Oesophageal,
pharyngeal,
laryngeal,
and oral lesions may be caused by the accidental or intentional ingestion of caustic substances.
The caustic effect is a tissutal necrosis with an acute edematous phase,
followed by a progressive fibrotic stenosis due to the healing process that reduces the oesophageal lumen only to a few millimeters.
In the acute stage,
perforation and necrosis may occur.
Long-term complications include stricture formation in the esophagus,
antral stenosis and eventually the development of esophageal carcinoma.
Alkali and acids,
due to their different mechanisms of action,
can cause different kind of lesions: acids form scars on necrotic tissue,
a fact that prevents their action at a greater depth,
alkaline agents causes them to combine with tissue proteins to form proteinates,
and with fats to form soap in addition to water.
These products favor the penetration of the remaining alkali into the tissue by increasing the solubility of the caustic soda,
causing the injury of all the tissue thickness.
On the other hand alkali can be neutralized by gastric secretion,
with a consequent reduction of its action on the mucosa of the stomach,
this is not valid for the acid agents,
that cause damages especially in the antropyloric region in addition to the mouth and the esophagus.
The severity of lesions is related to the quality/concentration of the caustic substance swallowed and the duration of mucosal exposure.
The relation between the time of contact agent /mucosae and concentration of the substance ingested are directly proportional with its ability to provoke severe injuries.
It is clear that the occurrence of stenosis of the esophagus is directly correlated with the amount of caustic ingested.
It had been evaluated that esophageal injury can be caused from ingestion of just under one tablespoon.
When the amount ingested is nearer two or three tablespoons,
there is an increased risk of fistulas,
perforations,
or even death.
Some studies documented that the incidence of stenosis was slightly lower in those who ingested water or milk after the alkali/acid agent than in those who did not,
but the difference was not statistically significant.
The objective of this study is to present the radiological findings in the oesophagus after caustic ingection.