2016 Volume 36 Issue 1 Pages 115-119
A 70-year-old female ingested 150mL of acidic cleaner in a suicide attempt. She attended a local clinic for treatment. However her vital signs rapidly deteriorated on the 2nd day after admission. She was then referred to the emergency and critical care center of Nagasaki University Hospital. An upper endoscopic examination on admission showed that the entire circumference of the esophageal mucosa appeared red and eroded, and the gastric mucosa appeared black. We found a large quantity of ascites and a necrotic ileocecum. It seemed difficult to reconstruct the digestive tract, since almost all of the small intestine had become red and edematous. We therefore performed a distal gastrectomy, gastrostomy, ileocecal resection and ileostomy without reconstruction. She was able to leave the emergency and critical care center on the 30th hospital day. Although almost all of the digestive tract, from the esophagus to the ileum, had been damaged, we could save this patient with the need for intestinal resection. Cases with necrosis of the digestive tract caused by ingestion of acidic substances rarely have damage reaching to the ileocecum.
