What is Caustic Ingestion?
Children are naturally curious and often place many things in their mouths, which can lead to serious esophageal injuries. The two main types of ingestion-related injuries are:
- Foreign Body Ingestion
- Objects like coins, pieces of toys, safety pins and paper clips can get stuck in the esophagus (food tube).
- Small batteries or magnets from toys, remotes or watches are particularly dangerous, causing severe tissue damage to the esophagus.
- Caustic Liquid Ingestion
- Liquids such as cosmetics, cleaning supplies or other chemicals can cause tissue damage and scarring in the esophagus. Scarring narrows the esophagus, making it hard to swallow.
What are the Symptoms of Caustic Ingestion?
A child who has an object stuck in their esophagus or who has swallowed a caustic substance would have some or all the following signs:
- Drooling
- Trouble swallowing
- Spitting up food
- Refusing food
- Weight loss
- Hoarse cry
- Having a hard time breathing
- Choking
- Pain
How is Caustic Ingestion Diagnosed?
Diagnosis and treatment depend on the type of object or liquid swallowed and the severity of the injury. Some ways to diagnose the damage include:
- Chest and neck X-rays help locate metal swallowed objects.
- Upper endoscopy (a tube with a light is placed in the throat) is used to check for damage to the esophagus.
- Esophagram (done two to three weeks after the injury) checks for narrowing.
How is Caustic Ingestion Treated?
Immediate treatment includes:
- Observation: To prevent vomiting, choking or having liquid get into the lungs.
- Endoscopy: To better see inside the esophagus, stomach and upper intestines.
- The child may need a nasogastric (NG) tube placed during endoscopy if there are serious burns.
- The NG tube helps prevent the esophagus from closing off completely and supports nutrition.
- Children are sedated during this procedure.
Long-term treatment may include:
- Esophageal dilations to help treat the narrowing of the esophagus (explained below)
- A gastrostomy tube for long-term nutrition
Tests
Upper Endoscopy
A doctor uses a thin bendable tube that is passed through the mouth and into the stomach and first part of the intestines to look for swelling or irritation. The doctor may remove small pieces of tissue during this test (biopsy). The tissue is examined under a microscope, and the findings help the doctor decide the best treatment plan.
Esophageal Dilation
During esophageal dilatation, a doctor uses a small balloon to stretch (dilate) the tight area. Using fluoroscopy (moving X-ray), the doctor can locate the narrowing and guide the balloon to the right spot.
