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Caustic IngestionsSymptoms as Predictors of Esophageal Injury
Ellen F. Crain, MD, PhD;
Jeffrey C. Gershel, MD;
Andrew P. Mezey, MD
Am J Dis Child. 1984;138(9):863-865.
Abstract
• The ingestion of a caustic substance can lead to severe damage to the esophagus. Currently, esophagoscopy is recommended for all patients with a history of caustic substance ingestion because clinical criteria have not proved to be reliable predictors of esophageal injury. The records of 79 consecutive patients younger than 20 years who were first seen with a history of corrosive ingestion were reviewed. The presence or absence of three serious signs and symptoms—vomiting, drooling, and stridor—as well as the presence and location of oropharyngeal burns were compared with the findings on subsequent esophagoscopy. Fifty percent (7/14) of the patients with two or more of these serious signs and symptoms (vomiting, drooling, and stridor) had serious esophageal injury as compared with no positive endoscopic results in the group with none or only one of these clinical findings. The presence of oropharnygeal burns did not identify patients with serious esophageal injury. These results suggest that the presence of two or more signs or symptoms in patients with a history of caustic substance ingestion may be a reliable predictor of esophageal injury.
(AJDC 1984;138:863-865)
Author Affiliations
From the Department of Pediatrics (Drs Crain, Gershel, and Mezey) and the Division of Ambulatory Care (Drs Crain and Gershel), Bronx (NY) Municipal Hospital Center, Albert Einstein College of Medicine.
Footnotes
Reprint requests to 1 West 20, Jacobi Hospital, Pelham Parkway South and Eastchester Road, Bronx, NY 10461 (Dr Crain).
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