Acid corrosive injury in patients with a history of partial gastrectomy: outcome analysis

Abstract

Background: Our purpose was to delineate the characteristics and outcome of acid-corrosive injury in patients with a history of gastric resection.

Material and methods: A total of 359 patients with a history of acid-corrosive injury were retrospectively reviewed. They were grouped based on past history with group 1 consisting of 8 patients with a history of gastric surgery (6 hemigastrectomies with Billroth II gastrojejunostomy, 2 partial gastrectomies with Billroth I gastroduodenostomy) and group 2 consisting of 351 patients without a history of previous gastric surgery. Clinical data, operative findings, treatment modalities and prognoses were compared.

Results: Group 1 patients required significantly more emergency surgical interventions (p=0.016) and more frequent resection of alimentary necrosis (p=0.007). In the operative findings of those undergoing emergency laparotomy, group 1 had a slightly higher incidence of total gastric necrosis with or without perforation (p=0.388), and a higher incidence of jejunal resection (p=0.001). However, group 1 patients had a relatively lower operative mortality rate compared to group 2 patients (p=0.640).

Conclusion: Acid-injured patients with a history of previous gastric surgery tended to have a higher incidence of mandatory emergency surgical exploration and resection of the alimentary tract. With early and prompt management, a good survival rate can still be anticipated.