The value of early endoscopy following caustic ingestion

C. Sugawa, R. J. Mullins, C. E. Lucas, W. C. Leibold

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    Abstract

    Ingestion of caustic material can cause injury ranging from a superficial burn to total necrosis of the esophagus, stomach and duodenum. Appropriate therapy is augmented by the prompt, accurate determination of the full extent of injury. During the past two years, eight patients have been treated for the ingestion of caustic materials, including acids in two patients, lye in two patients, bleach in two patients, ammonia in one patient and detergent in one patient. Each patient underwent fiberoptic endoscopic evaluation using a small caliber panendoscope. Sulfuric acid caused an extensive partial thickness injury to the esophagus, stomach and duodenal bulb in one patient who had pyloric stenosis develop which required a hemigastrectomy 30 days later. Hydrochloric acid in one patient caused extensive partial thickness injury to the stomach without damaging the esophagus or duodenum; resolution occurred by four weeks. Lye ingestion caused extensive mucosal inflammation of the esophagus, stomach and duodenum in one patient in whom a 1.5 centimeter gastric ulcer developed by two weeks but responded to a bland diet and antacids. Lye ingestion caused severe injury to the oral pharynx and esophagus in the other patient, who later underwent total gastrectomy for perforation on day 2. Bleach ingestion caused moderate esophagitis, gastritis and duodenitis in one patient and moderate gastritis in another patient. One patient was discharged within five days and the other, in two days. Detergent caused moderate proximal esophagitis; ammonia caused extensive inflammation of the mucosa of the oral pharynx, esophagus, stomach and duodenum. Both were discharged within five days. Fiberoptic endoscopy today allows for early, safe and accurate evaluation of caustic injury, thereby permitting rational therapy.

    Original languageEnglish (US)
    Pages (from-to)553-556
    Number of pages4
    JournalSurgery Gynecology and Obstetrics
    Volume153
    Issue number4
    StatePublished - Jan 1 1981

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    ASJC Scopus subject areas

    • Surgery
    • Obstetrics and Gynecology

    Cite this

    Sugawa, C., Mullins, R. J., Lucas, C. E., & Leibold, W. C. (1981). The value of early endoscopy following caustic ingestion. Surgery Gynecology and Obstetrics, 153(4), 553-556.