Caustic (corrosive) esophageal stricture developing after ingestion of a corrosive agent. Corrosive agents — most commonly strong bases — can cause significant tissue damage within seconds of ingestion. The resulting strictures can involve all esophageal segments and vary considerably in length.
Endoscopic dilation — initiated after acute injuries have healed and repeated at 1 to 3 week intervals, with intralesional steroid injection considered for complex strictures — did not achieve adequate improvement of symptoms or nutritional status. This protocol addresses management after that failure.
When dilation has not produced sufficient improvement, the approach shifts from endoscopic intervention toward reconstructive surgery — with specific timing requirements designed to reduce subsequent complications. The complete sequencing, surgical options, and criteria are detailed in the full protocol.
Corrosive agents, most commonly strong bases, can cause significant tissue damage within seconds of ingestion.
Caustic strictures can involve all esophageal segments and vary in length.
If a patient has no improvement despite 5 to 7 dilations, it is advised to stop dilations and consider reconstructive surgery.
Reconstructive surgery, such as colonic interposition, should be delayed at least 6 months to allow injuries to stabilize, thereby decreasing rates of cervical anastomotic strictures.
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