Gastric stricture following zinc chloride ingestion.
OBJECTIVE
We present the case of an adult who ingested soldering fluid containing zinc chloride (ZC) in a suicide attempt. He developed a gastric stricture that was managed successfully by laparoscopic Roux-en-Y gastrojejunostomy. An extensive literature review shows that there are few reports of ZC ingestion. Furthermore, management of corrosive gastrointestinal tract injury is debatable. The evidence is summarized in this case report.


RESULTS
ZC is a strong corrosive agent, which, following ingestion, is capable of producing widespread damage locally and systematically with long-lasting morbidity and significant mortality. The mainstay of treatment is supportive. Esophago-gastro-duodenoscopy is the diagnostic procedure of choice in the absence of perforation. Strictures that cannot be dilated endoscopically may require surgery. Emergency surgery is required for patients with evidence of perforation. Early and aggressive surgical resection in patients with high-grade burns may improve mortality and morbidity.


CONCLUSIONS
Because of the lack of data, it remains debatable as to the optimal management strategies following ZC ingestion. Our patient was managed conservatively throughout the acute phase. However following recognition of the gastric stricture, surgical intervention ensued and he underwent successful laparoscopic Roux-en-Y gastrojejunostomy and was subsequently discharged having made an excellent recovery.
Tayyem
Raed
R
Ayr Hospital, Ayr, UK. rtayyem@yahoo.com
Siddiqui
Tamim
T
Musbahi
Khaled
K
Ali
Abdulmajid
A
D000328:Adult; D000713:Anastomosis, Roux-en-Y; D002404:Catheterization; D002712:Chlorides / Q000506:poisoning*; D003251:Constriction, Pathologic / Q000139:chemically induced / Q000601:surgery; D016099:Endoscopy, Gastrointestinal; D006801:Humans; D010535:Laparoscopy; D008297:Male; D009067:Mouthwashes / Q000506:poisoning*; D011707:Pyloric Stenosis / Q000139:chemically induced* / Q000601:surgery; D013270:Stomach / Q000187:drug effects* / Q000601:surgery; D013406:Suicide, Attempted; D016896:Treatment Outcome; D017967:Zinc Compounds / Q000506:poisoning*
D002712:Chlorides; D009067:Mouthwashes; D017967:Zinc Compounds; C016837:zinc chloride