Endoscopic balloon dilatation in caustic-induced gastric outlet obstruction: case report

Sergio Morales-Moreno; Fernando Rivero-Yañez; Yoeli Marisa Escandon Espinosa; Katia Daniela López García; Carlos García-Arredondo; Ana Lilia Abundez-Pliego; Alan Isaac Valderrama-Treviño

doi:10.18203/2320-6012.ijrms20220527

Authors

Sergio Morales-Moreno Department of Gastrointestinal Endoscopy, Bicentennial Independence High Specialty Regional Hospital, ISSSTE, State of Mexico, Mexico
Fernando Rivero-Yañez Department of Gastrointestinal Endoscopy, Bicentennial Independence High Specialty Regional Hospital, ISSSTE, State of Mexico, Mexico
Yoeli Marisa Escandon Espinosa Department of Gastrointestinal Endoscopy, Bicentennial Independence High Specialty Regional Hospital, ISSSTE, State of Mexico, Mexico
Katia Daniela López García Department of Gastrointestinal Endoscopy, Bicentennial Independence High Specialty Regional Hospital, ISSSTE, State of Mexico, Mexico
Carlos García-Arredondo Department of Gastrointestinal Endoscopy, Bicentennial Independence High Specialty Regional Hospital, ISSSTE, State of Mexico, Mexico
Ana Lilia Abundez-Pliego Department of Surgery, PEMEX General Hospital, Ciudad del Carmen, Mexico
Alan Isaac Valderrama-Treviño Department of Angiology, Vascular and Endovascular Surgery, HGM, Dr. Eduardo Liceaga, CDMX, Mexico

DOI:

https://doi.org/10.18203/2320-6012.ijrms20220527

Keywords:

Caustic ingestion, Caustic-induced gastric outlet obstruction, Endoscopy, Endoscopic balloon dilatation, Acid injuries, Alkali injuries

Abstract

The ingestion of caustic substances is a not infrequent problem that requires multidisciplinary, medical, surgical and endoscopic management, since it can cause minor burns to total necrosis of the digestive tract wall. A 76 years old male patient with a history of chronic alcoholism presented to the emergency department complaining of heartburn and abdominal pain after ingesting muriatic acid, accidentally mistaking it for alcohol. Computed tomography (CT) scan showed no signs of perforation and endoscopy revealed grade IIIB stomach burns. On day 45 a new endoscopy was performed, documenting fibrosis scars in the antrum with significant retraction and secondary pyloric stenosis, which was managed with endoscopic balloon dilatation (EBD) without complications. In this case, as in most patients with caustic-induced gastric outlet obstruction (GOO) can be successfully treated by EBD.

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References

Nunez MJ, Loeb PM. Caustic injury to the upper gastrointestinal tract. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran. Gastrointestinal and liver disease. Pathophysiology, diagnosis, management. Philadelphia: WB Saunders Company; 2006; 515-24.

Gumaste VV, Pradijuman BD. Ingestion of corrosive substances by adults. Am J Gastroenterol. 1992;87(1):11-5.

Byme WJ. Forein bodies, bezoars and caustic ingestion. Gastrointest Endosc Clin N Am. 1994;4(1):99-119.

Vargas BO, Salgado E, Teves P, Ventura S, Calderón E. Caustics injuries in the upper gastrointestinal tract: clinical and endoscopic features. Rev Gastroenterol Peru. 2016;36(2):135-42.

Jones A. Caustic ingestions. Techniq Gastrointest Endosc. 2002;4(4):196-200.

Hoffman RS, Howland MA, Kamerow HN, Goldfrank LR. Comparison of titratable acid/alkaline reserve and pH in potentially caustic household products. J Toxicol Clin Toxicol. 1989;27(4-5):241-6.

Dantas RO, Mamede RC. Esophageal motility in patients with esophageal caustic injury. Am J Gastroenterol. 1996; 91(6):1157-61.

Contini S, Scarpignato C. Caustic injury of the upper gastrointestinal tract: a comprehensive review. World J Gastroenterol. 2013;19(25):3918-30.

Ramírez JMR. Control and medical treatment for ingestion of caustic substances. Medisan. 2010;14(3):406.

Hoffman RS, Burns MM, Gosselin S. Ingestion of Caustic substances. N Engl J Med. 2020;382(18):1739-48.

Bautista CA, Estevez ME, Varela CR, Jeremias AV, Sierra RT, Cadranel S. A retrospective analysis of caustic ingestion substances by children. Ten-year statistics in Galicia. Eur J Pediatr. 1997;156(5):410-4.

Rocha N, Aponte D, Montoya R. Muriatic acid: digestive exposure, case report and literature review. Rev Col Gatroenterol. 2011;26(4):328-31.

Chirica M, Bonavina L, Kelly MD, Sarfati E, Cattan P. Caustic ingestion. Lancet 2017;389(10083):2041-52.

Panieri E, Rode H, Millar AJ, Cywes S. Esophageal replacement in the management of corrosive strictures: when surgery indicated? Pediatr Surg Int. 1998;13(5-6):336-40.

Cowan D, Ho B, Sykes KJ, Wei JL. Pediatric oral burns: a ten-year review of patient characteristics, etiologies and treat- ment outcomes. Int J Pediatr Otorhinolaryngol. 2013;77(8):1325-8.

Sun Y, Ge Y, Fu Y, Yan L, Cai J, Shi K, et al. Mitomycin C induces fibroblasts apoptosis and reduces epidural fibrosis by regulating miR-200b and its targeting of RhoE. Eur J Pharmacol. 2015;765:198-208.

Chirica M, Kelly MD, Siboni S, Aiolfi A, Riva CG, Asti E, et al. Esophageal emergencies: WSES guidelines. World J Emerg Surg. 2019;14:26.

Kochhar R, Malik S, Reddy YR, Mallick B, Dhaka N, Gupta P. Endoscopic balloon dilatation is an effective management strategy for caustic-induced gastric outlet obstruction: a 15-year single center experience. Endosc Int Open. 2019;7(1):53-61.

Contini S, Scarpignato C. Caustic injury of the upper gastrointestinal tract: a comprehensive review. World J Gastroenterol. 2013;19(25):3918-30.

Methasate A, Lohsiriwat V. Role of endoscopy in caustic injury of the esophagus. World J Gastrointest Endosc. 2018;10(10):274-82.