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KMID : 0371319720140120013
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Journal of the Korean Surgical Society
1972 Volume.14 No. 12 p.13 ~ p.20
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Evaluation of Pathological Findings of the Stomach Following Ingestion of the Corrosive Substances
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김근호/Kim KH
지행옥/Jee HO
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Abstract
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The pathological findings of the stomach caused by ingestion of the corrosive substances have been studied in the acute and chronic states. The literature on the subject is reviewed. Pathological changes of the stomach associated with corrosive esophageal stricture occurred in 12 cases (11.5%) among a total 104 cases of corrosive esophageal stricture. The patterns of pathological changes of the stomach may be classified to the five type as follow; Type 1 : Extensive gastric demucosation, massive hemorrhage and gastric dilatation (acute stage). Type 2 : Kidney shaped deformity of the stomach with extensive corrosive demucosation of the stomach and entire gastric contraction without hemorrhage (acute stage). Type 3 : Hour-glass deformity of the stomach ring-form cicatric contraction between antrum and body of the stomach and gastric stenosis (chronic stage). Type 4 : Pyloro-antral obstruction of the stomach and cicatric contraction of entire antrum with dilatation of fundus and body due to accumulation of gastric juice (chronic stage). Type 5: Total necrosis of the esophagus and the stomach, acute peritonitis due to multiple perforation of the stomach and hepatomegaly (acute stage). Chronic corrosive gastritis was found mostly in the laparotomy for feeding gastrostomy, because the gastric symptoms were concealed by the symptoms of primary esophageal processes. Owing to the various pathological patterns of the stomach above mentioned, surgical approach to corrosive gastritis associated with corrosive esophageal stricture is accordingly complicated and the different procedures were properly used case by case at the time of feeding gastrostomy. When nutritional condition of the patient was improved following gastrostomy, retrosternal esophagoplasty using the right colon or the left colon was performed for corrosive esophageal stricture. Five cases (41.7%) of the total 12 cases of corrosive gastritis associated with corrosive esophageal stricture expired in the acute stage and the rest of 7 cases (58.3%) were survived by accomplishment of the first stage surgical procedures. 3 cases among the survivors of 7 cases received the second stage esophagoplasty with good result and the other 4 cases are planned to have esophagoplasty in future.
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