Caustic Ingestion

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.

 

Symptoms:

  • 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.

 

Complications:

  • 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.

Effects:

 

1.  Severe lip and edema ulceration:

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2.  Severe tongue burn and swelling:

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3.   Severe uvula and edema swelling:

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