Delayed Gastric Outlet Obstruction Following Battery Acid (Sulfuric Acid) Ingestion in a Child: A Case Report

Aims: To describe the clinical presentation, diagnostic evaluation, and successful multidisciplinary management of a paediatric patient who developed rapid, severe acute malnutrition secondary to delayed gastric outlet obstruction (GOO) following battery acid (sulfuric acid) ingestion. Study Design: Clinical case report. Place and Duration of Study: Department of Paediatrics, Azal Hospital, Yemen, between July 2026 and October 2026. Methodology: We report the case of a 5-year-old girl who presented three weeks after accidental battery acid ingestion with intractable non-bilious vomiting, complete food intolerance, and severe acute malnutrition (exhibiting a 50% body weight reduction from 20 kg to 10 kg). Serial upper gastrointestinal endoscopies were used to evaluate the extent of the corrosive injury. Because the resulting pyloric stricture was completely obliterated, posing an unacceptably high risk of perforation with endoscopic balloon dilatation, the multidisciplinary care team deferred immediate surgery. Instead, they implemented aggressive preoperative nutritional rehabilitation via total parenteral nutrition (TPN) and targeted electrolyte correction to reverse her severe catabolic state and optimise operative fitness. Results: Serial endoscopic evaluations confirmed severe pyloric stenosis and diffuse gastric ulceration, with relative sparing of the oesophageal mucosa. Following physiological stabilisation with TPN, surgeons performed a retrocolic posterior gastrojejunostomy on July 23, 2026. To mitigate the risk of enterogastric biliary reflux and subsequent alkaline gastritis, a Braun side-to-side jejunojejunostomy was concurrently constructed. The postoperative course was clinically uneventful. The patient rapidly regained tolerance for oral feeding and demonstrated consistent weight gain. At the 12-week postoperative follow-up (October 2026), she exhibited sustained catch-up growth (weighing 16 kg), tolerated a full regular diet without vomiting, and remained completely asymptomatic. Conclusion: Untreated, delayed GOO following battery acid ingestion precipitates life-threatening starvation and rapid physiological decline in paediatric patients. When mature corrosive strictures are completely obliterated and technically unsuitable for endoscopic dilatation, a synergistic approach integrating early endoscopic mapping, aggressive nutritional support (TPN), and timely surgical bypass utilizing a Braun anastomosis yields a safe, effective, and durable clinical recovery.