Skip to main content

Caustic Ingestion

  • Chapter
  • First Online:
Textbook of Emergency General Surgery

Abstract

Caustic ingestion is a rare but devastating condition, and the emergency management of these patients is a difficult challenge. Computed tomography has replaced endoscopy in therapeutic algorithms and can be used alone safely to select patients for emergency surgery or non-operative management. Better patient selection resulted in decreased use of emergency resection procedures and significant improvements in patient survival and nutritional outcomes. Despite recent progress mortality and morbidity rates in patients with digestive caustic necrosis are still very high. The present chapter outlines the modern principles of emergency management of caustic ingestion.

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 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 199.99
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

References

  1. Chirica M, Bonavina L, Kelly MD, Sarfati E, Cattan P. Caustic ingestion. Lancet. 2017;389(10083):2041–52.

    Article  PubMed  Google Scholar 

  2. Contini S, Scarpignato C. Caustic injury of the upper gastrointestinal tract: a comprehensive review. World J Gastroenterol. 2013;19(25):3918–30.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Chirica M, Resche-Rigon M, Bongrand NM, Zohar S, Halimi B, Gornet JM, et al. Surgery for caustic injuries of the upper gastrointestinal tract. Ann Surg. 2012;256(6):994–1001.

    Article  PubMed  Google Scholar 

  4. Chirica M, Brette MD, Faron M, Munoz Bongrand N, Halimi B, Laborde C, et al. Upper digestive tract reconstruction for caustic injuries. Ann Surg. 2015;261(5):894–901.

    Article  PubMed  Google Scholar 

  5. Bruzzi M, Chirica M, Resche-Rigon M, Corte H, Voron T, Sarfati E, et al. Emergency computed tomography predicts caustic esophageal stricture formation. Ann Surg. 2018;270(1):109–14.

    Article  Google Scholar 

  6. Chirica M, Resche-Rigon M, Pariente B, Fieux F, Sabatier F, Loiseaux F, et al. Computed tomography evaluation of high-grade esophageal necrosis after corrosive ingestion to avoid unnecessary esophagectomy. Surg Endosc. 2015;29(6):1452–61.

    Article  PubMed  Google Scholar 

  7. Chirica M, Resche-Rigon M, Zagdanski AM, Bruzzi M, Bouda D, Roland E, et al. Computed tomography evaluation of esophagogastric necrosis after caustic ingestion. Ann Surg. 2016;264(1):107–13.

    Article  PubMed  Google Scholar 

  8. Chirica M, Bonavina L, Cattan P. Ingestion of caustic substances. N Engl J Med. 2020;383(6):600.

    PubMed  Google Scholar 

  9. Hugh TB, Kelly MD. Corrosive ingestion and the surgeon. J Am Coll Surg. 1999;189(5):508–22.

    Article  CAS  PubMed  Google Scholar 

  10. Keh SM, Onyekwelu N, McManus K, McGuigan J. Corrosive injury to upper gastrointestinal tract: still a major surgical dilemma. World J Gastroenterol. 2006;12(32):5223–8.

    PubMed  PubMed Central  Google Scholar 

  11. Ramasamy K, Gumaste VV. Corrosive ingestion in adults. J Clin Gastroenterol. 2003;37(2):119–24.

    Article  PubMed  Google Scholar 

  12. Hoffman RS, Burns MM, Gosselin S. Ingestion of caustic substances. N Engl J Med. 2020;382(18):1739–48.

    Article  CAS  PubMed  Google Scholar 

  13. Contini S, Garatti M, Swarray-Deen A, Depetris N, Cecchini S, Scarpignato C. Corrosive oesophageal strictures in children: outcomes after timely or delayed dilatation. Dig Liver Dis. 2009;41(4):263–8.

    Article  CAS  PubMed  Google Scholar 

  14. Contini S, Swarray-Deen A, Scarpignato C. Oesophageal corrosive injuries in children: a forgotten social and health challenge in developing countries. Bull World Health Organ. 2009;87(12):950–4.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Ducoudray R, Mariani A, Corte H, Kraemer A, Munoz-Bongrand N, Sarfati E, et al. The damage pattern to the gastrointestinal tract depends on the nature of the ingested caustic agent. World J Surg. 2016;40(7):1638–44.

    Article  PubMed  Google Scholar 

  16. Chirica M, Kelly MD, Siboni S, Aiolfi A, Riva CG, Asti E, et al. Esophageal emergencies: WSES guidelines. World J Emerg Surg. 2019;14:26.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Bonavina L, Chirica M, Skrobic O, Kluger Y, Andreollo NA, Contini S, et al. Foregut caustic injuries: results of the world society of emergency surgery consensus conference. World J Emerg Surg. 2015;10:44.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Tohda G, Sugawa C, Gayer C, Chino A, McGuire TW, Lucas CE. Clinical evaluation and management of caustic injury in the upper gastrointestinal tract in 95 adult patients in an urban medical center. Surg Endosc. 2008;22(4):1119–25.

    Article  PubMed  Google Scholar 

  19. Zerbib P, Voisin B, Truant S, Saulnier F, Vinet A, Chambon JP, et al. The conservative management of severe caustic gastric injuries. Ann Surg. 2011;253(4):684–8.

    Article  PubMed  Google Scholar 

  20. Mensier A, Onimus T, Ernst O, Leroy C, Zerbib P. Evaluation of severe caustic gastritis by computed tomography and its impact on management. J Visc Surg. 2020;157(6):469–74.

    Article  CAS  PubMed  Google Scholar 

  21. Observational Study JAMA Surg. 2022;157(2):112–119. https://doi.org/10.1001/jamasurg.2021.6368. Outcomes Associated With Caustic Ingestion Among Adults in a National Prospective Database in France Alexandre Challine 1 2, Léon Maggiori 1, Sandrine Katsahian 2 3, Hélène Corté 1, Diane Goere 1, Andrea Lazzati 4 5, Pierre Cattan 1, Mircea Chirica 6 Affiliations expand PMID: 34878529; PMCID: PMC8655661. https://doi.org/10.1001/jamasurg.2021.6368

  22. Di Saverio S, Biscardi A, Piccinini A, Mandrioli M, Tugnoli G. Different possible surgical managements of caustic ingestion: diagnostic laparoscopy for Zargar’s grade 3a lesions and a new technique of “duodenal damage control” with “4-tubes ostomy” and duodenal wash-out as an option for extensive 3b lesions in unstable patients. Update Surg. 2015;67(3):313–20.

    Article  Google Scholar 

  23. Cattan P, Munoz-Bongrand N, Berney T, Halimi B, Sarfati E, Celerier M. Extensive abdominal surgery after caustic ingestion. Ann Surg. 2000;231(4):519–23.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Chirica M, Veyrie N, Munoz-Bongrand N, Zohar S, Halimi B, Celerier M, et al. Late morbidity after colon interposition for corrosive esophageal injury: risk factors, management, and outcome. A 20-year experience. Ann Surg. 2010;252(2):271–80.

    Article  PubMed  Google Scholar 

  25. Chirica M, Vuarnesson H, Zohar S, Faron M, Halimi B, Munoz Bongrand N, et al. Similar outcomes after primary and secondary esophagocoloplasty for caustic injuries. Ann Thorac Surg. 2012;93(3):905–12.

    Article  PubMed  Google Scholar 

  26. Chirica M, Kraemer A, Petrascu E, Vuarnesson H, Pariente B, Halimi B, et al. Esophagojejunostomy after total gastrectomy for caustic injuries. Dis Esophagus. 2013;27(2):122–7.

    Article  PubMed  Google Scholar 

  27. Lefrancois M, Gaujoux S, Resche-Rigon M, Chirica M, Munoz-Bongrand N, Sarfati E, et al. Oesophagogastrectomy and pancreatoduodenectomy for caustic injury. Br J Surg. 2011;98(7):983–90.

    Article  CAS  PubMed  Google Scholar 

  28. Faron M, Corte H, Poghosyan T, Bruzzi M, Voron T, Sarfati E, et al. Quality of life after caustic ingestion. Ann Surg. 2020;274(6):e529–34.

    Article  Google Scholar 

  29. Raynaud K, Seguy D, Rogosnitzky M, Saulnier F, Pruvot FR, Zerbib P. Conservative management of severe caustic injuries during acute phase leads to superior long-term nutritional and quality of life (QoL) outcome. Langenbecks Arch Surg. 2015;401(1):81–7.

    Article  PubMed  Google Scholar 

  30. Benjamin B, Agueb R, Vuarnesson H, Tranchart H, Bongrand NM, Sarfati E, et al. Tracheobronchial necrosis after caustic ingestion. Ann Surg. 2015;263(4):808–13.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Chirica, M., Corte, H., Cattan, P. (2023). Caustic Ingestion. In: Coccolini, F., Catena, F. (eds) Textbook of Emergency General Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-22599-4_58

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-22599-4_58

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-22598-7

  • Online ISBN: 978-3-031-22599-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics