Caustic ingestion. Issue 10083 (20th May 2017)

• Record Type: Journal Article
• Authors: Chirica, Mircea; Bonavina, Luigi; Kelly, Michael D; Sarfati, Emile; Cattan, Pierre
• Is Part Of: Lancet. Volume 389:Issue 10083(2017)
• Page Start: 2041
• Page End: 2052
• Publication Date: 2017-05-20
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Medicine; Medicine; Electronic journals; Periodicals; 610.5
• DOI: 10.1016/S0140-6736(16)30313-0
• Languages: English
• ISSNs: 0140-6736

Abstract

Summary: Corrosive ingestion is a rare but potentially devastating event and, despite the availability of effective preventive public health strategies, injuries continue to occur. Most clinicians have limited personal experience and rely on guidelines; however, uncertainty persists about best clinical practice. Ingestions range from mild cases with no injury to severe cases with full thickness necrosis of the oesophagus and stomach. CT scan is superior to traditional endoscopy for stratification of patients to emergency resection or observation. Oesophageal stricture is a common consequence of ingestion and newer stents show some promise; however, the place of endoscopic stenting for corrosive strictures is yet to be defined. We summarise the evidence to provide a plan for managing these potentially life-threatening injuries and discuss the areas where further research is required to improve outcomes.