Abstract

We read with immense interest, Biswas and Ray’s article ‘Outcomes of the management of corrosive injuries of the upper digestive tract in a Tertiary care center’ which highlights an algorithm for management of corrosive injuries aiming preservation of nutritional autonomy.1 Commonest site of injury was esophagus, the management protocol included Advanced Life Trauma Support guidelines, Endoscopic dilation and self-dilation for strictures, while surgery for emergencies.1 After discussing complications; A multivariate analysis of reasons for failed dilation determined long, cervical, and multiple esophageal strictures with inability to pass guidewire as major risk factors; this was in addition to Grade 4 dysphagia and delayed presentation found in univariate analyses.1 We applaud the findings but would also recommend additions. Study classifies the type of corrosive agent i.e. acid or alkali, but does not include physical properties e.g. pH, state or amount to determine extent of injury. Solid state is linked with deep burns.2 Large amount of detergents and bleaches with pH 9–11 cause injury, whereas small but concentrated forms of laundry and dishwater detergents also cause extensive injury.2

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