Case Report of International Journal of Case Reports
Catastrophic Upper Gastrointestinal Tract Complications Following Corrosive Ingestion
Yousef Alnajjar1, Mariam Thalji1, Hala Khadra1, Hazem Al Ashhab2, Yousef Abu Asbeh3
1 Faculty of Medicine, Al-Quds University, Jerusalem, Palestine.
2 Chief of the Department of Medicine, Al Quds university medical school, Palestine.
3 Department of surgery, Al Quds university medical school, Palestine.
Ingestion of caustic substances, either acidic or alkali, is a well-known cause of significant mortality and morbidity in the pediatric and adult populations. According to the pH, physical form, amount, and rate of ingestion of these substances, a wide range of immediate as well as possible subsequent chronic complications can result. Some patients may have minimal to mild symptoms. However, others can present with moderate or even serious symptoms, in the form of dysphagia, odynophagia, hoarseness, and epigastric pain. Herein we present a case of a 26-year-old male patient with a history of Nitric acid ingestion. He initially complained of severe chest and abdominal pain, associated with hematemesis, dysphagia, odynophagia, hypersalivation, and inability to tolerate oral intake. Initial Esophagogastroduodenoscopy (EGD) showed diffuse mucosal ulceration reaching the second part of the duodenum. Multiple subsequent EGDs revealed more extensive damage and subsequent esophageal stricture and pyloric stenosis for which multiple dilatation attempts were done. The patient received extensive supportive management during his hospitalization course, but the damage was severe enough that he was referred for surgical management. Such catastrophic sequels of caustic ingestion are still encountered, especially in developing countries. We present this case looking forward to raising awareness about this dangerous phenomenon and highlighting the significance of immediate identification and grading of the injury.
Keywords: Caustic injuries, esophageal Stricture, pyloric stenosis, Corrosive
How to cite this article:
Yousef Alnajjar, Mariam Thalji, Hala Khadra, Hazem Al Ashhab, Yousef Abu Asbeh. Catastrophic Upper Gastrointestinal Tract Complications Following Corrosive Ingestion. International Journal of Case Reports, 2023, 7:282. DOI: 10.28933/iijcr-2022-10-0905ya
References:
1. Lupa, M., et al., Update on the diagnosis and treatment of caustic ingestion. Ochsner J, 2009. 9(2): p. 54-9.
2. Contini, S. and C. Scarpignato, Caustic injury of the upper gastrointestinal tract: a comprehensive review. World J Gastroenterol, 2013. 19(25): p. 3918-30.
3. Cheng, H.T., et al., Caustic ingestion in adults: the role of endoscopic classification in predicting outcome.BMC Gastroenterol, 2008. 8: p. 31.
4. Temiz, A., et al., Predictability of outcome of caustic ingestion by esophagogastroduodenoscopy in children. World J Gastroenterol, 2012. 18(10): p. 1098-103.
5. Ananthakrishnan N, K.R., Kate V. Corrosive injury of esophagus and stomach. In: Mishra PK, editor. Textbook of Surgical Gastroenterology, 1st ed., New Delhi, India: Jaypee; 2016.
6. Lakshmi, C.P., et al., A hospital-based epidemiological study of corrosive alimentary injuries with particular reference to the Indian experience. Natl Med J India, 2013. 26(1): p. 31-6.
7. Mamede, R.C. and F.V. De Mello Filho, Treatment of caustic ingestion: an analysis of 239 cases. Dis Esophagus, 2002. 15(3): p. 210-3.
8. Chiu, Y.C., et al., The effects of endoscopic-guided balloon dilations in esophageal and gastric strictures caused by corrosive injuries. BMC Gastroenterol, 2013. 13: p. 99.
9. Kalayarasan, R., N. Ananthakrishnan, and V. Kate, Corrosive Ingestion. Indian J Crit Care Med, 2019. 23(Suppl 4): p. S282-s286.
10. Chirica, M., et al., Caustic ingestion. Lancet, 2017. 389(10083): p. 2041-2052.
11. De Lusong, M.A.A., A.B.G. Timbol, and D.J.S. Tuazon, Management of esophageal caustic injury. World J Gastrointest Pharmacol Ther, 2017. 8(2): p. 90-98.
12. Kluger, Y., et al., Caustic ingestion management: world society of emergency surgery preliminary survey of expert opinion. World J Emerg Surg, 2015. 10: p. 48.
13. Bonavina, L., et al., Foregut caustic injuries: results of the world society of emergency surgery consensus conference. World J Emerg Surg, 2015. 10: p. 44.
14. Alipour Faz A, Arsan F, Peyvandi M, Oroei M, shafagh O, Yousefi M, Peyvandi H. Epidemiologic Features and Outcomes of Caustic Ingestions; a 10-Year Cross-Sectional Study. Emergency. 2017; 5(1): e56.
15. Kate V, A.N., Kalayarasan R, Corrosive Injury of Esophagus and Stomach, ed. P.K. Mishra. 2016: Jaypee Brothers Medical Publishers (P) Ltd.
16. Chirica, M., et al., Esophageal emergencies: WSES guidelines. World J Emerg Surg, 2019. 14: p. 26.
17. Hugh, T.B. and M.D. Kelly, Corrosive ingestion and the surgeon. J Am Coll Surg, 1999. 189(5): p. 508-22.
18. Keh, S.M., et al., Corrosive injury to upper gastrointestinal tract: Still a major surgical dilemma. World J Gastroenterol, 2006. 12(32): p. 5223-8.
19. Chang, J.M., et al., The role of age in predicting the outcome of caustic ingestion in adults: a retrospective analysis. BMC Gastroenterol, 2011. 11: p. 72.
20. Zargar, S.A., et al., The role of fiberoptic endoscopy in the management of corrosive ingestion and modified endoscopic classification of burns. Gastrointest Endosc, 1991. 37(2): p. 165-9.
21. Poley, J.W., et al., Ingestion of acid and alkaline agents: outcome and prognostic value of early upper endoscopy. Gastrointest Endosc, 2004. 60(3): p. 372-7.
22. Andreoni, B., et al., Esophageal perforation and caustic injury: emergency management of caustic ingestion. Dis Esophagus, 1997. 10(2): p. 95-100.
23. Estrera, A., et al., Corrosive burns of the esophagus and stomach: a recommendation for an aggressive surgical approach. Ann Thorac Surg, 1986. 41(3): p. 276-83.
24. Chirica, M., et al., Surgery for caustic injuries of the upper gastrointestinal tract. Ann Surg, 2012. 256(6): p. 994-1001.
25. Park, K.S., Evaluation and management of caustic injuries from ingestion of Acid or alkaline substances. Clin Endosc, 2014. 47(4): p. 301-7.
26. Chibishev, A., N. Simonovska, and A. Shikole, Post-corrosive injuries of upper gastrointestinal tract. Prilozi, 2010. 31(1): p. 297-316.
27. Ananthakrishnan, N., G. Parthasarathy, and V. Kate, Chronic corrosive injuries of the stomach-a single unit experience of 109 patients over thirty years. World J Surg, 2010. 34(4): p. 758-64.
28. Kochhar, R., et al., Endoscopic balloon dilatation is an effective management strategy for caustic-induced gastric outlet obstruction: a 15-year single center experience. Endosc Int Open, 2019. 7(1): p. E53-e61.
29. Millar, A.J. and S.G. Cox, Caustic injury of the oesophagus. Pediatr Surg Int, 2015. 31(2): p. 111-21.
30. Mahawongkajit, P. Acute Management in Corrosive Ingestion. In: Ahmed, M., editor. Dysphagia – New Advances [Internet]. London: Intech Open; 2021 [cited 2022 Oct 14]. Available from: https://www.intechopen.com/chapters/79574. Doi: 10.5772/intechopen.101475.
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