Protocolo diagnóstico y terapéutico de la ingesta de cáusticos

Abstract

The ingestion of caustic agents is a medical emergency due to the serious injuries they can cause to the upper digestive tract. It is estimated to have a frequency of 38.7 cases/100,000 inhabitants and a mortality rate of 1%–4% in Western countries. There are two typical scenarios: accidental ingestion, of small quantity and with a more benign course, and ingestion with the purpose of self-harm, of larger quantity and with a worse prognosis. The initial management consists of ensuring hemodynamic stability and airway permeability, avoiding actions such as inducing vomiting or the use of neutralizing substances. Radiological tests together with endoscopy allow for assessing severity and stratifying the risk of complications. Treatment varies according to the Zargar classification, ranging from outpatient management to emergency surgery in cases of perforation. Long-term follow-up allows for the detection of complications such as esophageal stricture, esophagobronchial fistulas, and esophageal cancer.