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| ==Background==
| | #REDIRECT[[Caustic burn]] |
| {{Caustics background}}
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| ==Diagnosis==
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| *All pts w/ serious esophageal injuries have some initial sign or symptom
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| **E.g. stridor, drooling, vomiting
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| *Exam eyes and skin (splash and dribble injuries may easily be missed)
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| *GI tract injury
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| **Dysphagia, odynophagia, epigastric pain, vomiting
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| *Laryngotracheal injury
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| **Dysphonia, stridor, respiratory distress
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| **Occurs via aspiration of caustic or vomitus or inhalation of acidic fumes
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| ==Differential Diagnosis==
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| {{Caustic burn types}}
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| ==Work-Up==
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| ===Labs===
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| Only necessary in patients with significant injury or volume of ingestion
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| Consider:
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| *CBC
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| *Chemistry
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| *Lactic Acid
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| *Lactate
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| *Calcium level (if [[Hydrofluoric acid]] exposure)
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| *ECG
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| **May show QT-prolongation if hypocalcemic secondary to HF acid
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| *Screens for tylenol levels in suicidal patients at risk for congestions
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| ==Treatment==
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| ;First prevent personal exposure to the caustic agent by removing all clothing and decontaminating the patient
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| ===Acidic injuries (except [[Hydrofluoric acid]] acid)===
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| May also have non-anion gap acidosis (e.g. HCl)
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| *Respond well to copious saline or water irrigation
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| ===Alkali injuries===
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| *May appear superficial but often are deeper w/ ongoing burn
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| *Treat w/ copious irrigation and local wound debridement to remove residual compound
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| ==Disposition==
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| *Admit the following:
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| **Injuries that cross flexor or extensor surfaces
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| **Facial injuries
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| **Perineum injuries
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| **Partial-thickness injuries >10-15% of BSA
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| **All full-thickness burns
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| ==See Also==
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| *[[Caustic burns]]
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| *[[Burns]]
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| ==Source==
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| *Riffat F, Cheng A. Pediatric caustic ingestion: 50 consecutive cases and a review of the literature. Dis Esophagus. 2009;22(1):89-94. 2008 Oct 1. PMID: 18847446
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| *Zargar S et al. Ingestion of strong corrosive alkalis: spectrum of injury to upper gastrointestinal tract and natural history. The American Journal of Gastroenterology. 1992 87 (3), 337-41 PMID: 1539568
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| <references/>
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| [[Category:GI]]
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| [[Category:Tox]]
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