Open access peer-reviewed chapter

Acute Management in Corrosive Ingestion

Written By

Prasit Mahawongkajit

Submitted: 21 October 2021 Reviewed: 02 November 2021 Published: 06 December 2021

DOI: 10.5772/intechopen.101475

From the Edited Volume

Dysphagia - New Advances

Edited by Monjur Ahmed

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Abstract

Corrosive ingestion is an important health problem and medical emergency worldwide. It occurs by accident or by intention. Acids cause coagulation necrosis, and alkalis cause liquefaction necrosis. In the acute period, stabilization of the patient is most important. Airway assessment and prompt management are a priority for severe cases. Caustic substance reflux into the esophagus resulting in further damage should be prevented. The initial evaluation should be performed by endoscopy and graded according to the Zargar classification. Computed tomography (CT) should be used to assess injury to the esophagus because CT is non-invasive. For Zargar 3b injuries, views from both endoscopy and CT scans should be considered. Post-corrosive esophageal stricture is a complication that responds poorly to treatment. Research and development for stricture prevention are ongoing, especially for Zargar 2b and 3a cases.

Keywords

  • corrosive esophageal injury
  • caustic injury
  • esophageal perforation
  • post-corrosive esophageal stricture

1. Introduction

Corrosive ingestion is a medical emergency that is especially prevalent in developing countries such as Thailand [1, 2, 3, 4, 5, 6, 7, 8, 9]. Since 2020, the COVID-19 has had an enormous impact on many sectors worldwide, and it had affected the trend of rising incidence and severity of diseases [10]. However, the actual incidence should not be precise as the tip of the iceberg phenomenon is probably under-report [4, 8]. Currently, various studies on this topic are still being developed for medical knowledge to the achievement goal of the best practice. Perforation and stricture are complications of corrosive ingestion which are currently being researched and which are discussed in this chapter.

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2. Cause of injury

Caustic injuries are caused by the ingestion of substances with acid or base properties. Acids cause coagulation necrosis, and alkalis cause liquefaction necrosis. Corrosive ingestion in children is usually accidental. In adults, it might be related to suicide. Therefore, it is a public health concern with mental and socioeconomic aspects [1, 2, 6, 11].

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3. Impact of corrosive injury

Morbidity with mortality rates of corrosive injuries are high [12, 13]. Airway assessment and prompt management are priorities in emergency settings, especially in severe cases [2, 13, 14]. Extensive burns can cause the fragile esophageal wall to become perforated. Physicians must evaluate this condition as soon as possible. Stricture is another complication that physicians need to evaluate. Post-corrosive esophageal strictures cause patients to suffer and are difficult to treat [2, 3, 4, 9, 12, 15, 16, 17, 18, 19].

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4. Pathophysiology

Caustic substances with pH less than two or more than 12 are especially destructive. Form, concentration, amount of ingestion, and contact duration also affect the results. Acidic substances generate coagulation necrosis which creates eschar formation. Eschar can limit the penetration of injuries [16]. On the other hand, alkaline substances melt the tissue protein and initiate liquefactive necrosis with saponification that can penetrate deeper into the esophageal wall [17].

Perforation occurs in the acute stage of severe esophageal injuries. As a consequence of perforation, stricture follows during the recovery stage. Tissue injuries after corrosive ingestion go through three phases. Phase 1 is characterized by cell necrosis and thrombosis, 48–72 hours after the event. Next, in Phase 2, there is mucosal sloughing with ulceration of the esophageal wall plus fibroblast colonization and granulation. This phase continues for 14 days from the Phase 1, and the esophagus is friable during this phase. Finally, in Phase 3, the healing process starts in the third week and usually continues 3–6 months [3, 20, 21].

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5. Management

When patients arrive at the emergency department, stabilization of the patient is the most important target for this stage [21]. Signs and symptoms that often occur in corrosive ingested patients include burning of the oral cavity, drooling, nausea, and vomiting. Upper gastrointestinal bleeding can be found in severe cases, indicating substance injuries to the alimentary tract. Respiratory trauma can result in hoarseness, difficulty to breathe, stridor, and airway compromise. Esophagus perforation can be expressed as mediastinitis, chest wall emphysema, and pneumothorax, depending on time and severity.

Physicians should first examine the airway, especially for signs of aspiration or laryngeal injury. Physical examination and history taking should be done for details of the corrosive substance, the volume, timing before admission, pre-hospital treatment, and cause of ingestion. The patient should be given nil per os (NPO) and adequate resuscitation. Nasogastric tube intubation, gastric lavage, administration of emetic drugs, and neutralizing agents are not recommended because reflux of these agents into the esophagus could result in further damage [1, 8, 21]. Intravenous broad-spectrum antibiotics may benefit a patient with high-grade esophageal injuries. The investigation by chest and abdominal radiography should be evaluated. In cases of attempted suicide, the patient should be evaluated by the psychiatric department [1, 3, 4, 9, 22, 23].

The initial evaluation of the severity of a caustic injury provides important information. Esophagogastroduodenoscopy (EGD) is recommended for grading esophageal injuries following the Zargar classification (Table 1). Zargar classification can assist prognosis and guide clinical management [16]. The EGD should be done as soon as possible within 24–48 hours. Performing endoscopy after 48 hours is not recommended because the tissue injuries go through Phase 2 when they should not be subjected to an unwanted event [16, 21]. For patients with Zargar grade 1 and 2a, an oral diet may be given. Patients with Zargar grade 2b and 3a can start an oral diet once they can swallow saliva. Esophagectomy should be performed on patients with Zargar grade 3b injuries.

Zargar classificationDescription
Grade 0Normal finding on endoscopic examination
Grade 1Edema and hyperemia of the mucosa
Grade 2aFriability, blisters, exudates, hemorrhages, whitish membrane, erosions, and superficial ulceration
Grade 2bGrade 2a plus deep discrete or circumferential ulceration
Grade 3aSmall scattered areas of multiple ulceration and areas of necrosis with brown-black or grayish discoloration
Grade 3bExtensive necrosis

Table 1.

Zargar classification of corrosive esophageal injury.

The method for assessing the degree of esophageal damage by computed tomography (CT) with scoring was recently established as a noninvasive modality [24]. Nowadays, the use of CT scans of the chest and abdomen is increasing. CT can assist prognosis after ingestion, but it is still inconclusive [25, 26, 27]. CT also provides extraesophageal information regarding anatomies such as the mediastinum, lung, and pleural cavity, which endoscopies do not (Table 2).

ScoreEndoscopic score [16]Computerized tomography score [24]
0Grade 0; NormalNormal
IGrade 1; Edema and hyperemia of the mucosaNo definite swelling of esophagus wall (<3 mm, within normal limit)
IIGrade 2a; Friability, blisters, exudates, hemorrhages, whitish membrane, erosion, and superficial ulcerationEdematous wall thickening (>3 mm) without periesophageal soft tissue infiltration
Grade 2b; Grade 2a plus deep discrete or circumferential ulceration
IIIGrade 3a; Small scattered areas of multiple ulceration and areas of necrosis with brown-black or grayish discolorationEdematous wall thickening with periesophageal soft tissue infiltration pulse well-demarcated tissue interface
Grade 3b; Extensive necrosis
VIGrade 4; PerforationEdematous wall thickening with periesophageal soft tissue infiltration plus blurring of tissue interface or localized fluid collection around the esophagus or the descending aorta

Table 2.

Endoscopic score and computerized tomography score of corrosive esophageal injury.

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6. Perforation

Although an endoscopy is an important tool for initial evaluation, contraindications are suspected perforation, oral cavity necrosis, and airway injury with compromised respiration. CT scans can safely provide details about esophageal transmural necrosis consisting of esophageal wall blurring, peri-esophageal fat stranding, and no enhancement of esophageal wall after administration of intravenous contrast [24]. Recent studies reported that unnecessary esophagectomy following endoscopic evaluation of patients with Zargar grade 3b could have been avoided if CT had been used [28, 29, 30].

Both CT and endoscopy have distinctive advantages. CT is minimally invasive with high sensitivity and specificity [24, 25, 27, 28, 29, 30]. Intra-luminal evaluation by endoscopy reveals subtle details of the esophageal mucosa and degrees of damage [31]. The combination of CT and endoscopy is especially useful for examining patients with Zargar 3b injuries [8, 30, 31].

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7. Stricture

As the esophagus is healing following ingestion of a corrosive substance, the possibility of stricture should be assessed. Post-corrosive esophageal stricture is a complication that produces suffering for victims [9, 15, 17]. Esophageal dilation is a therapeutic intervention of choice to perform at the onset of stricture. If left until later, the procedure becomes more difficult, decreasing the success and increasing adverse events [21, 32, 33, 34, 35, 36]. Esophageal dilatation can be performed repeatedly according to schedule and using various dilators such as Maloney-Hurst, Savary-Gilliard, and Balloon dilator under the endoscopy, fluoroscopy, or both. Alternative methods for post-corrosive esophageal stricture such as esophageal stenting [21, 37, 38], intralesional steroids [21, 39, 40, 41, 42, 43], and, Mitomycin-C [21, 44, 45, 46, 47, 48] have been published with various outcomes. These options might supplement dilation with better results. In cases of severe stricture, failure to dilate, or refractory strictures, surgery might be necessary (Figure 1) [4, 18, 19, 49, 50, 51, 52, 53, 54].

Figure 1.

The treatment options for post-corrosive esophageal stricture. (A) Severe post-corrosive esophageal stricture; (B) Savary-Gilliard dilator; (C) endoscopic balloon dilation; (D) esophagectomy with open right thoracotomy; (E) esophagectomy with video-assisted thoracoscopic surgery (VATS); (F) reconstruction with cervical anastomosis after esophagectomy; (G, H) right side colonic conduit for esophageal replacement; and (I) subcutaneous colon interposition.

Post-corrosive esophageal stricture should highly consider inpatient with Zargar grade 2b and 3a [4, 5, 8, 9, 16, 55]. Although various treatment strategies have been developed, none of them can provide outstanding results. Stricture prevention would be the ideal method. Corticosteroids reduce inflammation, but the benefit is inconclusive. Steroids cause severe adverse side effects such as esophageal candidiasis, gastric ulcer, ethmoiditis, osteomyelitis, and osteoporosis [56, 57, 58]. Recent studies have demonstrated that omeprazole with proton pump inhibitor activity could enhance healing, reduce stricture, and reduce the short-term risk of developing esophageal stricture in patients with 2b and 3a corrosive injuries [9, 59, 60, 61]. However, further studies of omeprazole are needed to corroborate these findings (Figure 2).

Figure 2.

Schematic diagram of corrosive ingestion in esophageal injury.

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8. Conclusion

Corrosive ingestion is a serious medical emergency that is a global problem, especially in several developing countries. When patients arrive at the emergency department, stabilization of the patient is initially the most important target. Airway assessment and prompt management are the priorities for emergency settings, especially in severe cases. Any intervention that might cause substance reflux into the esophagus resulting in further damage is not recommended. Current methods for assessing the degree of esophageal damage are early endoscopy for Zargar classification and CT scan, which focuses on ruling out perforation. Post-corrosive esophageal stricture can be a consequent complication with poor treatment outcomes, and stricture prevention is an interesting idea.

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Conflict of interest

The author declares no conflict of interest.

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Notes/thanks/other declarations

Special thanks to Michael Jan Everts for assistance in editing the English version of this chapter.

References

  1. 1. Chirica M, Kelly MD, Siboni S, et al. Esophageal emergencies: WSES guidelines. World Journal of Emergency Surgery: WJES. 2019;14:26. DOI: 10.1186/s13017-019-0245-2
  2. 2. Hoffman RS, Burns MM, Gosselin S. Ingestion of caustic substances. The New England Journal of Medicine. 2020;382(18):1739-1748. DOI: 10.1056/NEJMra1810769
  3. 3. Kalayarasan R, Ananthakrishnan N, Kate V. Corrosive ingestion. Indian Journal of Critical Care Medicine. 2019;23(Suppl 4):S282-S286. DOI: 10.5005/jp-journals-10071-23305
  4. 4. Contini S, Scarpignato C. Caustic injury of the upper gastrointestinal tract: A comprehensive review. World Journal of Gastroenterology. 2013;19(25):3918-3930. DOI: 10.3748/wjg.v19.i25.3918
  5. 5. Havanond C. Is there a difference between the management of grade 2b and 3 corrosive gastric injuries? Journal of the Medical Association of Thailand. 2002;85(3):340-344
  6. 6. Havanond C. Clinical features of corrosive ingestion. Journal of the Medical Association of Thailand. 2003;86(10):918-924
  7. 7. Havanond C, Havanond P. Initial signs and symptoms as prognostic indicators of severe gastrointestinal tract injury due to corrosive ingestion. The Journal of Emergency Medicine. 2007;33(4):349-353. DOI: 10.1016/j.jemermed.2007.02.062
  8. 8. Chirica M, Bonavina L, Kelly MD, Sarfati E, Cattan P. Caustic ingestion. Lancet. 2017;389(10083):2041-2052. DOI: 10.1016/S0140-6736(16)30313-0
  9. 9. Mahawongkajit P, Tomtitchong P, Boochangkool N, et al. Risk factors for esophageal stricture in grade 2b and 3a corrosive esophageal injuries. Journal of Gastrointestinal Surgery. 2018;22(10):1659-1664. DOI: 10.1007/s11605-018-3822-x
  10. 10. Thongchuam C, Mahawongkajit P, Kanlerd A. The effect of the COVID-19 on corrosive ingestion in Thailand. Open Access Emergency Medicine. 2021;13:299-304. DOI: 10.2147/OAEM.S321218
  11. 11. Li Y, Langworthy J, Xu L, Cai H, Yang Y, Lu Y, et al. Nationwide estimate of emergency department visits in the United States related to caustic ingestion. Diseases of the Esophagus. 2020;33(6):doaa012. DOI: 10.1093/dote/doaa012
  12. 12. Alipour Faz A, Arsan F, Peyvandi H, et al. Epidemiologic features and outcomes of caustic ingestions: A 10-year cross-sectional study. Emergency (Tehran, Iran). 2017;5(1):e56
  13. 13. Struck MF, Beilicke A, Hoffmeister A, et al. Acute emergency care and airway management of caustic ingestion in adults: Single center observational study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 2016;24:45. DOI: 10.1186/s13049-016-0240-5
  14. 14. Bird JH, Kumar S, Paul C, Ramsden JD. Controversies in the management of caustic ingestion injury: An evidence-based review. Clinical Otolaryngology. 2017;42(3):701-708. DOI: 10.1111/coa.12819
  15. 15. Zargar SA, Kochhar R, Nagi B, Mehta S, Mehta SK. Ingestion of corrosive acids. Spectrum of injury to upper gastrointestinal tract and natural history. Gastroenterology. 1989;97(3):702-707
  16. 16. Zargar SA, Kochhar R, Mehta S, Mehta SK. The role of fiberoptic endoscopy in the management of corrosive ingestion and modified endoscopic classification of burns. Gastrointestinal Endoscopy. 1991;37(2):165-169. DOI: 10.1016/s0016-5107(91)70678-0
  17. 17. Zargar SA, Kochhar R, Nagi B, Mehta S, Mehta SK. Ingestion of strong corrosive alkalis: Spectrum of injury to upper gastrointestinal tract and natural history. The American Journal of Gastroenterology. 1992;87(3):337-341
  18. 18. Awsakulsutthi S, Havanond C. A retrospective study of anastomotic leakage between patients with and without vascular enhancement of esophageal reconstructions with colon interposition: Thammasat University Hospital experience. Asian Journal of Surgery. 2015;38(3):145-149. DOI: 10.1016/j.asjsur.2015.01.005
  19. 19. Mahawongkajit P, Boochangkool N. Comparison of preoperative CT colonography and colonoscopy for esophageal reconstruction with colonic interposition. Surgery Research and Practice. 2020;2020:6585762. DOI: 10.1155/2020/6585762
  20. 20. Osman M, Russell J, Shukla D, Moghadamfalahi M, Granger DN. Responses of the murine esophageal microcirculation to acute exposure to alkali, acid, or hypochlorite. Journal of Pediatric Surgery. 2008;43(9):1672-1678. DOI: 10.1016/j.jpedsurg.2008.01.069
  21. 21. Methasate A, Lohsiriwat V. Role of endoscopy in caustic injury of the esophagus. World Journal of Gastrointestinal Endoscopy. 2018;10(10):274-282. DOI: 10.4253/wjge.v10.i10.274
  22. 22. Salzman M, O’Malley RN. Updates on the evaluation and management of caustic exposures. Emergency Medicine Clinics of North America. 2007;25(2):459-476. DOI: 10.1016/j.emc.2007.02.007
  23. 23. Bonavina L, Chirica M, Skrobic O, et al. Foregut caustic injuries: Results of the world society of emergency surgery consensus conference. World Journal of Emergency Surgery : WJES. 2015;10:44. DOI: 10.1186/s13017-015-0039-0
  24. 24. Ryu HH, Jeung KW, Lee BK, et al. Caustic injury: Can CT grading system enable prediction of esophageal stricture? Clinical Toxicology (Philadelphia, Pa.). 2010;48(2):137-142. DOI: 10.3109/15563650903585929
  25. 25. Agarwal A, Srivastava DN, Madhusudhan KS. Corrosive injury of the upper gastrointestinal tract: The evolving role of a radiologist. The British Journal of Radiology. 2020;93(1114):20200528. DOI: 10.1259/bjr.20200528
  26. 26. Gupta P, Gulati A, Reddy YR, Samanta J, Kochhar R. Does esophageal wall thickness on computed tomography predict response to endoscopic dilatation in patients with corrosive esophageal strictures? JGH Open. 2019;3(5):405-408. DOI: 10.1002/jgh3.12176
  27. 27. Bahrami-Motlagh H, Hadizadeh-Neisanghalb M, Peyvandi H. Diagnostic accuracy of computed tomography scan in detection of upper gastrointestinal tract injuries following caustic ingestion. Emergency (Tehran, Iran). 2017;5(1):e61
  28. 28. Chirica M, Resche-Rigon M, et al. Computed tomography evaluation of high-grade esophageal necrosis after corrosive ingestion to avoid unnecessary esophagectomy. Surgical Endoscopy. 2015;29(6):1452-1461. DOI: 10.1007/s00464-014-3823-0
  29. 29. Isbister GK, Page CB. Early endoscopy or CT in caustic injuries: A re-evaluation of clinical practice. Clinical Toxicology (Philadelphia, Pa.). 2011;49(7):641-642. DOI: 10.3109/15563650.2011.604035
  30. 30. Chirica M, Resche-Rigon M, Zagdanski AM, et al. Computed tomography evaluation of esophagogastric necrosis after caustic ingestion. Annals of Surgery. 2016;264(1):107-113. DOI: 10.1097/SLA.0000000000001459
  31. 31. Bonnici KS, Wood DM, Dargan PI. Should computerised tomography replace endoscopy in the evaluation of symptomatic ingestion of corrosive substances? Clinical Toxicology (Philadelphia, Pa.). 2014;52(9):911-925. DOI: 10.3109/15563650.2014.957310
  32. 32. Tharavej C, Pungpapong SU, Chanswangphuvana P. Outcome of dilatation and predictors of failed dilatation in patients with acid-induced corrosive esophageal strictures. Surgical Endoscopy. 2018;32(2):900-907. DOI: 10.1007/s00464-017-5764-x
  33. 33. Singhal S, Kar P. Management of acid- and alkali-induced esophageal strictures in 79 adults by endoscopic dilation: 8-years’ experience in New Delhi. Dysphagia. 2007;22(2):130-134. DOI: 10.1007/s00455-006-9064-1
  34. 34. Ilkin Naharci M, Tuzun A, et al. Effectiveness of bougie dilation for the management of corrosive esophageal strictures. Acta Gastroenterologica Belgica. 2006;69(4):372-376
  35. 35. Chiu YC, Liang CM, Tam W, et al. The effects of endoscopic-guided balloon dilations in esophageal and gastric strictures caused by corrosive injuries. BMC Gastroenterology. 2013;13:99. DOI: 10.1186/1471-230X-13-99
  36. 36. Kim JH, Song HY, Kim HC, et al. Corrosive esophageal strictures: Long-term effectiveness of balloon dilation in 117 patients. Journal of Vascular and Interventional Radiology. 2008;19(5):736-741. DOI: 10.1016/j.jvir.2008.01.015
  37. 37. Abreu M, Nunes I, Corujeira S, Tavares M, Trindade E, Dias JA. Caustic esophageal stenosis: A case report of endoscopic dilation with a dynamic stent. GE Portuguese Journal of Gastroenterology. 2016;23(4):218-223. DOI: 10.1016/j.jpge.2015.12.006
  38. 38. Kochhar R, Samanta J, Basha J, et al. Biodegradable stents for caustic esophageal strictures: Do they work? Dysphagia. 2017;32(4):575-582. DOI: 10.1007/s00455-017-9800-8
  39. 39. Kochhar R, Ray JD, Sriram PV, Kumar S, Singh K. Intralesional steroids augment the effects of endoscopic dilation in corrosive esophageal strictures. Gastrointestinal Endoscopy. 1999;49(4 Pt 1):509-513. DOI: 10.1016/s0016-5107(99)70052-0
  40. 40. Kochhar R, Makharia GK. Usefulness of intralesional triamcinolone in treatment of benign esophageal strictures. Gastrointestinal Endoscopy. 2002;56(6):829-834. DOI: 10.1067/mge.2002.129871
  41. 41. Nijhawan S, Udawat HP, Nagar P. Aggressive bougie dilatation and intralesional steroids is effective in refractory benign esophageal strictures secondary to corrosive ingestion. Diseases of the Esophagus. 2016;29(8):1027-1031. DOI: 10.1111/dote.12438
  42. 42. Szapáry L, Tinusz B, Farkas N, et al. Intralesional steroid is beneficial in benign refractory esophageal strictures: A meta-analysis. World Journal of Gastroenterology. 2018;24(21):2311-2319. DOI: 10.3748/wjg.v24.i21.2311
  43. 43. Randhawa FA, Butt NF, Talat SO, Sabir SH, Qamar MA. Effectiveness of intralesional steroid injections with dilatation in corrosive oesophageal strictures—A randomized control trial. The Journal of the Pakistan Medical Association. 2018;68(11):1556-1559
  44. 44. Nagaich N, Nijhawan S, Katiyar P, Sharma R, Rathore M. Mitomycin-C: ‘a ray of hope’ in refractory corrosive esophageal strictures. Diseases of the Esophagus. 2014;27(3):203-205. DOI: 10.1111/dote.12092
  45. 45. Méndez-Nieto CM, Zarate-Mondragón F, Ramírez-Mayans J, Flores-Flores M. Topical mitomycin C versus intralesional triamcinolone in the management of esophageal stricture due to caustic ingestion. Revista de Gastroenterología de México. 2015;80(4):248-254. DOI: 10.1016/j.rgmx.2015.07.006
  46. 46. El-Asmar KM, Hassan MA, Abdelkader HM, Hamza AF. Topical mitomycin C can effectively alleviate dysphagia in children with long-segment caustic esophageal strictures. Diseases of the Esophagus. 2015;28(5):422-427. DOI: 10.1111/dote.12218
  47. 47. Ghobrial CM, Eskander AE. Prospective study of the effect of topical application of mitomycin C in refractory pediatric caustic esophageal strictures. Surgical Endoscopy. 2018;32(12):4932-4938. DOI: 10.1007/s00464-018-6253-6
  48. 48. Flor MM, Ribeiro IB, DE Moura DTH, Marques SB, Bernardo WM, DE Moura EGH. Efficacy of endoscopic topical mitomycin C application in caustic esophageal strictures in the pediatric population: A systematic review and meta-analysis of randomized controlled trials. Arquivos de Gastroenterologia. 2021;58(2):253-261. DOI: 10.1590/S0004-2803.202100000-38
  49. 49. Harlak A, Yigit T, Coskun K, et al. Surgical treatment of caustic esophageal strictures in adults. International Journal of Surgery. 2013;11(2):164-168. DOI: 10.1016/j.ijsu.2012.12.010
  50. 50. Okonta KE, Tettey M, Abubakar U. In patients with corrosive oesophageal stricture for surgery, is oesophagectomy rather than bypass necessary to reduce the risk of oesophageal malignancy? Interactive Cardiovascular and Thoracic Surgery. 2012;15(4):713-715. DOI: 10.1093/icvts/ivs320
  51. 51. Nayar R, Varshney V, Suman S, Soni S, Kumar N. Thoracolaparoscopic-assisted esophagectomy for corrosive-induced esophageal stricture. Cureus. 2020;12(5):e7909. DOI: 10.7759/cureus.7909
  52. 52. Gurram RP, Kalayarasan R, Gnanasekaran S, Pottakkat B. Minimally invasive retrosternal esophageal bypass using a mid-colon esophagocoloplasty for corrosive-induced esophageal stricture. World Journal of Surgery. 2020;44(12):4153-4160. DOI: 10.1007/s00268-020-05719-4
  53. 53. Knezević JD, Radovanović NS, Simić AP, et al. Colon interposition in the treatment of esophageal caustic strictures: 40 years of experience. Diseases of the Esophagus. 2007;20(6):530-534. DOI: 10.1111/j.1442-2050.2007.00694.x
  54. 54. Radovanović N, Simić A, Kotarac M, et al. Colon interposition for pharyngoesophageal postcorrosive strictures. Hepato-Gastroenterology. 2009;56(89):139-143
  55. 55. Ain QU, Jamil M, Safian HA, et al. Assessing the degree of acute esophageal injury secondary to corrosive intake: Insights from a public sector hospitals of a developing country. Cureus. 2020;12(10):e10858. DOI: 10.7759/cureus.10858
  56. 56. Katibe R, Abdelgadir I, McGrogan P, Akobeng AK. Corticosteroids for preventing caustic esophageal strictures: Systematic review and meta-analysis. Journal of Pediatric Gastroenterology and Nutrition. 2018;66(6):898-902. DOI: 10.1097/MPG.0000000000001852
  57. 57. Usta M, Erkan T, Cokugras FC, et al. High doses of methylprednisolone in the management of caustic esophageal burns. Pediatrics. 2014;133(6):E1518-E1524. DOI: 10.1542/peds.2013-3331
  58. 58. Pelclová D, Navrátil T. Do corticosteroids prevent oesophageal stricture after corrosive ingestion? Toxicological Reviews. 2005;24(2):125-129. DOI: 10.2165/00139709-200524020-00006
  59. 59. Topaloglu B, Bicakci U, Tander B, et al. Biochemical and histopathologic effects of omeprazole and vitamin E in rats with corrosive esophageal burns. Pediatric Surgery International. 2008;24(5):555-560. DOI: 10.1007/s00383-008-2126-8
  60. 60. Cakal B, Akbal E, Köklü S, Babalı A, Koçak E, Taş A. Acute therapy with intravenous omeprazole on caustic esophageal injury: A prospective case series. Diseases of the Esophagus. 2013;26(1):22-26. DOI: 10.1111/j.1442-2050.2011.01319.x
  61. 61. Mahawongkajit P, Tomtitchong P, Boochangkool N, Mingmalairak C, Awsakulsutthi S, Havanond C. A prospective randomized controlled trial of omeprazole for preventing esophageal stricture in grade 2b and 3a corrosive esophageal injuries. Surgical Endoscopy. 2021;35(6):2759-2764. DOI: 10.1007/s00464-020-07707-0

Written By

Prasit Mahawongkajit

Submitted: 21 October 2021 Reviewed: 02 November 2021 Published: 06 December 2021