Ingestion of corrosive substances by adults.

Compared with the ingestion of corrosive substances in children, this problem tends to be more serious, in adults, because its intent is often suicidal, rather than accidental. The severity and extent of damage produced to the gastrointestinal tract depends on the morphological form of the caustic agent. In the acute stage, perforation and necrosis may occur. Long-term complications include esophageal stricture, antral stenosis, and the development of esophageal carcinoma. X-rays of the abdomen and chest should be done initially to detect any evidence of perforation. Endoscopy should be performed as soon as possible in all cases to evaluate the extent and severity of damage, unless there is evidence of perforation. A complete examination is feasible in most cases. Stricture formation is more common in patients with second- and third-degree burns. Measures to prevent stricture formation, including the use of steroids, have not been successful. Esophageal carcinoma usually occurs 40 yr after the time of injury.