Author(s): Chaudhary A, Puri AS, Dhar P, Reddy P, Sachdev A,
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Abstract 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.
This article was published in World J Surg
and referenced in Health Care : Current Reviews