Esophageal Injury Secondary to Caustic Ingestion
What is a caustic ingestion?
A caustic ingestion, which is a medical emergency, occurs when a child ingests a toxic substance. This is often a household cleaning material or laundry detergent. There are two forms of caustic ingestion- an alkaline agent or an acidic agent- this is determined by the pH of the substance.
Examples of Toxic substances in the household:
- Common household cleaning products such as oven or drain cleaners.
- Laundry detergent pods are often ingested as they are colorful and attract the attention and curiosity of the child.
- Hair relaxers.
Age group most at risk: Toddlers and Preschool age children.
- Choking or difficulty swallowing
- Vomiting or the vomiting of blood
- Bleeding from the mouth
- Abdominal pain or chest pain
- Respiratory distress
Treatment: A caustic ingestion or suspicion of one is a medical emergency
- Often the child will need EGD-Upper endoscopy to evaluate the extent of the damage to the esophagus or stomach.
- Respiratory support may be needed if upper airway is injured.
Risks of Caustic Ingestion:
The amount of the toxic material ingested is often small but the degree of injury can still be great.
- Severe swelling of the mouth, throat or esophagus.
- Upper airway injury or respiratory distress.
- Necrosis of the mouth, throat, esophagus or stomach.
- The long term complications of caustic ingestion include loss of esophageal motility, esophageal stricture or stenosis.
- Gastric injury is less common in children since they usually do not ingest an amount large enough to reach the stomach.
1. Severe lip and edema ulceration:
2. Severe tongue burn and swelling:
3. Severe uvula and edema swelling: