Gastric perforation after corrosive ingestion

Abstract

Purpose: To describe a series of children with gastric perforation (GP) after corrosive ingestion.

Methods: Case notes of children treated for GP complicating corrosive ingestion between May 2001 and April 2010 were retrospectively reviewed.

Results: Seventy-six children with corrosive ingestion were treated during the study period of which 5 (6.6%) developed GP. This complication was evident on admission in one case and developed within 48 h in the others. The major clinical findings were abdominal pain, tenderness, and distension with radiologic evidence of pneumoperitoneum. Associated pathology included necrosis of the abdominal esophagus in one case and duodenal perforation in another. Two cases have died during surgery while three survived with free of complications related to GP repair. Two patients developed gastric outlet obstruction (one with an esophageal stricture) on follow-up.

Conclusions: GP is a rare but major complication of corrosive ingestion. Children who swallow corrosives should be closely monitored and pediatric surgeons should be aware of this potential early complication. The possibility of associated pathology should be considered when undertaking surgical repair.