Surgical management of extensive corrosive injuries of the alimentary tract

Abstract

To evaluate the surgical results of extensive corrosive injuries of the alimentary tract, 28 patients underwent emergency operations after ingestion of massive amount of caustics. The intent to commit suicide was the motivation for all these adults. Hydrochloride acid was the most frequently ingested agent--ingested by 22 patients. Among these 28 patients, 22 underwent cervical esophagostomy, esophagogastrectomy and feeding jejunostomy or concomitant splenectomy (n = 13), or both, resulting in the morbidity rate of 18 percent and mortality rate of 9 percent; the remaining six patients additionally underwent duodenectomy, segmental jejunectomy, pancreaticojejunostomy and concomitant resections of the adjacent organs, resulting in a morbidity rate of 100 percent and mortality rate of 50 percent. Extensive corrosive injuries of the alimentary tract usually caused an uncontrollable infection. The complicated surgical interventions resulted in extensive physiologic disturbances. However, appropriate surgical management could save the lives of most of these patients, even the damage of alimentary tract extended beyond the pylorus to the jejunum.