Evaluation and Management of Post-caustic Stenosis

doi:10.37358/3700

Abstract

After caustic ingestion, patients may be either asymptomatic or may exhibit a variety of initial signs and symptoms, depending on the digestive segment predominantly affected. The DROOL system is a noninvasive scoring method used for the evaluation of esophageal lesions and has a good correlation with the development of esophageal stenosis. Management of these patients depends on several factors, including the presence of the symptomatology, in addition to the nature of the caustic substance. Upper endoscopy is indicated in the first 48 hours or after the first two weeks, when it is recommended to start endoscopic dilation sessions. If endoscopic treatment is inefficient, surgical treatment is required. Keywords: caustic ingestion, esophageal stenosis, esophageal bypass

Highlights

After caustic ingestion, patients may be either asymptomatic or may exhibit a variety of initial signs and symptoms, depending on the digestive segment predominantly affected
The DROOL system is a noninvasive scoring method used for the evaluation of esophageal lesions and has a good correlation with the development of esophageal stenosis
Charcoal administration is not recommended as charcoal des not adsorb caustic substances [1,2]

Summary

Introduction

Patients may be either asymptomatic or may exhibit a variety of initial signs and symptoms, depending on the digestive segment predominantly affected. A multicenter, observational Italian study of 102 patients revealed that the presence of three or more signs or symptoms was indicative of a severe esophageal lesions [5]. In a study Mamede et al, was observed that 89.3% of patients developed esophagitis following caustic ingestion and mortality was 1% in the acute phase [9]. The esophageal stricture frequency varies from 25 to 90% of cases, even in children with severe caustic lesionss [9,10].

Results

Conclusion