Iranian Journal of Toxicology (Jun 2014)
A middle age addicted man with caustic stomach
Abstract
Background: The term caustic generally refers to alkaline and the term corrosive generally refers to acidic agents' injury; however, in medical literature caustic is frequently a term applied to both substances. Ingested alkali typically damage the esophagus more than stomach or duodenum, whereas acids usually cause more severe gastric injury. Since esophagus has a slightly alkaline pH, its epithelium is more resistant to acids, so that only 6 to 20% of those who ingest these substances present lesions in this organ. Case : A middle-aged addicted man who drunk hydrochloric acid accidentally had extensive necrosis of the stomach with remarkable sparing of the esophagus on second look exploration. A total gastrectomy with a Roux-en-Y esophago-jejunostomy with feeding jejunostomy was performed. Conclusion : In caustic GI injury, patients who are operated on and found to have no evidence of extensive esophago-gastric necrosis, a biopsy of the posterior gastric wall should be performed to exclude occult injury. If histologically there is a question of viability, a second look operation should be performed within 36 hours.
