Surgical Management of Gastric Outlet Obstruction Due to Corrosive Injury

Corrosive gastric injury is common in India due to easily available acids which are ingested mostly for suicide attempt. Resulting gastric outlet strictures need operation in majority of the patients. We review our experience of surgical management of these cases. Thirty-seven consecutive patients over the last 4 years with corrosive gastric strictures were reviewed. Extent of gastric cicatrisation was assessed by endoscopy and barium study. Nutrition was maintained, if necessary by feeding jejunostomy. Early definitive operation was preferred. Outcome of surgery was assessed. Patients presented with vomiting, weight loss, and dysphagia. Twenty patients (54 %) had predominant gastric corrosive injury. The oesophageal stricture in other 17 patients (46 %) could be managed easily by endoscopic dilatation. Prepyloric short gastric stricture was found in 19 patients (51 %). Surgical procedures included stricturoplasty for short strictures and gastrojejunostomy for more extensive distal gastric cicatrisation. Complications included wound infection in six (16 %) patients and pneumonitis in four (11 %) patients. All patients gained weight within 6 to 8 weeks. Management of corrosive gastric injury depends on the extent of gastric involvement, associated oesophageal stricture, and general condition of the patient. Early definitive operation and avoiding gastric resection can give satisfactory outcome.