Role of computed tomography in the assessment of caustic ingestion severity: A comprehensive review

Abstract

Caustic ingestion is a relatively rare but potentially catastrophic gastroenterological emergency. Upper gastrointestinal (GI) endoscopy is currently regarded as the gold standard modality not only to assess the depth and the extension of GI caustic injury, but also to guide the appropriate treatment. Intriguingly, contrast-enhanced computed tomography (CECT) has recently emerged as a promising non-invasive and more accurate alternative to endoscopy in this setting. However, to date, evidence concerning the role of CECT as an alternative or complementary diagnostic tool to endoscopy in caustic ingestion is still limited. The aim of our review was to summarize and discuss the current evidence concerning the role of CECT in the emergency diagnosis of caustic ingestion and its value in assessing injury severity among non-pediatric patients.

Keywords: Caustic ingestion; Corrosive ingestion; Contrast-enhanced computed tomography; Computed tomography; Endoscopy; Upper gastrointestinal endoscopy

Core Tip: Upper gastrointestinal endoscopy has traditionally been the mainstay for the severity assessment in caustic ingestion, driving proper treatment and dictating patient prognosis. However, contrast-enhanced computed tomography (CECT) has emerged as a promising non-invasive alternative to endoscopy. Nevertheless, to date, evidence concerning the role of CECT in the diagnostic process of caustic ingestion is still limited. Our study aimed to review the current evidence concerning the role of CECT in the severity assessment of caustic ingestion.