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2017 ; 8
(2
): 90-98
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Management of esophageal caustic injury
#MMPMID28533917
De Lusong MAA
; Timbol ABG
; Tuazon DJS
World J Gastrointest Pharmacol Ther
2017[May]; 8
(2
): 90-98
PMID28533917
show ga
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.
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