Pyloric stricture after corrosive ingestion in children: an attempt to address the optimum management of this rarity


  • Amit Kumar Jadhav Department of Pediatric Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
  • Goutam Chakraborty Department of Pediatric Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
  • Nidhi Sugandhi Department of Pediatric Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
  • Sameer Kant Acharya Department of Pediatric Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India



Corrosive pyloric stricture, corrosive ingestion, Heineke Mickulicz pyloroplasty, Billroth I anastomosis


Corrosive ingestion in pediatric population can have devastating consequences. Pyloric stricture which is a rarer complication has not been discussed in details in existing literature. Whereas the presentation is more or less similar, a “case specific” approach may be required for the best outcome. We analyzed our series of eight patients to formulate a suitable approach to its management. This was a prospective observational study in the department of Pediatric Surgery in a tertiary health care centre in central India. Eight (n=8) patients with corrosive injuries exclusive to the pyloric antrum were analyzed with respect to the corrosive ingested, symptomatology, nutritional status, investigation findings, surgery undertaken and follow up. Total number of patients in our study were eight. Male -7 and female-1, mean age of 6.8 years, ranging from 4 and 10 years, most common agent was acid, ingested accidentally. Period of development of gastric outlet obstruction was 23 days, range between 11 days and 33 days. Initially presented with odynophagia but later developed features of gastric outlet obstruction. Procedure performed were Heineke Mickulicz pyloroplasty and Billroth I gastroduodenostomy with FJ depending on the intra operative findings. No significant post operative complications were encountered on follow up, all the patients had improved general condition and gained adequate weight. No re do surgeries were performed. Corrosive injury of the UGI tract is not uncommon in children. Pyloric stricture as a complication is relatively rare. Parents may seek consultation late only after the child has lost reasonable amount of weight. UGI Endoscopy and UGI contrast study are indispensable to evaluate the severity of damage and formulate the optimum plan of surgery. Early surgical intervention gives excellent result. Both Pyloroplasty and Billroth I anastomosis are safe with low morbidity and excellent long term outcome.


Naik RR, Vadivelan M. Corrosive poisoning. Indian journal of clinical practise. 2012;23:131-4.

Park KS. Evaluation and Management of caustic injuries from Ingestion of Acid or Alkaline substances. Clin Endoscopy. 2014;47:301-7.

Contini S, Scarpignato C. Caustic injury of the upper gastrointestinal tract: a comprehensive review. World J Gastroenterol. 2013;19(25):3918-930.

Ozukutan BH, Ceylan H, Ertaskim I, Yapici S. Pediatric gastric outlet obstruction following corrosive ingestion. PediatrSurg Int. 2010;26:615-18.

Agarwal S, Sikora SS, Kumar A, Saxena R, Kapoor VK. Surgical management of corrosive strictures of stomach. Indian J Gastroenterol. 2004;23(5):178-80.

Zargar SA, Kochhar R, Nagi B, Mehta S, Mehta SK. Ingestion of corrosive acids. Spectrum of injury to upper gastrointestinal tract and natural history. Gastroenterology. 1989;97(3):702-07.

Gray HK, Holmes CL. Pyloric stenosis caused by ingestion of corrosive substances; report of case. SurgClin North Am. 1948;28:1041-56.

Hsu CP, Chen CY, Hsu NY, Hsia JY. Surgical treatment and its long-term result for caustic-induced prepyloric obstruction. Eur J Surg. 1997;163(4):275-79.

Sharma Shyam, Debnath P R, Agrawal L D, Vipul G. Gastric outlet obstruction without esophageal involvement: A late sequelae of acid ingestion in children, JIAPS. 2007;12:47-9.

Poocharoen W. Corrosive injury induced gastric outlet obstruction in children A case report. Thai J Surg. 2020;29:54-8.

Cheng YS, Li MH, Chen WX, Chen NW, Zhuang QX, Shang KZ. Comparison of different intervention procedures in benign strictures of gastrointestinal tract. World J Gastroenterol. 2004;10(3):410-14.






Case Series