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Role of Endoscopic Ultrasound (EUS) in Predicting Stricture Formation Following Caustic Injury
Mark Anthony De Lusong1, A Nico Nahar Pajes2, Mara Teresa Panlilio2
1Division of Gastroenterology, Department of Medicine, University of the Philippines-Philippine General Hospital, Taft Avenue, 1000, Manila, Philippines. madelusong@up.edu.ph.
Digestive Diseases and Sciences
|November 4, 2025
Summary
Endoscopic ultrasound (EUS) shows promise in predicting esophageal strictures after caustic ingestion, complementing standard endoscopy. This may improve risk stratification and guide patient management for better outcomes.
Area of Science:
- Gastroenterology
- Medical Imaging
- Public Health
Background:
- Caustic ingestion causes significant morbidity, including esophageal strictures.
- Esophagogastroduodenoscopy (EGD) grades mucosal injury but not wall depth.
- Endoscopic ultrasound (EUS) assesses transmural involvement but its prognostic value in caustic injury is unclear.
Purpose of the Study:
- To evaluate the prognostic role of EUS in predicting stricture formation after caustic ingestion.
- To compare EUS findings with EGD (Zargar classification) for risk stratification.
- To assess the clinical outcomes and complication rates associated with EUS in this context.
Main Methods:
- Prospective cohort study of 63 adults with caustic ingestion.
- All patients underwent EGD and EUS within 24 hours.
- Follow-up for 12 weeks to monitor stricture development and clinical outcomes.
Main Results:
- Strictures developed in 41% of patients; male sex was a significant risk factor.
- EUS identified muscularis/serosal involvement correlating with stricture formation.
- No strictures formed in patients with Zargar grade I or mucosal-only EUS findings.
- Dysphagia was common (40%) at 12 weeks; no EUS complications occurred.
Conclusions:
- EUS provides valuable prognostic information complementary to EGD for caustic ingestion injuries.
- EUS may enhance risk stratification, especially for intermediate-to-high grade injuries.
- Early EUS integration could guide monitoring and interventions, improving patient outcomes.
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