Gastric perforation after corrosive ingestion

Abstract

GP is a rare but major complication of corrosive ingestion. Children who swallow corrosives should be closely monitored and pediatric surgeons should be aware of this potential early complication. The possibility of associated pathology should be considered when undertaking surgical repair.

Corrosive Injury of the Upper Gastrointestinal Tract: A Review

“…In the acute phase, it is clear that patients with evidence of perforation require immediate surgery [16,[53][54][55]. Patients with shock, acidosis, and coagulation disorders and those who have ingested large amounts of corrosives, usually tend to have severe injury on laparotomy and early surgical intervention may prove beneficial [56].…”

“…Loss of the gut mucosal barrier coupled with peritoneal and mediastinal contamination results in severe sepsis. Management of these patients involves urgent resuscitation with correction of fluid and electrolyte and acid-base abnormalities, administration of broad spectrum antibiotics and immediate surgical exploration [4,16,[55][56][57][58][59].…”

“…Indications for emergency surgery rely more often on clinical grounds than on radiological findings; in the presence of doubtful clinical features a decision to perform laparotomy is likely more advantageous for patients than a conservative attitude especially in patients who ingested large amounts of corrosive substances [4,16,[55][56][57][58][59]. Laboratory and endoscopic criteria for emergency surgery have been suggested, including disseminated intravascular coagulation, renal failure, acidosis and third degree esophageal burns.…”

“…Unfortunately, these are often late findings and surgery may improve mortality and morbidity in grade 3A injuries only. Severe injuries of the stomach at endoscopy require careful monitoring with a low threshold for laparotomy [56]. Conservative management of severe gastric injuries at laparotomy, with partial or total conservation of the stomach, has been recently advocated by some in the absence of clinical and biological signs of severity [56,59].…”

Burns Caused by Sitting on Corrosive Material

“…The duration of the contact with the substance is also important [3]. Superficial lesions heal smoothly; deeper lesions can lead to contraction in the chronic period [4]. The easy access of children to these widely-used cleaning substances resulting from the careless or deliberate use of these materials has been causing serious health problems in children.…”