Gastric stricture following corrosive agent ingestion: A case report. (2020)

• Record Type: Journal Article
• Authors: Gunadi, ; Munandar, Mukhamad Arif; Fauzi, Aditya Rifqi; Simanjaya, Susan; Damayanti, Wahyu
• Is Part Of: International journal of surgery case reports. Volume 75(2020)
• Page Start: 539
• Page End: 542
• Publication Date: 2020
• Subjects: Corrosive agent -- Endoscopic examination -- Gastric outlet obstruction -- Gastrojejunostomy and Braun anastomosis -- Gastric stricture -- Pediatric case; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2020.09.067
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: Different caustic agents will have a different impact on tissue damage and specific organs. Appropriate supporting examination is necessary to precisely diagnose gastric stricture due to corrosive ingestion. Gastrojejunostomy and Braun anastomosis is a good option for gastric outlet obstruction due to corrosive ingestion. Abstract: Introduction: Gastric stricture due to corrosive ingestion is a rare cause of obstruction in the upper gastrointestinal tract in children. However, only a few reports highlight the management of the stricture of the gastric antrum and pylorus, i.e. gastric outlet obstruction (GOO) due to corrosive ingestion, particularly in children. Presentation of case: We report a 1-year-old male who presented with chief complaints of upper abdominal pain and profuse vomiting after accidentally ingesting sulfuric acid one month prior. On physical examination, minimal epigastric distension was found. Endoscopic examination showed oesophagitis, erosive gastritis, multiple gastric ulcers and suspicion of pyloric stricture. We decided to perform an exploratory laparotomy and found severe strictures from the major curvature to the gastric pylorus. Subsequently, we conducted gastrojejunostomy and Braun anastomosis. The patient was discharged on the eighth postoperative day uneventfully. Discussion: Endoscopy is a reliable technique for assessing upper digestive tract mucous membranes after caustic agent ingestion because it helps in making a definitive diagnosis, especially to define the anatomic location and injury severity. The timing and type of surgery for GOO is controversial. We performed Braun anastomosis in addition to gastrojejunostomy because of several advantages over other surgical methods. Conclusion: We recommend choosing an appropriate supporting examination to precisely diagnose gastric stricture due to corrosive ingestion. Gastojejunostomy and Braun anastomosis show a good outcome for gastric stricture due to corrosive ingestion, particularly in children.