Key investigations

Key investigations for caustic ingestion are:

• thoraco-abdominal computed tomography (CT) scan—to assess the depth of oesophageal, gastric and duodenal mucosal injuries, to detect perforations and predict development of oesophageal strictures. CT scan may be more accurate than endoscopy in detecting perforation and depth of tissue injury
• upper gastrointestinal tract endoscopy—to assess the severity of gastrointestinal injury, and guide therapy in patients with ongoing symptoms or signs. The ideal time to perform an endoscopy is 6 to 24 hours after ingestion, when lesions will be obvious and the risk of perforation is relatively lower
• X-ray of the neck, chest and abdomen—to assess for viscus perforation or the presence of a foreign body (eg a button battery); X-ray is not as sensitive as CT scan.