Shuwail Anas Mohammed, Al-Amry Ali Lotf, Obadiel Yasser Abdurabo, Alsurmi Mohammed Mohammed, Al-Dhubaibi Afaf Mohammed, Al-Hubaishi Jalal Mohammed, Jowah Haitham Mohammed
Department of Surgery, Al-Thawra Modern General Hospital, Sana'a City, Yemen.
Department of Surgery, Amran University, Amran, Yemen.
Qatar Med J. 2025 Aug 12;2025(3):74. doi: 10.5339/qmj.2025.74. eCollection 2025.
This study aims to evaluate the outcomes of surgical treatment in adult and pediatric patients with post-corrosive gastric outlet obstruction (GOO) in Yemen.
A prospective observational study was conducted at Al-Thawra Modern General Hospital (TMGH), from January 1, 2019 to January 31, 2023. The study involved 77 patients, comprising both adults and children, who were admitted for surgical treatment of post-corrosive GOO. Data were collected from medical records, patient interviews, and follow-up visits.
Among the 77 patients, 77% ( = 59) were pediatric patients and 23% ( = 18) were adults. The mean age of the cohort was 10.6 years, with an average age of 4.12 years for pediatric patients and 30.8 years for adults. The primary cause of post-corrosive GOO was the accidental ingestion of acidic substances, accounting for 97% of cases. Common symptoms at presentation included vomiting, early satiety, and weight loss. Definitive surgery was performed in one stage in 95% of patients, with Heineke-Mikulicz pyloroplasty being the most common procedure (82%) in pediatric cases, whereas gastrojejunostomy was mainly used in adults (67%). Postoperative complications occurred in 22% of patients, with vomiting, wound infection, and aspiration pneumonia being the most common. Anastomotic restriction was observed in two pediatric patients who required reoperation. The overall mortality rate was 1.3%, with one pediatric patient having succumbed. Notably, improvements in GOO symptoms were observed in 96% of patients. Pediatric patients had a longer median hospital stay (6.5 days) than adult patients (6 days).
Corrosive injuries, particularly in the pediatric population, pose a significant issue in Yemen due to the unsafe storage of sulfuric acid. It is recommended to conduct early surgical interventions within 4 weeks after ingestion to prevent weight loss and to reduce prolonged hospitalization. Further research and interventions are needed to prevent such injuries, improve public awareness, and regulate the sale and storage of corrosive substances.
本研究旨在评估也门成年和儿科腐蚀性胃出口梗阻（GOO）患者的手术治疗效果。
2019年1月1日至2023年1月31日在萨那现代综合医院（TMGH）进行了一项前瞻性观察研究。该研究纳入了77例因腐蚀性GOO入院接受手术治疗的患者，包括成人和儿童。数据收集自病历、患者访谈及随访。
77例患者中，77%（n = 59）为儿科患者，23%（n = 18）为成人。队列的平均年龄为10.6岁，儿科患者平均年龄为4.12岁，成人患者平均年龄为30.8岁。腐蚀性GOO的主要原因是意外摄入酸性物质，占病例的97%。就诊时的常见症状包括呕吐、早饱感和体重减轻。95%的患者在一期进行了确定性手术，在儿科病例中，海涅克 - 米库利奇幽门成形术是最常见的手术方式（82%），而胃空肠吻合术主要用于成人（67%）。22%的患者出现术后并发症，呕吐、伤口感染和吸入性肺炎最为常见。两名儿科患者出现吻合口狭窄，需要再次手术。总死亡率为1.3%，有一名儿科患者死亡。值得注意的是，96%的患者GOO症状有所改善。儿科患者的中位住院时间（6.5天）比成人患者（6天）长。
由于硫酸储存不安全，腐蚀性损伤在也门尤其是儿科人群中是一个重大问题。建议在摄入后4周内尽早进行手术干预，以防止体重减轻并减少住院时间延长。需要进一步的研究和干预措施来预防此类损伤、提高公众意识并规范腐蚀性物质的销售和储存。
