Surgical management of corrosive strictures of stomach

Indian J Gastroenterol. 2004 Sep-Oct;23(5):178-80.

Abstract

Background: Corrosive injuries of the upper aero-digestive tract are a frequent cause of morbidity in India. We report here our institution's experience in managing patients with corrosive strictures of the stomach.

Methods: Records of 28 patients who underwent definitive surgery for corrosive strictures of the stomach in our institution over a 15-year period were reviewed.

Results: The main presenting complaints were vomiting (75%), dysphagia (46%) and significant weight loss (100%). Pre-operative evaluation included barium and endoscopic studies. Most patients had antro-pyloric strictures (n=22); in 6 patients, however, near-total or total gastric involvement was observed. Thirteen (46%) patients had associated strictures of the esophagus; of these, 7 responded to esophageal dilation. Strictures of the stomach were managed with resectional procedures like distal gastrectomy (n=16), subtotal gastrectomy (1) or total gastrectomy (3) and esophagogastrectomy (1) in 21 (75%) patients. The remaining 7 patients underwent bypass procedures like gastrojejunostomy (5), stricturoplasty (1), and colonic bypass of esophagus and stomach (1). Three patients had entero-cutaneous fistulae in the postoperative period. One patient died in hospital of septicemia and malnutrition.

Conclusions: In patients with corrosive strictures of the stomach, surgery, tailored according to the extent of gastric involvement and presence of associated esophageal strictures, gives excellent results.

MeSH terms

  • Adolescent
  • Adult
  • Anastomosis, Surgical
  • Burns, Chemical / etiology
  • Burns, Chemical / mortality
  • Burns, Chemical / surgery*
  • Caustics / poisoning*
  • Constriction, Pathologic / chemically induced
  • Constriction, Pathologic / surgery
  • Developing Countries
  • Esophageal Stenosis / chemically induced
  • Esophageal Stenosis / surgery
  • Female
  • Follow-Up Studies
  • Gastrectomy / methods*
  • Gastric Outlet Obstruction / chemically induced
  • Gastric Outlet Obstruction / surgery*
  • Humans
  • India
  • Male
  • Middle Aged
  • Pyloric Stenosis / chemically induced
  • Pyloric Stenosis / surgery*
  • Retrospective Studies
  • Risk Assessment
  • Survival Rate
  • Treatment Outcome

Substances

  • Caustics