Abstract
Isolated involvement of the lower gastrointestinal tract with relative sparing of the oesophagus and the stomach is extremely rare following corrosive agent ingestion. We report a case of isolated full thickness jejunal necrosis following sulphuric acid cocktail ingestion. A 42 year old man presented with history of consuming 200ml of sulphuric acid mixed with alcohol, with suicidal intent. On exploration there were multiple, full thickness necrotic areas in the proximal jejunum with minimal congestion of the oesophagus, stomach and duodenum. Inversion of the jejunal necrotic areas with feeding jejunostomy was carried out. However postoperatively patient developed progressive pulmonary insufficiency with features of sepsis and expired on the nineteenth day following a bout of massive haematemesis. Corrosive agents when taken in considerable amount mixed with other fluids can lead to full thickness small bowel necrosis with relative sparing of the proximal gastrointestinal tract.
Highlights
Accidental or suicidal ingestion of sulphuric and hydrochloric acids, leading to esophagogastric injury is not uncommon [1,2,3]
We report a case of isolated full thickness jejunal necrosis following sulphuric acid cocktail ingestion
Corrosive agents when taken in considerable amount mixed with other fluids can lead to full thickness small bowel necrosis with relative sparing of the proximal gastrointestinal tract
Summary
Accidental or suicidal ingestion of sulphuric and hydrochloric acids, leading to esophagogastric injury is not uncommon [1,2,3]. Concomitant acid injury of the lower gastrointestinal tract is a rare occurrence due to acid induced pylorospasm with consequent gastric pooling, and neutralizing effect of the bile [1,5,6,7]. Isolated necrosis of the lower gastrointestinal tract with relative sparing of the proximal gastrointestinal tract is extremely rare with limited reports [2,4,5]. We present a case of isolated full thickness jejunal necrosis with relative sparing of the proximal gastrointestinal tract following sulphuric acid cocktail ingestion
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