SURGICAL MANAGEMENT FOR CORROSIVE ANTROPYLORIC STRICTURES: RETROSPECTIVE ANALYSIS IN A TERTIARY CARE SETTING

Background: Corrosive Oesophagogastric injuries are widely prevalent in India with a subset of individuals presenting with isolated antropyloric strictures without oesophageal and proximal gastric strictures. These strictures often progress to gastric outlet obstruction (GOO). Thorough evaluation to define the extent of stricture and appropriate management of isolated gastric injuries yield favourable outcomes with morbidity compared to extensive corrosive injuries. Materials and Methods: We conducted a retrospective analysis of 12 patients who underwent Antrectomy with Billroth-1 reconstruction for isolated Antropyloric stricture following corrosive ingestion at the Department of General Surgery, Basaveshwara Teaching and General Hospital affiliated with Mahadevappa Rampure Medical College, Kalaburagi, from November 2022 to April 2024. Extent of gastric cicatrisation was evaluated by upper GI Endoscopy and Barium study. Nutritional support, if required, was provided via feeding jejunostomy, followed by definitive operation performed between 3rd to 6th month post ingestion. Patients were followed by upper GI endoscopy. Results: All patients had isolated antropyloric stricture without any oesophageal or proximal gastric involvement. 82% had suicidal intent of ingestion and 18% accidental. Antrectomy with Billroth-1 anastomosis was performed. The postoperative period was uneventful, with no instances of anastomotic leak or intra-abdominal collection. All patients gained weight within 8 weeks. Conclusion: Ingestion of corrosive carries high late morbidity. Surgery is the mainstay of management for corrosive-induced gastric injuries with good short- & long-term results. Surgical procedure should be tailored according to the patient\'s general condition and extent of gastric injury. We advocate resection to eliminate the risk of malignancy in the scarred stomach, and the potential risk of stomal ulceration following gastrojejunostomy. Keywords: Corrosive injury, antropyloric stricture, antrectomy, Billroth-1 anastomosis.