Corrosive-induced gastric outlet obstruction in children: a retrospective observational study from a tertiary care center in Bihar, India.
DOI:
https://doi.org/10.51168/sjhrafrica.v7i3.2727Keywords:
Corrosive ingestion, Gastric outlet obstruction, Pediatric, Acid injury, Alkali injuryAbstract
Background:
Corrosive ingestion remains an important cause of gastrointestinal injury in children, particularly in developing countries. Gastric outlet obstruction (GOO) is a serious delayed complication resulting from fibrosis and stricture formation following corrosive injury.
Objective:
To evaluate the clinical profile, management strategies, and outcomes of children with corrosive-induced gastric outlet obstruction.
Methods:
A retrospective observational study was conducted in the Department of Pediatric Surgery, Government Medical College & Hospital, Purnea, Bihar, India, between January and August 2025. Medical records of 100 children diagnosed with corrosive-induced GOO were reviewed. Demographic characteristics, type of corrosive agent, clinical presentation, endoscopic findings, treatment modalities, and outcomes were analyzed. Chi-square test was used to assess the association between corrosive type and severity of obstruction.
Results:
Among 100 children, 62.0% were aged 3–6 years. Acid ingestion accounted for 68.0% of cases, while alkali ingestion accounted for 32.0%. Vomiting (92.0%) and weight loss (74.0%) were the most common presenting symptoms. Endoscopy revealed pyloric stricture in 81.0% of patients. Surgical management was required in 56.0% of cases, whereas 44.0% were managed conservatively. A significant association was observed between acid ingestion and severe gastric outlet obstruction (χ²=6.45, p=0.011). Clinical improvement occurred in 78.0% of patients, while complications and mortality were observed in 14.0% and 8.0%, respectively.
Conclusion:
Corrosive-induced gastric outlet obstruction remains a significant cause of morbidity in children. Early diagnosis and individualized management improve clinical outcomes.
Recommendation:
Community awareness regarding safe storage of corrosive substances and prompt medical evaluation following ingestion should be strengthened to reduce preventable complications.
References
Contini S, Scarpignato C. Caustic injury of the upper gastrointestinal tract: A comprehensive review. World J Gastroenterol. 2013;19:3918-3930. https://doi.org/10.3748/wjg.v19.i25.3918
Ramasamy K, Gumaste VV. Corrosive ingestion in adults. J Clin Gastroenterol. 2003;37:119-124. https://doi.org/10.1097/00004836-200308000-00005
Zargar SA, Kochhar R, Mehta S, Mehta SK. The role of fiberoptic endoscopy in the management of corrosive ingestion. Gut. 1991;32:1333-1337.
Kay M, Wyllie R. Caustic ingestions in children. Curr Opin Pediatr. 2009;21:651-654. https://doi.org/10.1097/MOP.0b013e32832e2764
Anderson KD, Rouse TM, Randolph JG. A controlled trial of corticosteroids in children with corrosive injury. J Pediatr Surg. 1990;25:327-330. https://doi.org/10.1056/NEJM199009063231004
Kikendall JW. Caustic ingestion injuries. Gastroenterology. 1991;100:178-182.
Howell JM, Dalsey WC, Hartsell FW. Steroids for the treatment of corrosive esophageal injury. Ann Emerg Med. 1992;21:1091-1094. https://doi.org/10.1016/S0196-0644(05)82815-X
Previtera C, Giusti F, Casati A. Caustic ingestion in children. Pediatr Surg Int. 1990;5:332-335.
Bautista Casasnovas A, Estevez Martinez E, Varela Cives R. A retrospective analysis of caustic ingestion in children. J Pediatr Gastroenterol Nutr. 1997;25:286-291.
Katzka DA. Caustic injury to the esophagus. Am J Gastroenterol. 2001;96:1116-1119. https://doi.org/10.1007/s11938-001-0047-x
Cheng HT, Cheng CL, Lin CH, Tang JH. Caustic ingestion in adults: The role of endoscopic classification. World J Gastroenterol. 2008;14:451-455. https://doi.org/10.1186/1471-230X-8-31
Ertekin C, Alimoglu O, Akyildiz H. The results of caustic ingestions. Pediatr Surg Int. 2004;20:599-603.
Tekant G, Eroglu E, Erdogan E. Corrosive injury-induced gastric outlet obstruction. J Pediatr Surg. 2001;36:1014-1017. https://doi.org/10.1053/jpsu.2001.24725
Ananthakrishnan N, Parthasarathy G, Kate V. Chronic corrosive injuries of the stomach. Natl Med J India. 2010;23:27-31.
Lahoti D, Broor SL, Basu PP. Corrosive esophageal strictures: Predictors of response to dilation. Gastrointest Endosc. 1995;41:196-200. https://doi.org/10.1016/S0016-5107(95)70337-3
Pelclova D, Navratil T. Do corticosteroids prevent oesophageal stricture after corrosive ingestion? Hum Exp Toxicol. 2005;24:125-129. https://doi.org/10.2165/00139709-200524020-00006
Cheng YJ, Kao EL, Lin CC. Surgical management of gastric outlet obstruction after corrosive injury. BMC Gastroenterol. 2010;10:68-72.
Gupta SK, Croffie JM, Fitzgerald JF. Is esophagoscopy necessary in all caustic ingestions? Indian J Pediatr. 2001;68:857-860.
Poley JW, Steyerberg EW, Kuipers EJ. Ingestion of acid and alkaline agents. Gastrointest Endosc. 2004;60:372-377.https://doi.org/10.1016/S0016-5107(04)01722-5
Huang YC, Ni YH, Lai HS. Corrosive esophagitis in children. Pediatr Neonatol. 2011;52:306-310.
Wu MH, Lai WW, Lin MY. Surgical treatment for gastric outlet obstruction after corrosive injury. J Formos Med Assoc. 2010;109:82-86.
Betalli P, Falchetti D, Giuliani S. Caustic ingestion in children: Predictive factors. Endoscopy. 2008;40:547-552.
Christesen HB. Prediction of complications following unintentional caustic ingestion. Acta Paediatr. 1994;83:212-215. https://doi.org/10.1111/j.1651-2227.1994.tb13053.x
World Health Organization. Guidelines for the prevention of poisoning. Geneva: WHO; 2008.
American Society for Gastrointestinal Endoscopy. Guideline on management of ingested caustic substances. Gastrointest Endosc. 2015;81:1-10.
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