Is Multi-detector Computed Tomography an Early Predictor for Esophageal Injury Following Acute Caustic Ingestion?

Abstract

austic ingestion is a frequent presentation to emergency departments and early identification of poor outcome is essential for early decision making and better management plan. Till now, in our hospitals, there is no early predictor for esophageal injury in cases of acute caustic ingestion because endoscopy –despite being the gold standard in corrosive cases- is not done, as it is invasive, thus carrying the risk of perforation, together with the fact of being an added suffering for a patient that is already in pain. Moreover, it doesn’t visualize accurately the esophageal muscle layer burns and necrosis which lead to esophageal stricture, unlike Computed Tomography (CT) scan which is non-invasive and shows both the esophageal wall and the extramural extent of the disease. This study aimed to evaluate the role of Multi-detector Computed Tomography (MDCT) scan as an early predictor for esophageal injury following acute caustic ingestion, and also to compare CT grading system with DROOL score in predicting development of esophageal injury in patients with acute caustic ingestion.