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328 Corrosive Ingestion and Oesophageal Replacement

Key Summary Points
1. A preventive scheme is essential to avoid the devastating 5. Fever, shock, dyspnoea, and acute abdomen strongly indicate
accidental injuries due to corrosive ingestion. oesophageal or gastric perforation.
2. Alkaline injury is more extensive than acid injury due to the 6. Dysphagia is the late presentation due to stricture.
delay in the protective reflexes in an acid injury and rapid 7. Diagnosis is by imaging and endoscopy.
penetration of alkali into the tissues.
8. The goals of therapy are to prevent and treat perforation as
3. The most severe caustic injury generally occurs in early as possible, to avoid strictures of the oesophagus and
the narrowest portion of the oesophagus, usually the stomach, and to replace or bypass the damaged organ to allow
midoesophagus in the region of the aortic arch. normal swallowing of food.
4. Early clinical manifestations include persistent salivation, 9. Therapy is variable.
dysphagia, hoarseness of voice and stridor, retrosternal chest
pain, and hematemesis.

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