Acute corrosive injury most commonly affects the upper aerodigestive tract and may necessitate emergency surgery in a minority of cases when transmural necrosis develops. The present case manifested with multiorgan dysfunction and subsequently deteriorated, developing acute peritoneal signs that required emergency surgical intervention. Intraoperatively, the distal thoracic esophagus and proximal stomach appeared unexpectedly viable; however, there was extensive transmural circumferential gangrene involving the distal stomach, duodenal C-loop, and proximal jejunum. A surgical decision between pancreatoduodenectomy and pancreas-sparing duodenectomy was required. Given the patient’s poor general condition and hemodynamic instability, pancreas-sparing duodenectomy with ampullo-jejunal anastomosis was performed. Although the postoperative course was complicated, the patient gradually recovered and was discharged on an oral liquid diet. This report outlines the complexities associated with such atypical presentations and emphasizes the importance of individualized surgical decision-making and multidisciplinary postoperative care in the comprehensive management of acute corrosive injuries.
Chundru et al. (Tue,) studied this question.