Severe Corrosive Injury Secondary to Chlorine Bleach Ingestion: A Case Report

Corrosive injuries to the upper gastrointestinal tract, particularly those caused by alkaline substances, often result in more severe and deeper tissue injuries than those observed after ingestion of acidic substances. We report a case of severe corrosive injury following ingestion of chlorine bleac...

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Main Author: Yonghoon Choi
Format: Article
Language:English
Published: Korean College of Helicobacter and Upper Gastrointestinal Research 2024-12-01
Series:The Korean Journal of Helicobacter and Upper Gastrointestinal Research
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Online Access:http://helicojournal.org/upload/pdf/kjhugr-2024-0055.pdf
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author Yonghoon Choi
author_facet Yonghoon Choi
author_sort Yonghoon Choi
collection DOAJ
description Corrosive injuries to the upper gastrointestinal tract, particularly those caused by alkaline substances, often result in more severe and deeper tissue injuries than those observed after ingestion of acidic substances. We report a case of severe corrosive injury following ingestion of chlorine bleach (200 mL), an alkaline agent. Initial endoscopic evaluation revealed severe esophageal and gastric injuries with necrosis (Zargar grade 3b), without any signs of perforation. The treatment plan included prolonged fasting with total parenteral nutrition, and enteral feeding was initiated via jejunostomy 1 month after hospitalization. The patient was hospitalized and discharged on several occasions until we observed complete healing of the esophagus and stomach. Follow-up endoscopy performed 4 months after the injury showed improvement in the esophageal wall; however, severe stenosis prevented oral intake. Therefore, the patient underwent surgical intervention, including esophagectomy, total gastrectomy, and esophagocolojejunostomy, 7 months post-injury. Since the initial surgery, the patient underwent repeat wound revision procedures, percutaneous drainage, reconstruction, and bougienation owing to anastomotic leakage, infection, and stenosis for approximately a year. The patient received oral and jejunostomy tube feeding for approximately 2.5 years after the initial injury. Early endoscopy was useful to confirm the severity and predict the prognosis of corrosive injuries in this case. Severe corrosive injuries following ingestion of alkaline substances are associated with poor clinical prognosis, as anticipated. Caution is warranted for the diagnosis and treatment of this condition.
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spelling doaj-art-4bcedeecd24a4a9bb35d7c3dfead88422025-08-20T03:33:08ZengKorean College of Helicobacter and Upper Gastrointestinal ResearchThe Korean Journal of Helicobacter and Upper Gastrointestinal Research1738-33312024-12-0124436536910.7704/kjhugr.2024.0055875Severe Corrosive Injury Secondary to Chlorine Bleach Ingestion: A Case ReportYonghoon Choi0 Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, KoreaCorrosive injuries to the upper gastrointestinal tract, particularly those caused by alkaline substances, often result in more severe and deeper tissue injuries than those observed after ingestion of acidic substances. We report a case of severe corrosive injury following ingestion of chlorine bleach (200 mL), an alkaline agent. Initial endoscopic evaluation revealed severe esophageal and gastric injuries with necrosis (Zargar grade 3b), without any signs of perforation. The treatment plan included prolonged fasting with total parenteral nutrition, and enteral feeding was initiated via jejunostomy 1 month after hospitalization. The patient was hospitalized and discharged on several occasions until we observed complete healing of the esophagus and stomach. Follow-up endoscopy performed 4 months after the injury showed improvement in the esophageal wall; however, severe stenosis prevented oral intake. Therefore, the patient underwent surgical intervention, including esophagectomy, total gastrectomy, and esophagocolojejunostomy, 7 months post-injury. Since the initial surgery, the patient underwent repeat wound revision procedures, percutaneous drainage, reconstruction, and bougienation owing to anastomotic leakage, infection, and stenosis for approximately a year. The patient received oral and jejunostomy tube feeding for approximately 2.5 years after the initial injury. Early endoscopy was useful to confirm the severity and predict the prognosis of corrosive injuries in this case. Severe corrosive injuries following ingestion of alkaline substances are associated with poor clinical prognosis, as anticipated. Caution is warranted for the diagnosis and treatment of this condition.http://helicojournal.org/upload/pdf/kjhugr-2024-0055.pdfcorrosive injurychlorine bleachstrictureprognosis
spellingShingle Yonghoon Choi
Severe Corrosive Injury Secondary to Chlorine Bleach Ingestion: A Case Report
The Korean Journal of Helicobacter and Upper Gastrointestinal Research
corrosive injury
chlorine bleach
stricture
prognosis
title Severe Corrosive Injury Secondary to Chlorine Bleach Ingestion: A Case Report
title_full Severe Corrosive Injury Secondary to Chlorine Bleach Ingestion: A Case Report
title_fullStr Severe Corrosive Injury Secondary to Chlorine Bleach Ingestion: A Case Report
title_full_unstemmed Severe Corrosive Injury Secondary to Chlorine Bleach Ingestion: A Case Report
title_short Severe Corrosive Injury Secondary to Chlorine Bleach Ingestion: A Case Report
title_sort severe corrosive injury secondary to chlorine bleach ingestion a case report
topic corrosive injury
chlorine bleach
stricture
prognosis
url http://helicojournal.org/upload/pdf/kjhugr-2024-0055.pdf
work_keys_str_mv AT yonghoonchoi severecorrosiveinjurysecondarytochlorinebleachingestionacasereport