Of 73 patients with co-existent esophageal injury, the esophageal strictures required surgery in 18. In patients with total esophageal obstruction, who were unable to undergo radiological contrast studies, diagnosis of gastric outlet obstruction was aided by an erect abdominal radiograph done after overnight fasting to show a gastric fluid level.
Most patients with gastric outlet obstruction were in a state of malnutrition. Hence it was the policy of the unit to do a preliminary feeding jejunostomy to build up the nutritional status of all patients prior to surgery.
Details of surgical intervention are shown in Table 2. In 84/91 patients with type I chronic corrosive gastric injury, Billroth I gastrectomy was performed. Three of these patients also had a simultaneous esophageal bypass. In 5 patients a loop gastrojejunostomy alone was done to bypass the strictured region because these patients had concomitant esophageal strictures and underwent an esophagocologastric bypass. These patients were not considered fit enough to undergo both a prolonged esophagocologastric bypass and a gastric resection.