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KMID : 0371319710130070023
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Journal of the Korean Surgical Society
1971 Volume.13 No. 7 p.23 ~ p.32
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The Surgicl Managements and Patterns of Pathological Changes of the Stomach due to Ingestion of the Corrosive Substances
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鄭永煥/Jung, Young Whan
金共秀/池幸玉/金近鎬/Kim, Kong Soo/Jee, Heng Ok/Kim, Kun Ho
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Abstract
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The pathological changes of the stomach caused by ingestion of the corrosive substanses have
been studied in the acute and chronic states. The various surgical managements according to the
pathological findings and deformities of the stomach were described. The literature on the subject
is reviewed.
pahological change of the stomach associated with corrosive esopahgeal stricture occured in 11
cases (10.9%) among a total of 101 cases of corrosive esophageal structure.
The patterns of pahological change of the stomach may be classified to the five type as follows;
Type 1 : Extensive gastric demucosation due to corrosion, gastric hemorrhage and dilatation
of stomach . (acute stage)
Type 2 : kidney-form deformity due to extensive gastric demucosation and contraction of the
entire stomach. (acute stage)
Type 3 : Hour-glass deformity due to cicatric contraction between antrum, and body of the
stomach (chronic stage)
Type 4 : Pyloro-antral obstruction due to cicatric contraction and dilatation of hundus because an
accumulation of the gastric juice. (chronic stage)
Type 5 : Total necrosis of the esophagus and the stomach, acute peritonitis due to multipe
perforation of the gastric juice. (chronic stage)
The chronic corrosive gastritis was found mostly in the laparotomy for feeling gastrostomy,
because the gastric symptoms were concealed by the symptoms of primary esophageal processes.
Owing to the various paholigi patterns of the stomach above mentioned, surgical approach
to corrosive gstritis associater with corrosive esophageal stricture is accordingly complicated
and the following different procedures were properly used case by case at the time of feeding
gastrostomy. That is, gastric resection by BillrothrⅠtype or Roux-en-Y gastrojejubnostomy for
complete obstraction of entire gastric antrum, and modified Heller´s operation for Hour-glass
deformity of antrum with feeding gastrotomy or feeding jejunostomy. For Kidney-from deformity
was performed only feeding jejunostomy.
When nutritional condition of the patient had been improved following gastrostomy, retristernal
esophagoplasty uwing the right colon or the left colon was performed for corrosive esophageal
stricture.
Five cases (45.5%) of the total 11 cases of corrosive gastriris associated with corrosive esoph
ageal stricture were expired and the rest of 6 cases (54.5%) were survived with accomplishment
of the first stage surgical precedures. Three cases among the survives of 6 cases received the second
stage esophagoplasty with good result and the other 3 cases are planned to have esophagoplasty
in future.
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