Citation

Wato M, Inaba T, Izumikawa K, Takahashi S, Takaguchi K, Kita K, Kawai K. Gastroenterological Endoscopy 2004; 46(9): 2101-2106.

Copyright

(Copyright © 2004)

DOI

unavailable

PMID

unavailable

Abstract

A 59 years-old man was admitted to our hospital because of severe epigastralgia. The patient had ingested 100mL of 36% hydrochloric acid for the suicide purpose at home. Endoscopic examination on admission revealed the black mucosa of the esophagus and stomach. The grayish white mucosa with deep ulceration of the esophagus and the black mucosa with large ulceration of the stomach were found on 7th days. These finding suggested the necrosis of all layer of the esophageal and gastric wall. Although the patient was successfully treated with the antibiotic agent, proton pump inhibitor and intravenous hyperalimentation, swallowing disturbance was appeared during the clinical course. We treated the three portions of the esophageal stenose with balloon dilator but his symptom was not improved and he could not swallow the saliva. On the 77th hospital day, esophago-gastrectomy and substernal bypass with descending colon interposition was performed. The resected specimen showed esophagus and stomach were severely constricted and inelastic and the microscopic finding revealed the severe inflammation and fibrosis of all the layers. Intensive care including the mental support and the surgical treatment was necessary to treat corrosive injuries of gastrointestinal tract. We experienced a case of corrosive injuries of gastrointestinal tract with hydrochloric acid ingestion and showing the typical endoscopic findings during the clinical course.

Language: ja

Keywords

adult; human; male; case report; suicide attempt; hydrochloric acid; article; intensive care; caustic burn; dysphagia; esophagus burn; epigastric pain; antibiotic agent; stomach ulcer; histopathology; laboratory test; antibiotic therapy; esophagus resection; esophagus ulcer; gastrectomy; gastrointestinal endoscopy; intravenous feeding; proton pump inhibitor