A case of corrosive esophagitis caused by alkali ingestion requiring an esophagectomy

Abstract

A 58-year-old woman ingested 500 ml of alkali in a suicide attempt. Computed tomography (CT) showed a large fluid collection in the mediastinum around the esophagus. Gastrointestinal fiberscopy (GIF) showed a deep ulcer that was suspected of having a perforation. These findings suggested a corrosive esophagitis and danger of further perforation, which necessitated an esophagectomy. Surgical findings showed inflammation in the mediastinum around the esophagus, but no perforation was found. On histology, necrotic changes were seen throughout the entire mucous membrane. Corrosive esophagitis caused by alkali ingestion result in a delayed perforation. There is no consensus with respect to the extent of surgery required in the acute stage. However, it must be borne in mind that a perforation is fatal ; thus, the opportunity for a definitive solution should not be squandered.