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 2024/10/04 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.