Clin Endosc.  2014 Jul;47(4):301-307. 10.5946/ce.2014.47.4.301.

Evaluation and Management of Caustic Injuries from Ingestion of Acid or Alkaline Substances

• Park KS

• KMID: 1907928
• DOI: http://doi.org/10.5946/ce.2014.47.4.301

Abstract

Although the numbers have decreased compared with in the past, cases of patients who ingest caustic substances and visit the emergency room are not rare. However, well-summarized data about caustic injuries are insufficient. Therefore, in this article, I will discuss the etiologic causative agents, injury mechanism, and clinical characteristics, as well as the endoscopic evaluation of the degree of injury and proper management of the patient, in gastrointestinal caustic injury.

Keyword

Caustic injury; Acids; Alkalies

MeSH Terms

Alkalies
Eating*
Emergency Service, Hospital
Humans
Alkalies

Figure

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  Fig. 1 Diffuse liquefaction necrosis of the entire esophagus is noted after the ingestion of alkaline substances.

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  Fig. 2 Caustic injury after the ingestion of acid material. Mild esophageal injury (A) is noted compared with widespread severe injury (B) in the stomach.

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  Fig. 3 Injury to the larynx and epiglottis after the ingestion of alkaline material. Vocal hoarseness, wheezing, and shortness of breath may occur upon injury to these areas.

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  Fig. 4 Endoscopic grading of the caustic gastrointestinal injury. (A) Grade 1 indicates only slight swelling and redness of the mucosa. (B) Grade 2A indicates the presence of superficial ulcers, bleeding, and exudates. (C) Grade 2B indicates local or encircling deep ulceration. (D) Grade 3A indicates focal necrosis. White arrows indicate focal necrosis. (E) Grade 3B indicates extensive necrosis.

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