treatment
Last reviewed 01/2018
The individual who has ingested corrosive is an emergency. Immediate management should entail the oral administration of a buffer solution to neutralise the corrosive agent, and giving analgesics, fluid replacement and antibiotics parenterally. Emetics are contra-indicated. Corticosteroids might be considered in order to dampen the expected inflammatory fibrosis.
When possible, a fibreoptic endoscope should be passed to assess the extent of pharyngeal and distal injuries. If perforation or gastric necrosis has occurred, surgical intervention is mandatory. This entails oesophagectomy with cervical oesophagostomy and gastrostomy if the stomach is intact. If the stomach is necrotic, gastrectomy and jejunostomy is required. Ultimately, the colon or jejunum may need to be anastomosed to the oesophageal remnant.
Frequently, there is a large amount of fibrotic stricturing that necessitates repeated dilatations. Fibrosis may predispose to the late development of carcinoma.