RT Book, Section
A1 Su, Stacey
A2 Sugarbaker, David J.
A2 Bueno, Raphael
A2 Burt, Bryan M.
A2 Groth, Shawn S.
A2 Loor, Gabriel
A2 Wolf, Andrea S.
A2 Williams, Marcia
A2 Adams, Ann
SR Print(0)
ID 1170408510
T1 Surgical Management of Corrosive Injury to the Esophagus
T2 Sugarbaker’s Adult Chest Surgery, 3e
YR 2020
FD 2020
PB McGraw-Hill Education
PP New York, NY
SN 9781260026931
LK accesssurgery.mhmedical.com/content.aspx?aid=1170408510
RD 2024/04/18
AB According  to  the  2013  annual  report  of  the  American  Association  of  Poison  Control  Centers,  there  were  nearly  60,000  reported  U.S.  cases  of  exposure  to  caustic  agents  (48,000  to  bleach,  7500  to  acids,  4000  to  alkalis),  most  of  which  occurred  by  ingestion.  The  true  incidence  of  caustic  ingestion  and  prevalence  of  lesions  such  as  strictures  is  likely  under-reported  worldwide.  There  are  two  age  groups  at  risk  for  this  exposure:  children  ages  2  to  6  years  who  ingest  household  cleaning  products  and  account  for  up  to  80%  of  caustic  ingestion  but  usually  sustain  mild  injuries;  and  adults  ages  30  to  40  years  who  have  ingested  strong  corrosives  with  suicidal  intent  and  present  with  life-threatening  injuries.  The  diagnosis  should  be  suspected  in  all  patients  brought  to  the  emergency  department  for  attempted  suicide.  Tissue  injury  from  caustic  ingestion  may  be  fatal  and  warrants  immediate  attention  from  a  wide  range  of  specialties  including  emergency  care  physicians,  surgeons,  anesthesiologists,  gastroenterologists,  radiologists,  otolaryngologists,  and  psychiatrists.  Every  effort  should  be  made  to  identify  the  ingested  substance  and  the  details  surrounding  the  ingestion,  because  the  severity  and  nature  of  injury  are  related  to  chemical  and  physical  properties  of  the  caustic  agent  (i.e.,  acid  vs.  base,  solid  vs.  liquid  form)  in  addition  to  the  concentration  and  volume  ingested.  The  properties  of  the  ingested  substance  affect  the  duration  of  contact  with  the  esophagus  and  influence  the  likelihood  of  injuries  to  other  organs  (e.g.,  pharynx,  stomach,  duodenum,  colon),1  ranging  in  severity  from  first-,  second-,  or  third-degree  burns  to  full-thickness  necrosis  and  perforation.