Caustic injury of the upper gastrointestinal tract: A comprehensive review

Table 1 Most commonly ingested caustic substances

Caustic substance	Type	Commercially available form
Acids	Sulfuric	Batteries
		Industrial cleaning agents
		Metal plating
	Oxalic	Paint thinners, strippers
		Metal cleaners
	Hydrochloric	Solvents
		Metal cleaners
		Toilet and drain cleaners
		Antirust compounds
	Phosphoric	Toilet cleaners
Alkali	Sodium hydroxide	Drain cleaners
		Home soap manufacturing
	Potassium hydroxide	Oven cleaners
		Washing powders
	Sodium carbonate	Soap manufacturing
		Fruit drying on farms
Ammonia	Commercial ammonia	Household cleaners
	Ammonium hydroxide	Household cleaners
Detergents, bleach	Sodium hypochlorite	Household bleach, cleaners
	Sodium polyphosphate	Industrial detergents
Condy’s crystals	Potassium permanganate	Disinfectants, hair dyes

Table 2 Computed tomography grading system for caustic lesions

Grade	Features
Grade 1	No definite swelling of esophageal wall
Grade 2	Edematous wall thickening without periesophageal soft tissue involvement
Grade 3	Edematous wall thickening with periesophageal soft tissue infiltration plus well-demarcated tissue interface
Grade 4	Edematous wall thickening with periesophageal soft tissue infiltration plus blurring of tissue interface or localized fluid collection around the esophagus or descending aorta

Reproduced from Ryu et al[40].

Table 3 Endoscopic classification of caustic injuries

Grade	Features
Grade 0	Normal
Grade 1	Superficial mucosal edema and erythema
Grade 2	Mucosal and submucosal ulcerations
Grade 2A	Superficial ulcerations, erosions, exudates
Grade 2B	Deep discrete or circumferential ulcerations
Grade 3	Transmural ulcerations with necrosis
Grade 3A	Focal necrosis
Grade 3B	Extensive necrosis
Grade 4	Perforations

Reproduced from Zargar et al[14].