A Paradigm Shift in Long-Term Surgical Sequelae after Corrosive Ingestion: A Contemporary Review

Abstract Background Corrosive ingestion remains a major cause of gastrointestinal morbidity in low- and middle-income countries. Traditionally, esophageal strictures dominated post-corrosive sequelae; however, changing patterns of corrosive agents may be altering the spectrum of complications. Methods This single-center retrospective observational study was conducted at Mayo Hospital, Lahore, over a one-year period (October 2024 to October 2025). Patients presenting with acute complications or chronic sequelae following corrosive ingestion were included. Demographic data, type of corrosive agent, presentation pattern, complications, surgical interventions, morbidity, and mortality were analyzed. Results A total of 118 patients were included, with a female predominance (72.9%) and a median age of 22 years. Washroom/toilet cleaners were the most common agents (72.9%). Gastric outlet obstruction was the predominant sequela (61.0%), exceeding esophageal strictures (21.2%). Gastrojejunostomy was the most frequently performed definitive procedure (57.6%). Overall mortality was 13.6%, with emergency presentations exhibiting significantly higher mortality compared to elective cases (78.6% vs 4.8%, p < 0.001). Conclusion This high-volume single-center study demonstrates a clear shift in corrosive ingestion sequelae in Pakistan toward gastric-dominant disease driven by acid-based household cleaners. Emergency presentations are associated with extremely high mortality, underscoring the need for early risk stratification, multidisciplinary management, and preventive public health strategies.