Management of corrosive oesophageal injuries: a review

Abstract

With the increasing incidence of corrosive oesophageal injuries, especially in the developing countries, understanding the pathophysiology and the approach to its management in the emergency and elective settings has become of paramount importance for the surgeon. The approach to the management varies depending on the time of the diagnosis and the location of injury. Endoscopy plays a key role as the first step in the evaluation of such patients in the emergency as well as late elective setting. With the advancement in endoscopic interventions, there has been a shift of preference towards the less invasive and less morbid endoscopic techniques to address the late sequelae of corrosive oesophageal injuries. Refractory cases eventually merit surgery, even at the cost of the morbidity and mortality associated with such rocedures. The surgical approach also varies depending on the location of the stricture, with the proximal 1/3rd strictures epresenting the most challenging location. A regular follow up and endoscopic surveillance are needed in these patients to screen for any late complications such as cancer or dysmotility.