Longterm Morbidity

Most long-term sequelae from caustic exposure are related to injuries to the GI tract. Acid ingestions may scar the pylorus and result in gastric outlet obstruction. Caustic alkali ingestions may result in esophageal strictures, which may result in dysphagia, odynophagia, and malnutrition. Controversy exists on the appropriate treatment—long-term dilation therapy versus surgery—for strictures. 22

Patients with caustic injuries to the esophagus are at risk for cancer of the esophagus. Increased risked for esophageal malignancy is up to 1000 times greater in patients with a history of caustic ingestion and is often seen decades after the initial ingestion and resulting esophageal injury. Some authorities advocate prophylactic esophagectomy in grade 3 lesions to decrease risk of potential future malignancy.

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