lye injury

lye injury

Toxicology A condition often caused by ingestion of bleach, suicidal in adults; accidental in children; 5% develop SCC 20-40 yrs after LI Clinical, acute Tachycardia, retrosternal pain, copious frothy mucus, hematemesis, sloughing of esophageal mucosa, dysphagia followed by fibrosing stricture Imaging Barium 'swallows' demonstrate pencil-thin esophageal lumen Management Bougienage is a therapeutic mainstay; given the potential for perforation, it is best begun ≥ 5 days post-insult; some prefer large-bore nasogastric tubes to bougienage, as the strictures formed are of a large and useful diameter; pharmacologic doses of corticosteroids may minimize fibrosis