Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Editorial
. 2017 May 6;8(2):90-98.
doi: 10.4292/wjgpt.v8.i2.90.

Management of esophageal caustic injury

Mark Anthony A De Lusong  1 , Aeden Bernice G Timbol  1 , Danny Joseph S Tuazon  1
Affiliations
Editorial

Management of esophageal caustic injury

Mark Anthony A De Lusong et al. World J Gastrointest Pharmacol Ther. .

Abstract

Ingestion of caustic substances and its long-term effect on the gastrointestinal system maintain its place as an important public health issue in spite of the multiple efforts to educate the public and contain its growing number. This is due to the ready availability of caustic agents and the loose regulatory control on its production. Substances with extremes of pH are very corrosive and can create severe injury in the upper gastrointestinal tract. The severity of injury depends on several aspects: Concentration of the substance, amount ingested, length of time of tissue contact, and pH of the agent. Solid materials easily adhere to the mouth and pharynx, causing greatest damage to these regions while liquids pass through the mouth and pharynx more quickly consequently producing its maximum damage in the esophagus and stomach. Esophagogastroduodenoscopy is therefore a highly recommended diagnostic tool in the evaluation of caustic injury. It is considered the cornerstone not only in the diagnosis but also in the prognostication and guide to management of caustic ingestions. The degree of esophageal injury at endoscopy is a predictor of systemic complication and death with a 9-fold increase in morbidity and mortality for every increased injury grade. Because of this high rate of complication, prompt evaluation cannot be overemphasized in order to halt development and prevent progression of complications.

Keywords: Caustic ingestion; Caustic injury; Corrosive ingestion; Esophageal caustic; Esophageal injury.

PubMed Disclaimer

Conflict of interest statement

Conflict-of-interest statement: All authors have no conflict of interest to declare. All authors have seen and approved the manuscript submitted. The article has not received prior publication and is not under consideration for publication elsewhere.

Figures

Figure 1
Figure 1
Endoscopic pictures of Zargar classification 0 to IIIB. A: Zargar Grade 0: Normal mucosa; B: Zargar Grade I: Edema and erythema of the mucosa; C: Zargar Grade IIA: Hemorrhage, erosions, blisters, superficial ulcers; D: Zargar Grade IIB: Circumferential bleeding, ulcers. Exudates; E: Zargar Grade IIIB: Focal necrosis, deep gray or brownish black ulcers; F: Zargar Grade IIIB: Extensive necrosis, deep gray or brownish black ulcers.
Figure 2
Figure 2
Management algorithm for caustic substance ingestion. CT: Computed tomography; GI: Gastroenterology; ICU: Intensive care unit.
See this image and copyright information in PMC

References

    1. Bronstein AC, Spyker DA, Cantilena LR, Green J, Rumack BH, Heard SE. 2006 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS) Clin Toxicol (Phila) 2007;45:815–917. - PubMed
    1. Lupa M, Magne J, Guarisco JL, Amedee R. Update on the diagnosis and treatment of caustic ingestion. Ochsner J. 2009;9:54–59. - PMC - PubMed
    1. Satar S, Topal M, Kozaci N. Ingestion of caustic substances by adults. Am J Ther. 2004;11:258–261. - PubMed
    1. Lakshmi CP, Vijayahari R, Kate V, Ananthakrishnan N. A hospital-based epidemiological study of corrosive alimentary injuries with particular reference to the Indian experience. Natl Med J India. 2013;26:31–36. - PubMed
    1. Kardon E. Caustic ingestion.Emergency Medicine Toxicology. Available from: http://www.medicine.medscape.com.

Publication types

LinkOut - more resources