Corrosive Ingestion

Question 1

………corrosive agents tend to cause injury to the esophagus more. While ……..causes more injury to stomach

Answer 1

Alkaline = esophagus 
Acidic = stomach

Question 2

Is drain cleaner usually acidic or alkaline ?

Answer 2

Alkaline because of sodium hydroxide

Question 3

Should you use neutralizing agent to treat corrosive ingestion?

Answer 3

Never

Question 4

Is gastric lavage is recommended in case of corrosive substance injury ?

Answer 4

No, because of the risk of re-exposure of the esophagus and stomach to the offending agent

Question 5

When is the best time to perform endoscopy in case of corrosive substance ingestion?

Answer 5

Best within 2 days, acceptable up to 4 days. After that it’s dangerous because the tissue in healing process which means it’s soft . But in some cases it still can be done up to 2 weeks

Question 6

Is intubation is necessary prior endoscopy?

Answer 6

No. It’s strictly indicated in people with respiratory distress. Otherwise a sedation should be used

Question 7

Why is CT considered better than endoscopy in case of corrosive substance ingestion?

Answer 7

It can reveal the transmural damage in the esophagus and stomach lining
Also it can show or predict perforation

Question 8

In case of corrosive ingestion, when is antibiotic is recommended?

Answer 8

In case of pulmonary involvement, also corticosteroids can be added ( although corticosteroids in esophageal strictures shows no benefits )