Thursday, September 19, 2013

Corrosive injury with gastric outlet obstruction

This was a 25 year old lady who had ingested bathroom cleaner (alkali) with a suicidal intent. Barium studies showed a long esophageal stricture (A1) and gastric outlet obstruction (A2: green arrow). On endoscopy we couldn't get far due to the extensive damage (B) and used Savary dilators (C: green arrow) to dilate the esophagus. There was extensive damage in the fundus (D), body and antrum (E: green arrow marks the wide open pylorus). The duodenal bulb was scarred and tubular (F:green arrow) with a pinhole narrowing between the bulb and descending duodenum (G: green arrows). She's definitely going to need surgery for that outlet obstruction.

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Second (actually 3rd) ERCP for post transplant biliary leak

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