Acute corrosive oesophagitis.

A review of the literature on the management of corrosive oesophagitis with subsequent stricture formation reveals a wide variation of opinion as to suitable treatment. European methods were at variance with those of North America. General practitioners, paediatricians, and internists tackled the problem from different points of view, and even among otolaryngologists there was considerable divergence of opinion. In the past, much of the treatment began after the formation of strictures, which inevitably involved prolonged bouginage with lengthy hospitalization on both an inpatient and out-patient basis. In recent years there have been radical changes in therapy, based on the concept of prevention of stricture formation. Over a period of 10 years the authors have devised a plan of treatment based on the pathology of this condition and reported experimental investigations. About 75% of cases of acute corrosive oesophagitis are caused by the ingestion of strong caustic solutions. Acids cause more superficial injuries in the oesophagus, while in the stomach they produce more serious damage, partly because they are not neutralized by gastric juice as alkalis tend to be. Many of our common lye preparations have the consistency and appearance of milk and thus are 'fair game for little hands'. Lye in the form of crystals is the most dangerous medium, producing, even in small amounts, intense, deep burns with all their sequelae.