Corrosive Induced Pyloric Obstruction With Oesophageal Sparing: A Case Report

We report an unusual case of isolated gastric outlet obstruction following ingestion of corrosive liquid by a 25 year old male banker who attempted suicide. He presented with features of gastric outlet obstruction three months following intentional ingestion of car battery fluid of concentrated sulphuric acid in an attempt to take his own life. Prior to this, patient had been on suspension from office as a result of some problems he had with his employers. He however had no prior history of psychiatric illness or peptic ulcer disease. Barium meal confirmed antro-pyloric stenosis with dilated proximal stomach and normal oesophagus. The patient underwent nutritional rehabilitation with supplemental parental and oral high calorie, high protein diet to regain some weight and offered restorative gastro-jejunostomy to by-pass the stenosis. He recovered uneventfully and had remained stable on follow up visits. Acids usually cause more damage to the stomach than the oesophagus but in this case the oesophagus escaped any form of injury thereby highlighting the relative resistance of the oesophageal mucosa to acid ingestion.