Skip to main content
SpringerLink
Log in

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

  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

Corrosive gastric injuries are not uncommon in developing countries because acids, which are more frequently associated with gastric injury, constitute the major type of offending chemical. The spectrum of gastric injury may vary from acute to varying types of chronic gastric involvement.

Methods

The 109 consecutive patients with chronic corrosive gastric injuries treated in a single tertiary care superspecialty institute over a period of 30 years were reviewed with special reference to presentation and problems in management.

Results

Acids contributed to 82.6% of chronic injuries. Chronic gastric injuries were usually one of five types in these patients. The majority had prepyloric strictures (83.5%). The remaining strictures were antral (4.6%), body (3.7%), pyloroduodenal (2.7%), or diffuse (5.5%).Twenty-one (22.8%) patients had a delayed gastric outlet obstruction, and18 patients had a concomitant esophageal stricture requiring a bypass. Most of the patients with chronic injury underwent surgical correction with Billroth I gastrectomy (77.1%), loop gastrojejunostomy (11.0%), and distal gastrectomy with Polya reconstruction (3.7%). Other procedures performed were pyloroplasty in 1 patient and colonic conduit jejunal anastomosis in 6 patients. One patient (1%) died in the postoperative period.

Conclusions

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Ananthakrishnan N, Subba Rao KSVK, Radjendiran P (1993) Mid-colon esophagocoloplasty for corrosive esophageal strictures. Aust N Z J Surg 63:389–395

    Article  CAS  PubMed  Google Scholar 

  2. Subba Rao KSVK, Kakar AK, Chandrasekhar V et al (1988) Cicatricial gastric stenosis caused by corrosive ingestion. Aust N Z J Surg 58:143–146

    Article  CAS  Google Scholar 

  3. Lahoti D, Broor SL (1993) Corrosive injury to the upper gastrointestinal tract. Indian J Gastroenterol 12:35–41

    Google Scholar 

  4. Bowill EG, Bulawa FA, Olivetti RG (1951) Severe corrosive gastritis with antral stenosis following ingestion of Saniflusis. Gastroenterology 17:436–441

    Google Scholar 

  5. Boikan WS, Singer HA (1930) Gastric sequelae of corrosive poisoning. Arch Intern Med 40:342–357

    Google Scholar 

  6. Ciftci AO, Senocak ME, Büyükpamukçu N et al (1999) Gastric outlet obstruction due to corrosive ingestion: incidence and outcome. Pediatr Surg Int 15:88–91

    Article  CAS  PubMed  Google Scholar 

  7. Lowe JE, Graham DY, Boisaubin EV Jr et al (1979) Corrosive injury of the stomach: the natural history and role of fibreoptic endoscopy. Am J Surg 137:803–806

    Article  CAS  PubMed  Google Scholar 

  8. Poteshman NL (1967) Corrosive gastritis due to hydrochloric acid ingestion—report of a case. Am J Roentgenol Rad Ther Nucl Med 99:182–185

    CAS  Google Scholar 

  9. Ananthakrishnan N (2008) Corrosive injuries of the esophagus and stomach. In: Tandon BN (ed) Tropical hepatogastroenterology. Elsevier, New Delhi, pp 39–56

    Google Scholar 

  10. Zargar SA, Kochhar R, Nagi B et al (1992) Ingestion of strong corrosive alkalis: spectrum of injury to upper gastrointestinal tract and natural history. Am J Gastroenterol 87:337–341

    CAS  PubMed  Google Scholar 

  11. Ramasamy K, Gumaste VV (2003) Corrosive ingestion in adults. J Clin Gastroenterol 37:119–124

    Article  PubMed  Google Scholar 

  12. Hugh BT, Kelly DM (1999) Corrosive ingestion and the surgeon. J Am Coll Surg 189:508–522

    Article  CAS  PubMed  Google Scholar 

  13. Ananthakrishnan N, Parthasarathy G, Kate V (2006) Gastric fluid level after overnight fast: test to diagnose gastric outlet obstruction in corrosive esophageal stricture. Indian J Gastroenterol 25:269–270

    CAS  PubMed  Google Scholar 

  14. Chung DK, Wines MP, Cummins GE et al (2003) Application of the Meckel’s scan in a case of gastric corrosive injury. Pediatr Surg Int 19:9–10

    CAS  PubMed  Google Scholar 

  15. Chaudhary A, Puri AS, Dhar P et al (1996) Elective surgery for corrosive-induced gastric injury. World J Surg 20:703–706

    Article  CAS  PubMed  Google Scholar 

  16. Hwang TL, Chen MF (1996) Surgical treatment of gastric outlet obstruction after corrosive injury—can early definitive operation be used instead of staged operation? Int Surg 81:119–121

    CAS  PubMed  Google Scholar 

  17. Eaton H, Tennekoon GE (1972) Squamous carcinoma of the stomach following corrosive acid burns. Br J Surg 59:382–387

    Article  CAS  PubMed  Google Scholar 

  18. Gonzalez LL, Zinninger MM, Altemeier WA (1962) Cicatricial gastric stenosis caused by ingestion of a corrosive substance. Am Surg 156:84

    CAS  Google Scholar 

  19. Nicosia JF, Thornton JP, Folk FA et al (1974) Surgical management of corrosive gastric injuries. Ann Surg 180:139–143

    Article  CAS  PubMed  Google Scholar 

  20. Pelclova D, Navratil T (2005) Do corticosteroids prevent esophageal stricture after corrosive ingestion? Toxicol Rev 24:125–129

    Article  CAS  PubMed  Google Scholar 

  21. Howell JM, Dalsey WC, Hartsell FW et al (1992) Steroids for the treatment of corrosive esophageal injury: a statistical analysis of past studies. Am J Emerg Med 10:421–425

    Article  CAS  PubMed  Google Scholar 

  22. Kochhar R, Sriram PV, Ray JD et al (1998) Intralesional steroid injections for corrosive induced pyloric stenosis. Endoscopy 30:734–736

    Article  CAS  PubMed  Google Scholar 

  23. Kaushik R, Singh R, Sharma R et al (2003) Corrosive-induced gastric outlet obstruction. Yonsei Med J 44:991–994

    PubMed  Google Scholar 

  24. Brown RA, Millar AJ, Numanoglu A (2002) Y–V advancement: antropyloroplasty for corrosive antral strictures. Pediatr Surg Int 18:252–254

    Article  CAS  PubMed  Google Scholar 

  25. Kumar A, Ansari M, Shukla D et al (2006) Augmentation gastroplasty using a segment of transverse colon for corrosive gastric stricture. Int J Colorectal Dis 21:470–472

    Article  PubMed  Google Scholar 

  26. Kochhar R, Sethy PK, Nagi B et al (2004) Endoscopic balloon dilatation of benign gastric outlet obstruction. J Gastroenterol Hepatol 19:418–422

    Article  PubMed  Google Scholar 

  27. Ananthakrishnan N, Subba Rao KSVK, Radjendiran P (1991) Delayed gastric outlet obstruction after esophagocoloplasty—clinical presentation with massive megacolon. Indian J Thorac Cardiovasc Surg 7:99

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India

    N. Ananthakrishnan, G. Parthasarathy & Vikram Kate

Authors
  1. N. Ananthakrishnan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G. Parthasarathy
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Vikram Kate
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to N. Ananthakrishnan.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ananthakrishnan, N., Parthasarathy, G. & Kate, V. Chronic Corrosive Injuries of the Stomach—A Single Unit Experience of 109 Patients Over Thirty Years. World J Surg 34, 758–764 (2010). https://doi.org/10.1007/s00268-010-0393-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-010-0393-8

Keywords

Search

Navigation