Corrosive intake with extensive esophageal and gastric damage

This was a forty year old gentleman who had ingested corrosive (alkaline toilet cleaner). The barium study showed a thin streak of contrast outlining the esophagus (A: green arrows). The stomach was small and deformed,  especially the antral region (B: green arrows marking the fundus and body; red arrows marking the antral area). The case was referred to the surgeon but the surgical team insisted for us to have a go at esophageal dilatation. They had hoped the esophagus could be salvaged. Things were worse than expected on endoscopy with extensive scarring and fibrosis and friability (C). We partially dilated the upper esophagus with a 30 French Savary dilator but it was the same story lower down. Further dilatation was abandoned and the case was referred for esophagectomy and gastrectomy with possible colonic interposition.

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.