Q) Which modality has no part in management of corrosive injury of esophagus?
a) Repeated Endoscopies routinely
b) Esophagectomy in some cases
c) Early emergency surgery routinely
d) Steroid use routinely
Alkali and acidic injuries to the esophagus, both leading causes of corrosive stricture of the esophagus, differ in their effects due to distinct chemical reactions with tissue.
Mechanism of Injury
- Alkali Injuries: Ingested alkalis (e.g., drain cleaners) cause liquefactive necrosis, where tissue rapidly breaks down. This process allows alkalis to penetrate deep into the esophageal layers, often causing severe, widespread injury that extends to adjacent tissues. As a result, alkali injuries frequently lead to extensive scarring and stricture formation over time, significantly impacting the esophageal lumen.
- Acidic Injuries: Acids like hydrochloric acid cause coagulative necrosis, resulting in protein denaturation and an eschar formation. This eschar limits acid penetration depth, typically causing more superficial injury compared to alkalis. However, mucosal damage can still be severe, leading to ulceration and potential esophageal stricture over time, especially if the injury affects the lower esophagus.