Surgical management of post corrosive acid ingestion symptomatic gastric outlet obstruction: single institute experience in 81 patients

Sushruth Shetty, Premal R. Desai, Mahendra S. Bhavsar, Hasmukh B. Vora, Laxman S. Khiria, Nikhil Jillawar, Ajay Kumar Yadav


Background: Corrosive injury resulting in gastric outlet obstruction (GOO) is fairly uncommon in world literature. We aim to study the socio-demographic variables of corrosive acid ingestion patients presenting as symptomatic GOO, along with the surgical procedure performed in these patients, post-operative complications and long term follow up data.

Methods: We included all patients with clinical features of gastric outlet obstruction following acid ingestion, who were operated in our department between January 2006 and April 2017. We collected patient’s demographic data, parameters during surgery, body weight and nutritional status pre- and post-operatively, which were all derived from case records and outpatient records. Follow up data of the patient were collected when possible.

Results: During the study period, 81 patients were enrolled in the study; 42 males, average age 35.76±3.53 years, 82% had suicidal intent of ingestion and 18% accidental; average follow-up period was 80.5 months. After an average period of 6 months, 94% underwent loop gastrojejunostomy. Approximately, 22% suffered complications like surgical site infections, postoperative fever, pulmonary infections and postoperative vomiting. Average follow up of 6.7 years done in 68 patients who underwent only bypass without resection, none of the patients developed any malignancy of upper gastrointestinal tract.

Conclusions: Staged treatment for GOO patients was seen to be associated with good clinical outcomes and few complications. Bypass of cicatrised stomach without resection gives acceptable results.


Complication, Corrosive, Gastric, Gastro-jejunostomy, Malignancy

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Shone DN, Nikoomanesh P, Smith-Meek MM, Bender JS. Malignancy is the most common cause of gastric outlet obstruction in the era of H2 blockers. Am J Gastroenterol. 1995;90(10).

Jaffin BW, Kaye MD. The prognosis of gastric outlet obstruction. Ann Surg. 1985;201(2):176-9.

Keh SM, Onyekwelu N, McManus K, McGuigan J. Corrosive injury to upper gastrointestinal tract: Still a major surgical dilemma. World J Gastroenterol. WJG. 2006;12(32):5223.

Agarwal S, Sikora SS, Kumar A, Saxena R, Kapoor VK. Surgical management of corrosive strictures of stomach. Indian J Gastroenterol. 2003;23(5):178-80.

Urban Agglomerations/Cities having population 1 lakh and above. Census of India website. Available at accessed April 28, 2017.

McAuley CE, Steed DL, Webster MW. Late sequelae of gastric acid injury. Am J Surg. 1985;149(3):412-5.

Doberneck RC, Berndt GA. Delayed gastric emptying after palliative gastrojejunostomy for carcinoma of the pancreas. Arch Surg. 1987;122(7):827-9.

Ciftci AO, Senocak ME, Büyükpamukçu N, Hiçsönmez A. Gastric outlet obstruction due to corrosive ingestion: incidence and outcome. Pediatr Surg Int. 1999;15:88.

Swain R, Behera C, Gupta SK. Fatal corrosive ingestion: A study from South and South-East Delhi, India (2005-2014). Medicine, Science and the Law. 2016;56(4):252-7.

Gupta V, Wig JD, Kochhar R, Sinha SK, Nagi B, Doley RP, Gupta R, Yadav TD. Surgical management of gastric cicatrisation resulting from corrosive ingestion. Int J Surg. 2009;7(3):257-61.

Tseng YL, Wu MH, Lin MY, Lai WW. Early surgical correction for isolated gastric stricture following acid corrosion injury. Digestive Surg. 2002;19(4):276-80.

Hwang TL, Chen MF. Surgical treatment of gastric outlet obstruction after corrosive injury--can early definitive operation be used instead of staged operation?. International Surg. 1995;81(2):119-21.

Ti TK. Oesophageal carcinoma associated with corrosive injury prevention and treatment by oesophageal resection. Br J Surg. 1983;70(4):223-5.

Zamir O, Hod G, Lernau OZ, Mogle P, Nissan S. Corrosive injury to the stomach due to acid ingestion. American Surgeon. 1985;51(3):170-2.