Skip to main content

Pathophysiology of Caustic Ingestion

  • Conference paper
Intensive Care Medicine
  • 1257 Accesses

Abstract

A 2005 report from the American Association of Poison Control Centers indicates that there were over 200,000 exposures to caustic substances in the form of household and industrial products, including acids (sulfuric acid, hydrochloric acid), alkalis (potassium hydroxide, sodium hydroxide), and other agents. While the majority of cases involved exposure of a body surface, such as the face, eyes, and extremities, ingestion of the caustic agent was the leading cause of death [1].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Lai MW, Klein-Schwartz W, Rodgers GC, et al (2006) 2005 Annual Report of the American Association of Poison Control Centers’ National Poisoning and Exposure Database. Clin Toxicol 44:803–932

    Google Scholar 

  2. Loeb-Abram PM, Eisenstein M (1998) Caustic injury to the upper gastrointestinal tract. In: Feldman M, Scharschmidt BF, Sleisenger MH, Fordtran JS (eds) Sleisenger and Fordtran’s Gastrointestinal and Liver Disease, 6th edition. W. B. Saunders Company, Philadelphia, pp 335–342

    Google Scholar 

  3. Gorman RL, Khing-Maung-Gyi MT, Klein-Schwartz W, et al (1992) Initial symptoms as predictors of esophageal injury in alkaline corrosive ingestions. Am J Emerg Med 10:189–194

    Article  PubMed  CAS  Google Scholar 

  4. Dale Browne J, Thompson JN (2005) Caustic ingestion. In: Cummings CW, Haughey BH, Thomas JR, Harker LA, Flint PW (eds) Cummings Otolaryngology: Head and Neck Surgery, 4th ed. Mosby, New York, pp 1869–1872

    Google Scholar 

  5. Zargar SA, Kochhar R, Nagi B, Mehta S, Mehta SK (1992) Ingestion of strong corrosive alkalis: spectrum of injury to upper gastrointestinal tract and natural history. Am J Gastroenterol 87:337–341

    PubMed  CAS  Google Scholar 

  6. Kynaston JA, Patrick MK, Shepherd RW, Raivadera PV, Cleghorn GI (1989) The hazards of automatic-dishwasher detergent. Med J Aust 151:155

    Google Scholar 

  7. Mattos GM, Lopes DD, Mamede RC, Ricz H, Mello-Filho FV, Neto JB (2006) Effects of time of contact and concentration of caustic agent on generation of injuries. Laryngoscope 116: 456–460

    Article  PubMed  Google Scholar 

  8. Havanond C (2002) Is there a difference between the management of grade 2b and 3 corrosive gastric injuries? J Med Assoc Thai 85:340–344

    PubMed  Google Scholar 

  9. Sivilotti MLA, Ford M (2000) Alkali ingestions. In: Ford M, Delaney KA, Ling L, Erickson T (eds) Clinical Toxicology, 1st ed. W. B. Saunders Company, Philadelphia, pp 1002–1007

    Google Scholar 

  10. Hoffman RS, Howland MA, Kamerow HN, Goldfrank LR (1989) Comparison of titratable acid/alkaline reserve and pH in potentially caustic household products. J Toxicol Clin Toxicol 27:241–261

    PubMed  CAS  Google Scholar 

  11. Boldt GB, Carroll RG (1996) Titratable acid/alkaline reserve is not predictive of esophageal perforation risk after caustic exposure. Am J Emerg Med 14:106–108

    Article  PubMed  CAS  Google Scholar 

  12. Kirsh MM, Ritter F (1976) Caustic ingestion and subsequent damage to the oropharyngeal and digestive passages. Ann Thorac Surg 21:74–82

    Article  PubMed  CAS  Google Scholar 

  13. Penner GE (1980) Acid ingestion: Toxicity and treatment. Ann Emerg Med 9:374–379

    Article  PubMed  CAS  Google Scholar 

  14. Ritter FN, Newman MH, Newman DE (1968) A clinical and experimental study of corrosive burns of the stomach. Ann Otol Rhin Laryngol 77:830–842

    CAS  Google Scholar 

  15. Clifton JC II (2001) Acid ingestions. In: Ford M, Delaney KA, Ling L, Erickson T (eds) Clinical Toxicology, 1st ed. W. B. Saunders Company, Philadelphia, pp 1009–1018

    Google Scholar 

  16. Gunel E, Caglayan F, Caglayan O, Akillioglu I (1999) Reactive oxygen radical levels in caustic esophageal burns. J Pediatr Surg 34:405–407

    Article  PubMed  CAS  Google Scholar 

  17. Homan CS, Maitra SR, Lane BP, Thode HC, Sable M (1994) Therapeutic effects of water and milk for acute alkali injury of the esophagus. Ann Emerg Med 24:14–20

    Article  PubMed  CAS  Google Scholar 

  18. Homan CS, Maitra SR, Lane BP, Thode HC Jr, Finkelshteyn J, Davidson L (1995) Effective treatment for acute alkali injury to the esophagus using weak-acid neutralization therapy: an ex-vivo study. Acad Emerg Med 2:952–958

    Article  PubMed  CAS  Google Scholar 

  19. Rumack BH, Burrington JD (1977) Caustic ingestions: a rational look at diluents. Clin Toxicol 11:27–34

    PubMed  CAS  Google Scholar 

  20. Bronsted JN (1923) Some remarks on the concept of acids and bases. Reel Trav Chim Pays Bas 42:718–728

    CAS  Google Scholar 

  21. Cardona JC, Daly JF (1971) Current management of corrosive esophagitis: An evaluation of results in 239 cases. Ann Otol Rhinol Laryngol 80:521–526

    PubMed  CAS  Google Scholar 

  22. Rubin MM, Jui V, Cozzi GM (1989) Treatment of caustic ingestion. J Oral Maxillofac Surg 47: 286–290

    Article  PubMed  CAS  Google Scholar 

  23. Zargar SA, Kochhar R, Nagi B, Mehta S, Mehta SK (1989) Ingestion of corrosive acids: Spectrum of injury to upper gastrointestinal tract and natural history. Gastroenterology 97:702–707

    PubMed  CAS  Google Scholar 

  24. Poley JW, Steyerberg EW, Kuipers EJ, et al (2004) Ingestion of acid and alkaline agents: outcome and prognostic value of early upper endoscopy. Gastrointest Endosc 60:372–377

    Article  PubMed  Google Scholar 

  25. Litovitz TL, Schmitz BF (1992) Ingestion of cylindrical and button batteries: An analysis of 2382 cases. Pediatrics 89:747–757

    PubMed  CAS  Google Scholar 

  26. Barber TE, Menke RD (1984) The relationship of ingested iron to the absorption of mercuric oxide. Am J Emerg Med 2:500–503

    Article  PubMed  CAS  Google Scholar 

  27. Anderson WJ, Anderson JR (1988) Hydrofluoric acid burns of the hand: Mechanism of injury and treatment. J Hand Surg 13A:52–57

    Google Scholar 

  28. Sadove R, Hainsworth D, Van Meter W (1990) Total body immersion in hydrofluoric acid. South Med J 83:698–700

    Article  PubMed  CAS  Google Scholar 

  29. Edinburg M, Swift R (1989) Hydrofluoric acid burns of the hands: A case report and suggested management. Aust NZ J Surg 59:88–91

    Article  CAS  Google Scholar 

  30. Kirkpatrick JJ, Enion DS, Burd DA (1995) Hydrofluoric acid burns: A review. Burns 21: 483–493

    Article  PubMed  CAS  Google Scholar 

  31. Klasaer AE, Scalzo AJ, Blume C, Johnson P, Thompson MW (1996) Marked hypocalcemia and ventricular fibrillation in two pediatric patients exposed to a fluoride-containing wheel cleaner. Ann Emerg Med 28:713–718

    Article  PubMed  CAS  Google Scholar 

  32. Mullett T, Zoeller T, Bingham H, et al (1987) Fatal hydrofluoric acid cutaneous exposure with refractory ventricular fibrillation. J Burn Care Rehabil 8:216–219

    Article  PubMed  CAS  Google Scholar 

  33. Cardona J, Boussemart T, Berthier M, Oriot D (1993) [Accidental bleach ingestion in children: Results of a survey of 11 anti-poison centres. Proposals for management.] Pediatrie 48:705–709

    PubMed  CAS  Google Scholar 

  34. Ward MJ, Routledge PA (1988) Hypernatraemia and hyperchloraemic acidosis after bleach ingestion. Hum Toxicol 7:37–38

    Article  PubMed  CAS  Google Scholar 

  35. Davids PH, Bartelsman JF, Tilanus HW, van Lanschot JJ (2001) [Consequences of caustic damage of the esophagus]. Ned Tijdschr Geneeskd 145:2105–2108

    PubMed  CAS  Google Scholar 

  36. Muhletaler CA, Gerlock AJ Jr, de Soto L, Halter SA (1980) Acid corrosive esophagitis: Radiographic findings. Am J Roentgenol 134:1137–1140

    CAS  Google Scholar 

  37. Hawkins DB, Demeter MJ, Barnett TE (1980) Caustic ingestion: Controversies in management: A review of 214 cases. Laryngoscope 90:98–109

    Article  PubMed  CAS  Google Scholar 

  38. Bautista Casasnovas A, Estevez Martinez E, Varela Cives R, Villanueva Jeremias A, Tojo Sierra R, Cadranel S (1997) A retrospective analysis of ingestion of caustic substances by children: Ten-year statistics in Galicia. Eur J Pediatr 156:410–414

    Google Scholar 

  39. Gumaste VV, Dave PB (1992) Ingestion of corrosive substances by adults. Am J Gastroenterol 87:1–5

    PubMed  CAS  Google Scholar 

  40. Waldeyer W (1908) Die Magenstrasse. Sitzungsber K Preuss, aka d Wissench Gesammtsitz 29: 595–606

    Google Scholar 

  41. Zargar SA, Kochhar R, Mehta S, Mehta SK (1991) The role of fiberoptic endoscopy in the management of corrosive ingestion and modified endoscopic classification of burns. Gastrointest Endosc 37:165–169

    Article  PubMed  CAS  Google Scholar 

  42. Johnson EE (1963) A study of corrosive esophagitis. Laryngoscope 73:1651–1696

    Article  PubMed  CAS  Google Scholar 

  43. Hopkins RA, Postlethwait RW (1981) Caustic burns and carcinoma of the esophagus. Ann Surg 194:146–148

    Article  PubMed  CAS  Google Scholar 

  44. Bautista A, Varela R, Villanueva A, Estevez E, Tojo R, Cadranel S (1996) Motor function of the esophagus after caustic burn. Eur J Pediatr Surg 6:204–207

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2008 Springer Science + Business Media Inc.

About this paper

Cite this paper

Osman, M., Granger, D.N. (2008). Pathophysiology of Caustic Ingestion. In: Vincent, JL. (eds) Intensive Care Medicine. Springer, New York, NY. https://doi.org/10.1007/978-0-387-77383-4_16

Download citation

  • DOI: https://doi.org/10.1007/978-0-387-77383-4_16

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-77382-7

  • Online ISBN: 978-0-387-77383-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics