title: Surgical management of gastric cicatrisation resulting from corrosive ingestion.
abstract: BACKGROUND
  Caustic injury to the stomach can be complicated by gastric stenosis. We review our experience with surgical management of symptomatic gastric stenosis.
  
  
  METHODS
  This is a retrospective chart review of patients who underwent surgery for gastric stenosis within 6 weeks to 26 months following corrosive ingestion. The data analyzed included the extent of cicatrisation, surgical procedure performed and outcome. Preoperative evaluation in these patients included a barium contrast study and upper gastrointestinal endoscopy.
  
  
  RESULTS
  Main presenting symptoms were nonbilious vomiting, early satiety, dysphagia and significant weight loss. Antropyloric strictures were present in 28 (64%) patients, total gastric involvement was seen in 16 (36%) patients, associated esophageal stenosis was present in 18 (40.91%) patients. Surgical procedures performed included distal gastrectomy with Billroth1 reconstruction in 31.82%, distal gastrectomy with Roux-en-Y reconstruction in 20.45%, stricturoplasty in 11.36%, subtotal gastrectomy in 18.18% and total gastrectomy with pouch reconstruction in another 18.18% patients. Complications encountered were pneumonitis in 18.18%, wound infection in 11.36%, intra-abdominal infection, anastomotic breakdown, reactivation of pulmonary tuberculosis and dumping syndrome, each in 2.27% patients. One patient (2.27%) died.
  
  
  CONCLUSIONS
  Surgical procedure should be tailored according to the extent of gastric involvement. Surgical resection is feasible and safe. Our results suggest that satisfactory outcome could be expected with different therapeutic modalities based on degree of cicatrisation.
authors.affiliation: Department of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Vikas
authors.initials: V
authors.lastname: Gupta
authors.forename: Jai D
authors.initials: JD
authors.lastname: Wig
authors.forename: Rakesh
authors.initials: R
authors.lastname: Kochhar
authors.forename: Saroj K
authors.initials: SK
authors.lastname: Sinha
authors.forename: Birinder
authors.initials: B
authors.lastname: Nagi
authors.forename: Rudra P
authors.initials: RP
authors.lastname: Doley
authors.forename: Rajesh
authors.initials: R
authors.lastname: Gupta
authors.forename: Thakur D
authors.initials: TD
authors.lastname: Yadav
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001466:Barium Sulfate; D002057:Burns, Chemical / Q000175:diagnosis / Q000601:surgery*; D002424:Caustics / Q000506:poisoning*; D002921:Cicatrix / Q000139:chemically induced* / Q000175:diagnosis / Q000601:surgery*; D003251:Constriction, Pathologic / Q000139:chemically induced / Q000175:diagnosis / Q000601:surgery; D003287:Contrast Media; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D002424:Caustics; D003287:Contrast Media; D001466:Barium Sulfate