Elective surgery for corrosive-induced gastric injury.
Gastric cicatrization is a well recognized late sequela of corrosive gastric injury, but the optimum timing and type of surgery for this complication are still unclear. Over a 7-year period (1988-1994) 34 patients underwent elective surgery for gastric lesions secondary to corrosive ingestion. A total of 18 (53%) patients had an associated esophageal stricture and presented with dysphagia, 15 (44%) patients had features of gastric outlet obstruction, 6 (18%) had diffuse gastric injury, and 28 (82%) had a segmental lesion. A tube jejunostomy was done in 23 (68%) patients to improve nutrition and resulted in a significant increase in weight and in the serum protein level after 8 weeks of tube feeding. Elective surgery was performed 3 to 24 months (average 7 months) after ingestion of the corrosive substance. Gastric resection was done in 20 (59%) patients and gastrojejunostomy (without vagotomy) in 11 (32%); at follow-up the latter group did not exhibit development of a stomal ulcer. In patients with an associated esophageal stricture, endoscopic dilatation was successful in 89% patients and simplified the surgical approach. In conclusion, the success of surgery for corrosive-induced gastric injury depends on selecting the right procedure and intervening at the appropriate time.
Chaudhary
A
A
Department of Gastrointestinal Surgery and Gastroenterology, G.B. Pant Hospital, New Delhi 110002, India.
Puri
A S
AS
Dhar
P
P
Reddy
P
P
Sachdev
A
A
Lahoti
D
D
Kumar
N
N
Broor
S L
SL
D000143:Acids / Q000506:poisoning*; D000293:Adolescent; D000328:Adult; D002057:Burns, Chemical / Q000601:surgery*; D002921:Cicatrix / Q000601:surgery*; D004940:Esophageal Stenosis / Q000139:chemically induced* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D005747:Gastric Fistula / Q000139:chemically induced / Q000601:surgery; D017219:Gastric Outlet Obstruction / Q000139:chemically induced / Q000601:surgery; D005774:Gastrostomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D013270:Stomach / Q000187:drug effects / Q000293:injuries*; D013406:Suicide, Attempted
D000143:Acids