Corrosive ingestion-induced esophageal injuries: A systematic review and meta-analysis

Esophageal corrosive injuries resulting from caustic substance ingestion present significant challenges. Management is complicated by the diverse nature of the injuries and the varying diagnostic approaches required. The aim of this study was to provide a comprehensive analysis of the epidemiology, diagnostic approaches, risk factors, and outcomes associated with esophageal corrosive injuries.

A systematic review and meta-analysis was conducted using the Medline, Embase, CINAHL, CENTRAL, and Web of Science databases, identifying studies from January 2000 to August 2024. Inclusion criteria encompassed clinical studies on patients with esophageal corrosive injuries, focusing on adults. Statistical analyses, including proportional meta-analysis and hierarchical summary receiver operating characteristic modeling, assessed incidence rates, diagnostic performance, and risk factors for mortality and stricture formation.

A total of 44 studies involving 6,093 patients were analyzed. Intentional ingestion was more prevalent (65.6%), with alkaline substances most frequently ingested (45.6%). The pooled mortality rate was 6.2%, while stricture formation occurred in 24.7% of cases. Endoscopy showed a sensitivity of 82.4% and a specificity of 70.2% for predicting adverse outcomes compared with 63.8% and 72.8% for computed tomography, respectively. Grade III injuries and intentional ingestion were strongly associated with increased risk of stricture formation and mortality.

Esophageal corrosive injury remains a significant medical challenge, particularly in cases involving intentional ingestion and severe injury grades. Endoscopy remains the preferred diagnostic modality, with superior sensitivity compared with computed tomography. Improved management strategies targeting high-risk patients could reduce morbidity and mortality associated with esophageal corrosive injuries.