Corrosive injury of the upper gastrointestinal tract is a worldwide clinical problem, mostly occurring in children. Alkaline agents produce deeper injuries whereas acidic agents produce superficial injuries usually. Hoarseness, stridor, and respiratory distress indicate airway injury. Dysphagia, odynophagia, and drooling of saliva suggest esophageal injury whereas abdominal pain, nausea, and vomiting are indicative of stomach injury. X-rays should be done to rule out perforation. Endoscopy is usually recommended in the first 12–48 h although it is safe up to 96 h after caustic ingestion. Endoscopy should be performed with caution and gentle insufflation. Initial management includes getting intravenous access and replacement of fluids. Hyperemia and superficial ulcerations have excellent recovery while deeper injuries require total parenteral nutrition or feeding jejunostomy. Patients suspected of perforation should be subjected to laparotomy. Common complications after corrosive injury are esophageal stricture, gastric outlet obstruction, and development of esophageal and gastric carcinoma.
2
Yeom HJ,
Shim KN,
Kim SE,
Lee CB,
Lee JS,
Cho YK.
et al.
Clinical characteristics and predisposing factors for complication of caustic injury of the upper digestive tract. Korean J Med 2006; 70: 371-7
3
Yoon KW,
Park MH,
Park GS,
Jung PJ,
Joo YE,
Kim HS.
et al.
A clinical study on the upper gastrointestinal tract injury caused by corrosive agent. Korean J Gastrointest Endosc 2001; 23: 82-7
4
Zargar SA,
Kochhar R,
Nagi B,
Mehta S,
Mehta SK.
Ingestion of corrosive acids. Spectrum of injury to upper gastrointestinal tract and natural history. Gastroenterology 1989; 97: 702-7
7
Osman M,
Russell J,
Shukla D,
Moghadamfalahi M,
Granger DN.
Responses of the murine esophageal microcirculation to acute exposure to alkali, acid, or hypochlorite. J Pediatr Surg 2008; 43: 1672-8
10
Gaudreault P,
Parent M,
McGuigan MA,
Chicoine L,
Lovejoy FH.
Jr. Predictability of esophageal injury from signs and symptoms: A study of caustic ingestion in 378 children. Pediatrics 1983; 71: 767-70
13
Rigo GP,
Camellini L,
Azzolini F,
Guazzetti S,
Bedogni G,
Merighi A.
et al.
What is the utility of selected clinical and endoscopic parameters in predicting the risk of death after caustic ingestion?. Endoscopy 2002; 34: 304-10
15
Ryu HH,
Jeung KW,
Lee BK,
Uhm JH,
Park YH,
Shin MH.
et al.
Caustic injury: Can CT grading system enable prediction of esophageal stricture?. Clin Toxicol (Phila) 2010; 48: 137-42
16
Chiu HM,
Lin JT,
Huang SP,
Chen CH,
Yang CS,
Wang HR.
et al.
Prediction of bleeding and stricture formation after corrosive ingestion by EUS concurrent with upper endoscopy. Gastrointest Endosc 2004; 60: 827-33
17
Kamijo Y,
Kondo I,
Kokuto M,
Kataoka Y,
Soma K.
Miniprobe ultrasonography for determining prognosis in corrosive esophagitis. Am J Gastroenterol 2004; 99: 851-54
18
Zargar SA,
Kochhar R,
Mehta S,
Mehta SK.
The role of fiberoptic endoscopy in the management of corrosive ingestion and modified endoscopic classification of burns. Gastrointest Endosc 1991; 37: 165-69
20
Cattan R,
Munoz-Bongrand N,
Berney T,
Halimi B,
Sarfati E,
Celerier M.
et al.
Extensive abdominal surgery after caustic ingestion. Ann Surg 2000; 231: 519-23
22
Baskin D,
Urganci N,
Abbasoglu L,
Alkim C,
Yalfin M,
Karadag C.
et al.
A standardised protocol for the acute management of corrosive ingestion in children. Pediatr Surg Int 2004; 20: 824-8
24
Fulton JA,
Hoffman RS.
Steroids in second degree caustic burns of the esophagus: A systematic pooled analysis of fifty years of human data: 1956-2006. Clin Toxicol (Phila) 2007; 45: 402-8
29
Kluger Y,
Ishay OB,
Sartelli M,
Katz A,
Ansaloni L,
Gomez CA.
et al.
Caustic ingestion management: World society of emergency surgery preliminary survey of expert opinion. World J Emerg Surg 2015; 10: 48
30
Demirbilek S,
Aydin G,
Yücesan S,
Vural H,
Bitiren M.
Polyunsaturated phosphatidylcholine lowers collagen deposition in a rat model of corrosive esophageal burn. Eur J Pediatr Surg 2002; 12: 8-12
31
Günel E,
Cağlayan F,
Cağlayan O,
Canbilen A,
Tosun M.
Effect of antioxidant therapy on collagen synthesis in corrosive esophageal burns. Pediatr Surg Int 2002; 18: 24-7
32
De PeppoF,
Zaccara A,
Dall’Oglio L,
Federici di AbriolaG,
Ponticelli A,
Marchetti R.
et al.
Stenting for caustic strictures: Esophageal replacement replaced. J Pediatr Surg 1998; 33: 54-7
33
Atabek C,
Surer I,
Demirbag S,
Caliskan B,
Ozturk H,
Cetinkursun S.
et al.
Increasing tendency in caustic esophageal burns and long-term polytetrafluorethylene stenting in severe cases: 10 years experience. J Pediatr Surg 2007; 42: 636-40
41
Zhang C,
Yu JM,
Fan GR,
Shi CR,
Yu SY,
Wang HP.
et al.
The use of a retrievable self-expanding stent in treating childhood benign esophageal strictures. J Pediatr Surg 2005; 40: 501-4
42
Vandenplas Y,
Hauser B,
Devreker T,
Urbain D,
Reynaert H.
A degradable esophageal stent in the treatment of a corrosive esophageal stenosis in a child. Endoscopy 2009; 41 (02) E73
43
Boron B,
Gross KR.
Successful dilatation of pyloric stricture resistant to balloon dilatation with electrocautery using a sphinctertome. J Clin Gastroenterol 1996; 23: 239-41
44
Hagiwara A,
Sonoyama Y,
Togawa T,
Yamasaki J,
Sakakura C,
Yamagishi H.
et al.
Combined use of electrosurgical incisions and balloon dilatation for the treatment of refractory postoperative pyloric stenosis. Gastrointest Endosc 2001; 53: 504-8
45
Lingala R,
Kota R.
Study of corrosive poisoning and its effects on upper gastrointestinal tract and surgical management – A single institution experience. J Evid Based Med Healthc 2017; 4: 2691-5