Esophageal Injury Secondary to Caustic Ingestion

What is a caustic ingestion? A caustic ingestion, which is a medical emergency, occurs when a child ingests a toxic substance.  This is often a household cleaning material or laundry detergent. There are two forms of caustic ingestion- an alkaline agent or an acidic agent- this is determined by the pH of the substance. Examples of Toxic substances in the household:

• Common household cleaning products such as oven or drain cleaners.
• Laundry detergent pods are often ingested as they are colorful and attract the attention and curiosity of the child.
• Hair relaxers.

Age group most at risk: Toddlers and Preschool age children. Symptoms:

• Choking or difficulty swallowing
• Vomiting or the vomiting of blood
• Bleeding from the mouth
• Abdominal pain or chest pain
• Respiratory distress

Treatment:  A caustic ingestion or suspicion of one is a medical emergency

• Often the child will need EGD-Upper endoscopy to evaluate the extent of the damage to the esophagus or stomach.
• Respiratory support may be needed if upper airway is injured.

Risks of Caustic Ingestion: The amount of the toxic material ingested is often small but the degree of injury can still be great. Complications:

• Severe swelling of the mouth, throat or esophagus.
• Upper airway injury or respiratory distress.
• Necrosis of the mouth, throat, esophagus or stomach.
• The long term complications of caustic ingestion include loss of esophageal motility, esophageal stricture or stenosis.
• Gastric injury is less common in children since they usually do not ingest an amount large enough to reach the stomach.