Caustic Ingestion
Basics
Description
Description
- Alkalis:
- Dissociate in the presence of H2O to produce hydroxy (OH−) ions, which leads to liquefaction necrosis
- Postingestion—mainly damages the esophagus:
- Gastric damage can occur (see “Acids”)
- Esophageal damage (in the order of increasing damage) consists of:
- Superficial hyperemia
- Mucosal edema
- Superficial blisters
- Exudative ulcerations
- Full-thickness necrosis
- Perforation
- Fibrosis with resulting esophageal strictures
- Do not directly produce systemic complications
- Acids:
- Dissociate in the presence of H2O to produce hydrogen (H+) ions, which leads to a coagulation necrosis with eschar formation
- Postingestion—damages the esophagus (see “Alkalis”) and stomach because of rapid transit time through esophagus:
- Gastric damage (in the order of increasing damage) consists of:
- Edema
- Inflammation
- Immediate or delayed hemorrhage
- Full-thickness necrosis
- Perforation
- Fibrosis with resulting gastric outlet obstruction
- Well-absorbed and can cause hemolysis of RBCs and a systemic metabolic acidosis
Etiology
Etiology
- Direct chemical injuries
- Injuries (dermal, ocular, respiratory, GI) occur secondary to acid and alkali exposures
- Many caustic agents (acids and alkalis) are found in common household and industrial products
- Caustic substances:
- Ammonia hydroxide
- Toilet bowel cleaner
- Formaldehyde:
- Embalming agent
- Hydrochloric acid:
- Toilet bowel cleaners
- Hydrofluoric acid:
- Glass etching industry
- Microchip industry
- Rust removers
- Iodine:
- Antiseptics
- Phenol:
- Antiseptics
- Sodium hydroxide:
- Drain cleaners
- Drain openers
- Oven cleaners
- Sodium borates, carbonates, phosphates, and silicates:
- Detergents (laundry powder, laundry pods)
- Dishwasher preparations
- Sodium hypochlorite
- Bleaches
- Sulfuric acid:
- Car batteries
- Button batteries
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Citation
Schaider, Jeffrey J., et al., editors. "Caustic Ingestion." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307121/all/Caustic_Ingestion.
Caustic Ingestion. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307121/all/Caustic_Ingestion. Accessed September 14, 2024.
Caustic Ingestion. (2016). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (5th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307121/all/Caustic_Ingestion
Caustic Ingestion [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2024 September 14]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307121/all/Caustic_Ingestion.
* Article titles in AMA citation format should be in sentence-case
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