What is the role of endoscopy in the workup of caustic ingestions?

Updated: Dec 09, 2020
  • Author: Derrick Lung, MD, MPH, FACEP, FACMT; Chief Editor: David Vearrier, MD, MPH  more...
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Answer

Endoscopy is generally indicated for the following patients:

  • Small children who are not tolerating liquids or with complaints of pain
  • Patients with a disk battery ingestion identified in the esophagus or stomach
  • Symptomatic older children and adults
  • Patients with abnormal mental status
  • Patients with intentional ingestions
  • Patients in whom injury is suspected for other reasons (eg, ingestion of large volumes or concentrated products)

However, because of the risk of increased injury, esophagoscopy should not be performed in patients with evidence of esophageal or gastrointestinal perforation, significant airway edema, or necrosis and in those who are hemodynamically unstable. Endoscopy is typically avoided when more than 24 hours have elapsed after the ingestion due to decreased wound strength and an increased risk of iatrogenic perforation. 


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