Caustic Esophageal Injury

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Caustic ingestion is one of the most devastating sources of injury to the esophagus. The damage is fast and extensive upon contact with the injurious substance. Knowledge of the specific caustic swallowed is important as damage may be minor or catastrophic depending upon the type and amount swallowed. Stabilization of the patient is most important initially as esophageal perforation is of greatest concern and will require immediate esophagectomy if suspected and the patient is not moribund. If surgery is not required, then airway assessment and urgent endoscopy is indicated regardless of the degree of oral ulceration, to assess the degree of injury. This will be the most important determinant of prognosis and therapy with low injury grades requiring observation and higher grades mandating long hospitalizations with total parenteral nutrition and/or jejunostomy tube feedings. There are few evidenced based trials evaluating the routine use of antibiotics and steroids in these patients so the decision to use them should be case specific and based on clinical judgement. In patients with severe injury, long term complications, particularly strictures, will need aggressive and often life long dilatations, if not surgical esophageal resection. Although routine screening for esophageal cancer is not wholly endorsed, one must recognize the significantly higher incidence of squamous cell cancer in these patients.

Original languageEnglish (US)
Title of host publicationPractical Gastroenterology and Hepatology: Esophagus and Stomach
PublisherWiley-Blackwell
Pages295-303
Number of pages9
ISBN (Print)9781405182737
DOIs
StatePublished - Aug 31 2010

Fingerprint

Caustics
Wounds and Injuries
Esophageal Perforation
Jejunostomy
Squamous Cell Neoplasms
Esophagectomy
Total Parenteral Nutrition
Enteral Nutrition
Esophageal Neoplasms
Esophagus
Endoscopy
Dilatation
Pathologic Constriction
Hospitalization
Eating
Steroids
Observation
Anti-Bacterial Agents
Incidence

Keywords

  • Acids
  • Alkalis
  • Bleaches
  • Caustic esophageal injury
  • Caustics
  • Detergents
  • Dobhoff tube
  • Nasopharyngeal laryngoscopy

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Katzka, D. A. (2010). Caustic Esophageal Injury. In Practical Gastroenterology and Hepatology: Esophagus and Stomach (pp. 295-303). Wiley-Blackwell. https://doi.org/10.1002/9781444327311.ch40

Caustic Esophageal Injury. / Katzka, David A.

Practical Gastroenterology and Hepatology: Esophagus and Stomach. Wiley-Blackwell, 2010. p. 295-303.

Research output: Chapter in Book/Report/Conference proceedingChapter

Katzka, DA 2010, Caustic Esophageal Injury. in Practical Gastroenterology and Hepatology: Esophagus and Stomach. Wiley-Blackwell, pp. 295-303. https://doi.org/10.1002/9781444327311.ch40
Katzka DA. Caustic Esophageal Injury. In Practical Gastroenterology and Hepatology: Esophagus and Stomach. Wiley-Blackwell. 2010. p. 295-303 https://doi.org/10.1002/9781444327311.ch40
Katzka, David A. / Caustic Esophageal Injury. Practical Gastroenterology and Hepatology: Esophagus and Stomach. Wiley-Blackwell, 2010. pp. 295-303
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