingestions can spare the esophagus but can result in corrosive-induced gastric outlet obstruction [5][6][7]. Other than dilute hydrofluoric acid (<8% concentration), systemic and metabolic abnormalities rarely occur.…”

“…Other less common complications include tracheal stenosis, tracheobronchial fistula, and aortoenteric or gastrocolic fistulization [27,28]. The mortality rate after caustic ingestions is 1-6% and is usually due to mediastinitis, peritonitis, or malnutrition [6,29].…”

Management of pyloric stricture in children: endoscopic balloon dilatation and surgery

“…Caustic ingestion causes liquefaction or coagulation necrosis, followed by cicatrization, which is a progressive process. Consequently, surgical intervention is recommended at the end of the cicatrization period [13,14]. We think that the extent and depth of gastric injury are important factors that should be considered to predict the outcome and to plan the time and technique of surgery.…”

“…Selection of surgical techniques and appropriate timing are controversial topics. Previous studies have recommended pyloroplasty, gastroduodenostomy, and partial or total gastrectomy, based on the location and extent of gastric injury [9][10][11]14].…”

Management of unusually extensive esophagogastric corrosive injuries: emergency measures and gastric reconstruction

“…Hyperemia or ulceration in the mouth or refusing oral intake because of dysphagia, "heartburn," dyspnea, or sialorrhea can be encountered. The late symptoms relating to progressive scarring of the damaged organ, such as esophageal stricture or gastric outlet obstruction, are difficulty in swallowing, vomiting, and weight loss [4]. Esophageal perforation with or without severe involvement of the airway (laryngeal edema, full-thickness burn of the tracheal wall, or necrosis of the trachea) and acute gastric necrosis with perforation are extremely rare initial manifestations of corrosive substance ingestion.…”