GASTRIC OUTLET OBSTRUCTION BY CAUSTIC INGESTION: CASE REPORT OF AN EARLY DEFINITIVE SURGICAL APPROACH

João Luís Pinheiro; José Pereira Pinto; Marta Ferreira; Luis Filipe Pinheiro; Conceição Marques; Carlos Casimiro

doi:10.34635/rpc.848

João Luís Pinheiro Serviço de Cirurgia Geral, Centro Hospitalar Tondela - Viseu, Portugal http://orcid.org/0000-0002-1942-8512
José Pereira Pinto Serviço de Cirurgia Geral, Centro Hospitalar Tondela - Viseu, Portugal http://orcid.org/0000-0002-1868-360X
Marta Ferreira Serviço de Cirurgia Geral, Centro Hospitalar Tondela - Viseu, Portugal; Cirurgia Esofagogastroduodenal, Centro Hospitalar Tondela - Viseu, Portugal http://orcid.org/0000-0001-7161-4286
Luis Filipe Pinheiro Serviço de Cirurgia Geral, Centro Hospitalar Tondela - Viseu, Portugal; Cirurgia Esofagogastroduodenal, Centro Hospitalar Tondela - Viseu, Portugal http://orcid.org/0000-0002-8367-2798
Conceição Marques Serviço de Cirurgia Geral, Centro Hospitalar Tondela - Viseu, Portugal; Cirurgia Esofagogastroduodenal, Centro Hospitalar Tondela - Viseu, Portugal
Carlos Casimiro Serviço de Cirurgia Geral, Centro Hospitalar Tondela - Viseu, Portugal

Abstract

Introduction: Ingestion of caustic products present a challenge to many physicians, as it remains a rare occurrence in the emergency room.

Presentation of Case: A 58-year-old male was brought to the emergency department after ingesting hydrochloric acid. A pre-pyloric stenosis developed and endoscopic dilation was attempted with no success. The patient underwent an open subtotal gastrectomy after 4 weeks, with no complications and significant clinical improvement.

Discussion: Gastric outlet obstruction mainly occurs in the prepyloric area. A surgical approach is reported as a safe alternative after the acute inflammatory phase subsided, and can be safely executed 4 weeks after the caustic ingestion if needed. The type of resection should be tailored to the extent of the lesions.

Conclusion: Surgical resection poses a safe alternative, after the acute inflammatory phase has subsided and allows for adequate symptomatic control. Liquid agents affect mostly areas where pooling occurs, being the gastric antrum a frequent area where caustic lesions take place.

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Author Biography

Marta Ferreira, Serviço de Cirurgia Geral, Centro Hospitalar Tondela - Viseu, Portugal; Cirurgia Esofagogastroduodenal, Centro Hospitalar Tondela - Viseu, Portugal

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