Corrosive esophageal injuries. I. A study of nine cases of concurrent accidental caustic ingestion

Treatment of corrosive injuries of the esophagus remains largely unsatisfactory, and severe esophageal burns still frequently result in stricture with accompanying morbidity or death. The nine patients presented here with 3-year follow-up accidentally drank a concentrated alkaline solution. All were teenagers or young adults who drank from the same bottle while at a party. The problems encountered in these patients led us to conclude that all patients with moderate to severe corrosive injury of the esophagus should have assessment of the entire esophagus and stomach at the time of initial assessment. Six patients underwent diagnostic laparotomy and one underwent thoracotomy as well for assessment of his esophageal injuries. Had we followed the traditional approach of esophagoscopy only to the level of the first circumferential burn, more severe and potentially life-threatening injuries would have been missed. Early endoscopic evaluation of the esophagus and stomach remains the standard for diagnosis; however, complete assessment may require laparotomy or thoracotomy. Early resection of necrotic tissue in the esophagus or stomach can lead to increased survival.