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Esophagogastric Complications After Caustic Ingestion: A Case Report
Carla Valencia1, Jose Prieto2, Javier Jara3
1Internal Medicine, Facultad de Medicina-Universidad del Azuay, Cuenca, ECU.
Cureus
|August 15, 2022
Summary
Corrosive agent ingestion causes severe gastrointestinal injury, leading to complications like esophageal stenosis and gastric outlet obstruction. Prompt recognition and grading of these lesions are crucial for patient outcomes.
Area of Science:
- Gastroenterology
- Toxicology
- Surgical Gastroenterology
Background:
- Ingestion of corrosive agents (acids or alkalis) is a significant cause of gastrointestinal (GI) tract injury.
- While accidental in children, adult ingestion is often linked to suicidal attempts, presenting with severe GI symptoms.
Observation:
- A 25-year-old male with a history of suicidal attempt presented with significant unintentional weight loss, dysphagia, emesis, and regurgitation.
- Endoscopic evaluation revealed severe esophageal stenosis (90%), esophagitis (Zargar 3a), and total pyloric stenosis.
- Initial dilation attempts were complicated by bleeding, necessitating hospitalization and a second procedure.
Findings:
- Successful esophageal dilation was achieved during the second endoscopy.
- Pyloric dilation was unsuccessful, leading to the performance of a jejunostomy for enteral nutrition by a hepato-pancreato-biliary surgeon.
- Caustic ingestion can result in acute injuries (laryngospasms, perforations, necrosis) and long-term sequelae (esophageal stenosis, gastric outlet obstruction, esophageal cancer).
Implications:
- This case underscores the importance of prompt recognition, accurate grading of corrosive GI injuries, and timely intervention.
- Effective management strategies are vital for improving patient prognosis and long-term outcomes following caustic agent ingestion.
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