Overview
What is the pathophysiology of caustic alkaline ingestions?
What is the pathophysiology of caustic ingestions?
What is the pathophysiology of caustic acid ingestions?
What are the common sources of caustic acid ingestions?
What are the common sources of caustic alkaline ingestions?
What is the incidence of caustic ingestions in the US?
How does the incidence of caustic ingestions vary by age?
What is the prognosis of caustic ingestions?
What information should patients be given about preventing caustic ingestions?
Presentation
What is the clinical history of caustic ingestions?
What are the signs and symptoms of caustic ingestions?
What is the focus of clinical history in suspected caustic ingestions?
What are the signs and symptoms of impending airway obstruction of caustic ingestions?
Which physical signs of injury suggest caustic ingestions?
What are indications of severe injury in patients with caustic ingestions?
What are complications of caustic ingestions?
DDX
What are the initial complications of caustic ingestions?
What are the late-developing complications of caustic ingestions?
What are the differential diagnoses for Caustic Ingestions?
Workup
Which lab tests are performed in the workup of caustic ingestions?
What is the role of imaging studies in the workup of caustic ingestions?
Which initial procedures are performed following a caustic ingestion?
What is the role of endoscopy in the workup of caustic ingestions?
What is the role of activated charcoal in the treatment of caustic ingestions?
What is the role of endoscopic ultrasonography in the evaluation of caustic ingestions?
Treatment
What is an algorithm used for the diagnosis and management of caustic ingestions?
What is the focus of treatment for caustic ingestions?
What are the criteria for discharge following treatment for a caustic ingestion?
What should be included in followup treatment after a caustic ingestion?
What is the prehospital care for caustic ingestions?
How are patients with caustic ingestions triaged in the emergency department (ED)?
What is the role of dilution in the emergency department care of caustic ingestions?
What is the role of neutralization in the emergency department care of caustic ingestions?
When is inpatient care indicated for caustic ingestions?
Which visualization technique is used for airway management in patients with caustic ingestions?
When is surgical consultation indicated for the treatment of caustic ingestions?
When is endoscopic consultation indicated for the management of caustic ingestions?
Which specialist consultations are beneficial for patients with caustic ingestion?
What is the role of steroids in the treatment of caustic ingestions?
How are esophageal strictures treated following a caustic ingestion?
How are caustic ingestions prevented?
Why is long-term endoscopic screening required for patients following a caustic ingestion?
Guidelines
What are the ESGE-ESPGHAN treatment guidelines for caustic ingestions in pediatric patients?
Medications
What is the focus of management for caustic ingestions?
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Caustic ingestions. Endoscopic view of the esophagus in a patient who ingested hydrochloric acid (Lime-a-way). Note the extensive thrombosis of the esophageal submucosal vessels giving the appearance similar to chicken wire. Courtesy of Ferdinando L Mirarchi, DO, Fred P Harchelroad, Jr, MD, Sangeeta Gulati, MD, and George J Brodmerkel, Jr, MD.
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Caustic ingestions. Endoscopic view of the esophagus in a patient who ingested hydrochloric acid (Lime-a-way). Note the appearance of the thrombosed esophageal submucosal vessels giving the appearance of chicken wire. Courtesy of Ferdinando L Mirarchi, DO, Fred P Harchelroad, Jr, MD, Sangeeta Gulati, MD, and George J Brodmerkel, Jr, MD.
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Caustic ingestions. Endoscopic view of the esophagus in a patient who ingested hydrochloric acid (Lime-a-way). Note the extensive burn and thrombosis of the submucosal esophageal vessels, which gives the appearance of chicken wire. Courtesy of Ferdinando L Mirarchi, DO, Fred P Harchelroad, Jr, MD, Sangeeta Gulati, MD, and George J Brodmerkel, Jr, MD.