Caustic Ingestion

Abstract

Caustic ingestions are rare, life-threatening injuries with life-long consequences. Injury can occur anywhere from the lips to stomach but tends to be most severe in the esophagus. Aspiration of caustic substances can lead to laryngeal or tracheobronchial injury and airway compromise. Caustic injuries come in two main varieties: acidic and alkaline-induced injuries. The type and state of agent determines in part the location of injury and depth of injury. Management consists of comprehensive evaluation and stabilization and must consider airway safety. Endoscopic evaluation and staging of the esophagus should be done within 24 hours of ingestion but not before 6 hours. Nasogastric tube placement should be considered based on the stage of the injury. Antibiotics, acid-suppressants, and corticosteroids may have a roll for certain patients but must be determined on an individual basis. Long-term follow up is required to monitor for strictures and patients with caustic esophageal injury are at increased risk of esophageal carcinoma. This review will help both junior and senior Otolaryngology residents recognize, evaluate and manage causing ingestions in pediatric patients. This review contains figures, tables, and references Keywords: Caustic ingestion, acid, alkali, endoscopic grading, strictures, mitomycin C, balloon dilatation