Late sequelae of gastric acid injury.

The late sequelae of gastric acid injury follow a predictable pattern and often require operative correction. Pyloric and antral stenoses are the most commonly cited late complications of acid ingestion. Other late sequelae include intractable pain, achlorhydria, protein-losing gastroenteropathy, duodenal atonicity, radiographic abnormalities, mucosal metaplasia, and gastric carcinoma. Resection of the injured gastric segment appears to provide the most favorable long-term result. Diligent patient follow-up is required to ensure adequate restoration of gastrointestinal function and to correct late-appearing complications. The distinction between the expected sites of gastrointestinal injury in acid versus alkali ingestion has become less clear with the recent introduction of readily available concentrated liquid household alkaline products, and the incidence of late gastric sequelae of caustic injuries has increased accordingly.