Abstract
Aim: Evaluate clinical pattern, diagnosis, surgical management and outcome of Gastric outlet obstruction in children post accidental ingestion corrosive (sulfuric acid of battery) , also role of continuing public education to reduce and avoid incidence these unfortunate events. Patients & method: prospective study for 20 patients’ children with isolated gastric outlet obstruction post corrosive sulfuric acid ingestion was admitted and operated in Saudi hospital at Hajjah Yemen in period April 2015_April 2021. The study evaluates patients’ demographic data, clinical presentation, diagnosis and management, also included in this study the Comparison proportions between two surgical procedures used for management this patient (group (A) pyloric resection and gastroduodenostomy and group (B) gastrojejunostomy with Braun anastomosis) with P value >0.05 was non-significant. Results: Twenty patients with gastric outlet obstruction (12 boys and 8 girls), (Mean age was 4.5). Main presenting symptom recurrent attacks vomiting and loss of weight. The interval between acid ingestion and presentation ranged from 3_4weeks(mean=3.5weeks). The History, Barium swallow and meal used as diagnostic tool because safe, inexpensive. Surgical procedure included group (A)pyloric resection and gastroduodenostomy (n=10) and group (B) gastrojejunostomy with Braun anastomosis (n=10). Comparison between the two surgical procedures show all safe, less morbid, no mortality and no significant difference in end outcome result follow-up period up 2 years, all patients are symptoms free and gained adequate weight. Conclusion: for patients children post corrosive accident ingestion with gastric outlet obstruction The History, barium swallow and meal used as diagnostic tool. Early surgery between 4_6 weeks by resection or bypass remains the treatment of choice with best result. To prevent these unfortunate events by encourage the Family education about clear labelling of dangerous substances and keeps this substance Far from reaching the kids. Key word: corrosive induce gastric outlet obstruction; pyloric stricture; gastric outlet obstruction in pediatrics
Highlights
Acid ingestion causing injury to the stomach was first reported in 1882, but it absolutely was not until 1962 that Karon described the pathophysiological events leading to stricture in those patients[1]
Comparisons between two types of operations procedure used for management gastric outlet obstruction post sulfuric acidic ingestion in our patients
Procedure was divided into two groups, group A pyloric stricture resection and gastroduodenostomy ( Billroth 1 ) and group B posterior gastro-jejunostomy with Braun anastomosis
Summary
Acid ingestion causing injury to the stomach was first reported in 1882, but it absolutely was not until 1962 that Karon described the pathophysiological events leading to stricture in those patients[1]. Children are in danger of the accidental exposure to such substances thanks to inadequate parental supervision and careless storing of these chemicals at homes [3]. Both acid and alkali when consumed, cause significant injury to the upper digestive tract. The stomach isolated injury with resulting in stenosis is extremely rare, accounting to as little as 3.8% of all the cases of corrosive ingestion, as reported in literature [5].
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