Wasserman R L, Ginsburg C M
J Pediatr. 1985 Aug;107(2):169-74. doi: 10.1016/s0022-3476(85)80119-0.
Caustic and corrosive substance ingestions are a significant cause of early and late morbidity and may cause esophageal carcinoma after a long latent period. Initial management should be directed at the assurance of adequate ventilation and cardiovascular stability as well as the prevention of vomiting. Early esophagoscopy (to the level of first lesion, if present) is useful to identify those patients who do not need hospitalization or treatment. Esophagoscopy and contrast esophagram are useful to define the full extent of esophageal injury, but should be withheld until after the acute phase. Glucocorticoids are probably useful in limiting the extent and severity of esophageal stricture, the most frequent and significant long-term sequela. Colon interposition is used in those situations in which dilation of a stricture has been unsuccessful, and may prevent the subsequent development of esophageal carcinoma.
腐蚀性物质摄入是早、晚期发病的一个重要原因，且在漫长的潜伏期后可能导致食管癌。初始处理应致力于确保充分通气和心血管稳定，以及预防呕吐。早期食管镜检查（至首个病变部位，如有）有助于确定那些无需住院或治疗的患者。食管镜检查和食管造影有助于明确食管损伤的全貌，但应在急性期过后进行。糖皮质激素可能有助于限制食管狭窄（最常见且严重的长期后遗症）的范围和严重程度。在狭窄扩张失败的情况下，采用结肠代食管术，这可能预防随后食管癌的发生。
