Caustic injury of the oesophagus

Caustic ingestion continues to be a significant problem world-wide especially in developing countries and particularly in the under 6 years age group. The presence or absence of symptoms or oral lesions does not reliably predict the existence or severity of oesophageal lesions. Upper endoscopy remai...

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Bibliographic Details
Published in:Pediatric surgery international 2015-02, Vol.31 (2), p.111-121
Main Authors: Millar, Alastair J. W., Cox, Sharon G.
Format: Article
Language:English
Subjects:
Burns, Chemical - diagnosis
Burns, Chemical - physiopathology
Burns, Chemical - therapy
Caustics - toxicity
Esophagoscopy
Esophagus - injuries
Humans
Medicine
Medicine & Public Health
Pediatric Surgery
Pediatrics
Review Article
Surgery
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Summary:Caustic ingestion continues to be a significant problem world-wide especially in developing countries and particularly in the under 6 years age group. The presence or absence of symptoms or oral lesions does not reliably predict the existence or severity of oesophageal lesions. Upper endoscopy remains the mainstay diagnostic modality for evaluation to define the extent and severity of the injury. The best predictor of morbidity and mortality is the extent of injury as assessed during initial evaluation. Early management strategies for caustic ingestion are well defined. Controversy still surrounds the use of steroids, antibiotics, antacid therapy in the acute phase, and the use of oesophageal stents and the frequency, timing and method of dilatation in the prevention and management of oesophageal strictures. There is a pressing need for non-invasive diagnostic modalities and effective therapeutic options to evaluate and treat the complications associated with caustic ingestion. Indications for definitive surgery or bypass and the type of procedure to use are also subject to ongoing debate.
ISSN:0179-0358
1437-9813
DOI:10.1007/s00383-014-3642-3