Early esophagoscopy for diagnosis of esophageal burns.

Abstract

Introduction A history of ingestion of corrosive chemical substances with or without associated labial, buccal, or pharyngeal lesions necessitates assumption of esophageal involvement until proven otherwise. The institution of long-term bougie or steroid therapy in all cases, without diagnosis of those patients who actually have esophageal burns, subjects the majority to unnecessary therapy. 1,2 The purpose of this paper is to present further evidence to that already present in the literature of the value of early esophagoscopy in diagnosis. Rationale Esophagoscopy and waiting for stricture formation are the only two sure methods of determining those burn cases which are stricture-prone from the large percentage which require no therapy for stricture. Since early therapy attempts to prevent stricture formation, the latter method has obvious drawbacks. Waggoner, 1 in a series of 51 cases of corrosive chemical ingestion, found only 8 burns of the esophagus (15.6%). Erythema alone was not considered a