Caustic Ingestions Differential Diagnoses

Updated: Oct 27, 2018
  • Author: Eric M Kardon, MD, FACEP; Chief Editor: David Vearrier, MD, MPH  more...
  • Print
DDx

Diagnostic Considerations

Airway obstruction may occur secondary to edema, bleeding, and the presence of necrotic material. Because this can develop rapidly, airway protection is paramount following caustic ingestions. Delays in securing a definitive airway can result in increased difficulty due to progressive airway edema.

Esophageal gastric, bowel, airway, or vascular perforation may occur.

Fluid losses from vomiting, third spacing, and gastrointestinal bleeding may lead to hypovolemia and shock. This is particularly true after ingestion of metallic chlorides.

After significant acidic ingestions, the patient may develop metabolic acidosis, hemolysis, and multiorgan failure including acute renal failure.

Hypocalcemia develops precipitously after ingestion of significant amounts of hydrogen fluoride.

In patients who survive the initial phases of injury, late-developing problems include the following:

  • Strictures
  • Fistula
  • Hypomotility disorders
  • Increased risk of gastrointestinal cancers

Differential Diagnoses