Lowe J E, Graham D Y, Boisaubin E V, Lanza F L
Am J Surg. 1979 Jun;137(6):803-6. doi: 10.1016/0002-9610(79)90099-0.
Most physicians recognize that the ingestion of lye is associated with severe esophageal damage. It is much less widely known that gastric injury is the predominant finding when acid is ingested. We are reporting on five patients who had severe gastric damage after ingestion of diluted sulfuric acid (three cases), capsules of potassium hydroxide, and Clinitest tablets (one case each). Fiberoptic endoscopy was used to localize the extent and severity of injury and to follow the evolution of the damage. The extent and location of injury varied with the amount and type of agent ingested. Acid ingestion resulted in severe gastritis, which eventually led to antral stenosis and gastric outlet obstruction requiring operative intervention in two cases. Potassium hydroxide capsules produced diffuse esophagitis, gastritis, and a non-healing large gastric ulcer. Clinitest tablets produced distal esophagitis and stricture and antral damage leading to gastric outlet obstruction which required operative intervention. These cases demonstrate the natural history of corrosive injury to the stomach and the value of fiberoptic endoscopy in the management of this problem.
大多数医生都认识到，摄入碱液会导致严重的食管损伤。但鲜为人知的是，摄入酸时，主要的损伤部位是胃。我们报告了5例患者，他们在摄入稀释硫酸（3例）、氢氧化钾胶囊和Clinitest片剂（各1例）后出现了严重的胃损伤。使用纤维内镜来确定损伤的范围和严重程度，并跟踪损伤的演变过程。损伤的范围和位置因摄入物质的量和类型而异。摄入酸会导致严重的胃炎，最终导致胃窦狭窄和胃出口梗阻，其中2例需要手术干预。氢氧化钾胶囊导致弥漫性食管炎、胃炎和一个不愈合的大胃溃疡。Clinitest片剂导致远端食管炎和狭窄以及胃窦损伤，导致胃出口梗阻，需要手术干预。这些病例展示了胃腐蚀性损伤的自然病程以及纤维内镜在处理这一问题中的价值。
