Corrosive Toxicity

1. Corrosives Toxicity
(BY AMMARA BATOOL)
(BSC (PU), PHARM D (UHS)

2. Group Members

3. Caustic ingestion
• Acids tend to affect the stomach more than the esophagus
because most available acids are liquids
• Acids cause coagulation necrosis
• Alkalis cause rapid liquefaction necrosis
• Alkalis tend to affect the esophagus more than the stomach,
but ingestion of large quantities severely affects both

4. Sources
Acids
Toilet bowel cleaner,
metal and cement
cleaning products and
rust removing products
Alkalis
Bleaches, oven cleaning
products, swimming
pool sanitizers,
dishwasher

5. Signs and symptoms
• burn upper GI tract tissues, sometimes resulting in esophageal or
gastric perforation.
• Symptoms may include , dysphagia, and pain in the mouth, chest, or
stomach
• Edema and erosin of lips tongue and mouth cavity
• Fever,Hypotension,Tachycardia,Respiratory distress, alter mental
status,Sepsis by bacterial colonization of dead tissue

6. Diagnosis
• Endoscopy
• Because the presence or absence of intraoral burns
does not reliably indicate whether the esophagus and
stomach are burned, meticulous endoscopy is indicated
to check for the presence and severity of esophageal
and gastric burns when symptoms or history suggests
more than trivial ingestion.

7. Management
• Water or milk may be administered in small amounts
• Supportive treatment
• Airway evaluation
• Cardiac monitoring
• Intravenous fluids and blood products may be required in the event
of significant bleeding, vomiting, or third spacing.

8. Don’t
• Do not do gastric emptying by emesis or lavage with a caustic
ingestion because it reexposes the upper GI tract to the caustic.
• Do not attempt to neutralize a caustic acid with an alkaline
substance (and vice versa) because it will produce heat that may
worsen tissue damage.
• Activated charcoal is contraindicated because it may infiltrate
burned tissue and interfere with endoscopic evaluation and insertion
of an NGT is contraindicated because it can damage already
compromised mucosal surfaces.)

9. Do
• Dilution with milk or water is only useful in the first few
minutes after ingesting a liquid caustic, but delayed
dilution may be useful after ingesting a solid caustic.
Dilution should be avoided if patients have nausea,
drooling, abdominal distention.
• Esophageal or gastric perforation is treated with
antibiotics and surgery . IV corticosteroids and
prophylactic antibiotics are not recommended. Strictures
are treated with bougienage or, if they are severe or
unresponsive, with esophageal bypass by colonic
interposition

10. Refrences
• Medscape
• Science direct
• https://www.google.com.pk/search?biw=1264&bih=657&tbm=isch&s
a=1&q=general+mechanism+of+alkalipoisoning&oq=general+mech
anism+of+alkalipoisoning&gs_l=psy-
ab.3...121810.123313.0.123748.6.6.0.0.0.0.278.1036.2-
4.4.0....0...1.1.64.psy-
ab..2.0.0.2j8FXvrDYhU#imgrc=oo_Ckqn9GZ7RfM:
• http://www.merckmanuals.com/professional/injuries-
poisoning/poisoning/caustic-ingestion
• http://www.healthfrom.com/Disease/view-440.html