Management overview for caustic ingestions

Caustic injuries most commonly occur after ingestion of either strong alkaline or acidic substances. Alkali ingestions are more common than acid ingestions because domestic and industrial cleaning agents commonly contain alkaline ingredients.

Specific management advice is given for the following caustic agents:

For all other caustic agents, follow the advice in this monograph. Other caustic agents include phenol and potassium permanganate.

Ingestion of highly caustic agents can cause rapid onset of life-threatening airway compromise and severe injury to the oropharynx and upper gastrointestinal tract. Early airway intervention can be life saving.

Internal injuries may be delayed in onset and more severe than the oral findings suggest. Observation for 4 to 6 hours is warranted to determine which patients require further investigation, treatment and surgical referral.

Patients with severe caustic injuries often require intensive care management and may require prolonged total parenteral nutrition or enteral tube feeding.