Wightman Rachel S, Read Kevin B, Hoffman Robert S
Medical Toxicology Fellow, Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, NY.
Assistant Curator, New York University Health Sciences Library, New York University School of Medicine, New York, NY.
Emerg Med Pract. 2016 May;18(5):1-17; quiz 17, 20. Epub 2016 May 1.
Caustics are common in household and industrial products, and, when ingested, they can pose a significant public health risk. Caustic exposures in adults typically present in the setting of occupational exposure or suicide attempt; exposures in children occur most often by unintentional ingestion. Caustics cause local damage upon contact with tissue surfaces and can lead to systemic toxicity. Endoscopy is recommended in all intentional ingestions (and many unintentional ingestions) to grade injury severity, determine treatment options, and assess prognosis; however, it is generally best performed within 24 hours post ingestion to avoid risk of perforation. Radiography and computed tomography may also be used to visualize injury in certain cases. This review examines the pathophysiology of caustic exposures, their clinical presentations, and the most current evidence on recommendations for decontamination, surgical consult, treatment, and disposition.
苛性碱在家庭和工业产品中很常见，摄入后会对公众健康构成重大风险。成人的苛性碱暴露通常发生在职业暴露或自杀未遂的情况下；儿童暴露最常见的原因是意外摄入。苛性碱与组织表面接触时会造成局部损伤，并可能导致全身毒性。对于所有故意摄入（以及许多意外摄入）的情况，建议进行内镜检查，以评估损伤严重程度、确定治疗方案并评估预后；然而，一般最好在摄入后24小时内进行，以避免穿孔风险。在某些情况下，也可使用放射摄影和计算机断层扫描来观察损伤情况。本综述探讨了苛性碱暴露的病理生理学、临床表现以及关于去污、外科会诊、治疗和处置建议的最新证据。
