Abstract
Corrosive ingestion in children is a common problem in low income countries. These agents cause injuries and later strictures of esophagus and stomach. Gastric outlet obstruction is known complication of acids and surgery is the mainstay of treatment. There are multitude of surgical options for these strictures depending on the involved segment of the stomach and experience of the surgeon. Here we present three cases of children who accidentally ingested acid stored in soda bottles and subsequently developed isolated pyloric strictures. These cases presented between August 2018 and April 2019 to our facility, a tertiary care hospital in Karachi, Pakistan. All three patients had an initial latent period of one to two weeks following corrosive ingestion, after which symptoms of gastric outlet obstruction appeared. Intraoperatively, all three had normal esophagus and antrum but scarred and strictured pylorus. Heineke-Mikulicz pyloroplasty was done in these cases without complications and the outcomes were satisfactory.
Highlights
Accidental corrosive ingestion in the pediatric age group is quite common in low middle income countries (LMICs), because these agents are readily available in unsafe packing and accessible to children in households
We report three cases of isolated pyloric stricture caused by corrosive ingestion managed at The
Corrosive ingestion causing injury to the stomach was first reported in 1882 but it was not until 1962 that Karon described the pathophysiological events leading to pyloric stenosis in adult patients.[6]
Summary
Accidental corrosive ingestion in the pediatric age group is quite common in low middle income countries (LMICs), because these agents are readily available in unsafe packing and accessible to children in households. The child drunk from a soda bottle in which toilet cleaner had been stored He was initially taken to a local hospital in his native town from where he was discharged after 24 hours of observation and good oral intake. He started vomiting 10 days after ingestion. The child was discharged three days later when he tolerated full feed He was followed up and nine months post-surgery, he was tolerating oral diet well and gaining weight. Heineke-Mikulicz pyloroplasty was performed with a trans anastomotic nasojejunal tube left in place, through which feeding was started 24 hours later She started oral feeds on fifth day and reached full feeds on the seventh postoperative day before eventual discharge. At her most recent outpatient followup, two months post procedure, she was gaining weight steadily on a full oral diet
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