engleski

Massive necrosis of the upper gastrointestinal tract with acute gastric perforation and metabolic acidosis after hydrochloric acid ingestion.

Hydrochloric acid (HCI ; pH, I) is a widespread product in households around the world, used as a toilet c1eaner.As an easy available substance it becomes one of the main causes of the corrosive injuries of the gastrointestinal tract. According to literature, acid causes around 90% of all injuries of the esophagus and stomach and two- thirds of these events occur because of accidental ingestion by children under the age of 6 years. Intentional injury is associated with suicidal ingestion and various psychiatric disorders. While ingestion of alkali resu Its primarily in esophageal damage, acids tend to spare the esophagus and produce necrosis of the stomach as in thermal burns. The mechanism of damage is also different ; alkalis produce liquefaction necrosis and acids coagulation necrosis. The most important complications after corrosive substance ingestion are esophageal and gastric burns and necrosis (which may result in severe strictures), perforations and bleeding. The extent and the severity of corrosive gastric injury is directly related to the concentration and amount of acidic substance as well as the period of time in the stomach, and to the amount of gastric content at the time of ingestion.We are reporting a case of massive necrosis of the upper GI tract with acute gastric perforation and rnetabo!ic acidosis due to suicidal acid ingestion, and discussing its c1inical presentation, course, management 'and pathological findings.

HCl acid ; gastrointestinal tract ; perforation

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