J Med Assoc Thai 1999; 82 (6):628

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Delayed Sequelae of Hydrochloric Acid Ingestion
Wilasrusmee C Mail, Sirikulchayanonta V , Tirapanitch W

Hydrochloric acid is the active ingredient in common toilet bowl cleaner agents used in
Thailand but it is occasionally abused for suicidal attempts by ingestion. Clinicopathological description
caused by this agent has rarely been mentioned in the literature. We reported three cases of
gastric outlet obstruction. Two of these cases were initially treated in provincial hospitals by gastric
lavages. No clinical symptoms relating to ingestion and swallowing were present in the early period
after ingestion but patients developed vomitting and cachexia a few months later. Among these
three cases, pylorus and antrum were the most common sites of injury. All cases were gastrectomized
and pathlogical findings of the resected specimens showed mucosal ulceration. submucosal fibrosis.
thickening of muscularis mucosae, and eosinophilic infiltrations. Most cases in the literature had
preoperative jejunostomy preformed but our cases did not have such a preoperative procedure. The
outcomes of all cases were considered good and no postoperative complication was found. This
presentation is aimed to stimulate physicians to be aware of delayed complications of hydrochloric
acid ingestion and long term follow-up is required even though the initial symptoms of the patients
were minimal.
Key word : Hydrochloric Acid, Delayed Sequelae, Gastric Outlet Obstruction

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