Contents
Introduction
ACID (CORROSIVE) INJURY TO STOMACH
Strong acids or alkalies cause corrosive injury to the stomach. Ingestion of these substances can have disastrous effects on the upper GI tract. A caustic or corrosive material destroys and eats away the tissues. They are typically acids or alkalis. Alkalis may cause less harm; they may harm the esophagus but leave the stomach unharmed. Acid ingestions can cause serious gastric outlet obstruction.
Acids
Acids are pungent liquids and are very bitter. They can be ingested only in small quantities. It can cause coagulative necrosis and the coagulum gives some protection to the primary tissues. It can accumulate in the antrum and cause severe pyloric spasms, damaging the stomach. It causes severe strictures in the pre-pyloric area. Some household acidic agents are:
- Antirust compounds – hydrochloric acid
- Sulphuric acid – found in batteries
- Toilet cleaners contain either sulphuric acid or hydrochloric acid
- Swimming pool cleaners also contain either acids
Alkalis
Alkalis are odourless and tasteless, and an individual can partake large quantities of this liquid by mistake. It takes time to pass through the esophagus due to its viscosity. Alkalis predominantly cause esophageal injury and stomach injuries are primarily ruled out. The lipoproteins contained on the mucosal surface are destroyed consequentially penetrating the muscular layers. It causes liquefaction necrosis or colliquative necrosis where the tissue gets transformed into a liquid mass. It can also cause severe inflammatory reactions leading to vascular thrombosis and necrosis. Alkalis are found in household agents such as:
- Denture cleaning tablets
- Bleach
- Washing powders and detergents
- Drain cleaners NaOH 4 to 54% of sodium hydroxide
- Hair straighteners contain lye or potassium carbonate
Symptoms
- Stridor – affecting the larynx and pharynx – high pitched breathing sound due to blockage in the throat
- Laryngitis – swelling and inflammation of the voice box
- Hoarseness – difficulty making sounds whilst trying to speak
- Dysphagia – difficulty in swallowing
- Odynophagia – painful swallowing in the oropharynx or esophagus
- Epigastric pain – pain concentrated on the upper abdomen
- Hematemesis – vomiting of blood
- Hypotension – blood pressure is lower than normal
- Peritonitis – inflammation of the peritoneum
- Chest pain
- Fever
