Integrative Biomedical Research
Integrative Biomedical Research (Journal of Angiotherapy) | Online ISSN 3068-6326
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Volume 8 Number 8 2024
REVIEWS (Open Access)
Clinical Spectrum, Pathophysiology, and Multidisciplinary Management of Caustic Ingestion Injuries in the Upper Gastrointestinal Tract
Habib Farah Awwad Alanazi 1, Abdullah Rashed Tami Alzuabi 2, Ali Mohammed Abdullah Alshehri 1, Amin Saleha Ali Alshehri 2, Ghareeb Mohammed Ghareeb Alruwaili 2, Mohmmed Abulhedie Alamri 2, Faleh Mohammed Lafi Alshalawi 3, Ali Naif Ali Alotaibi 4, Ahmad Mohammed Alharbi 2, Adel Mohammed AlJabri 2, Mohammed Daleem Alotaibi 2, Majed Abdulrahman Al-Shehri 4 Habib Farah Awwad Alanazi 1, Abdullah Rashed Tami Alzuabi 2, Ali Mohammed Abdullah Alshehri 1, Amin Saleha Ali Alshehri 2, Ghareeb Mohammed Ghareeb Alruwaili 2, Mohmmed Abulhedie Alamri 2, Faleh Mohammed Lafi Alshalawi 3, Ali Naif Ali Alotaibi 4, Ahmad Mohammed Alharbi 2, Adel Mohammed AlJabri 2, Mohammed Daleem Alotaibi 2, Majed Abdulrahman Al-Shehri 4, Fahad Ayidh H Alotaibi 4, Faisal Bunayyan Binyah Alrashdi 4
Journal of Angiotherapy 8 (8) 1-12 https://doi.org/10.25163/angiotherapy.8810683
Submitted: 10 June 2024 Revised: 15 August 2024 Accepted: 22 August 2024 Published: 24 August 2024
Abstract
Caustic ingestion remains a significant global emergency, particularly affecting children through accidental exposure and adults through intentional selfharm. The resulting injuries span the oral cavity, pharynx, esophagus, stomach, and duodenum, with alkaline agents producing liquefactive necrosis and acids causing coagulative necrosis. This updated review aims to summarize current knowledge on the clinical presentation, evaluation, management, complications, and outcomes of caustic ingestions in emergency and paramedic settings. The article synthesizes evidence from recent clinical studies and expert guidelines, addressing epidemiology, pathophysiology, diagnostic strategies, endoscopic grading, imaging modalities, and multidisciplinary management approaches. Findings highlight that early recognition and airway stabilization are critical, with up to 50% of adult cases requiring intubation. Endoscopy within 24 hours remains the gold standard for injury grading, while CT imaging assists in assessing deep tissue involvement. Severe cases may lead to perforation, mediastinitis, strictures, or multiorgan failure. Treatment includes supportive care, selective use of NG tubes, endoscopic dilation, stenting, and, in extreme cases, surgical resection. Optimal outcomes depend on early airway protection, timely endoscopic evaluation, individualized management, and coordinated multidisciplinary care. Preventive strategies—including safe chemical storage, childresistant packaging, and enhanced mentalhealth support—are essential to reduce incidence and longterm morbidity.
Keywords: Caustic ingestion, emergency care, esophageal injury, endoscopy, liquefactive necrosis, coagulative necrosis, airway management, gastrointestinal burns, stricture, multidisciplinary management.
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