Corrosive substances

 Products containing strong acids (e.g. hydrochloric or sulphuric acid) or alkalis (e.g. sodium hydroxide, calcium carbonate) may be ingested, accidentally or intentionally, causing gastrointestinal pain, ulceration and necrosis, with risk of perforation.

   External decontamination, if needed, should be performed after initial resuscitation. Gastric lavage should not be attempted and neutralising chemicals should not be administered after large ingestions because of the risk of tissue damage from heat release. Cardiorespiratory monitoring is necessary and full blood count, renal function, coagulation and acid-base status should be assessed. An erect chest X-ray should be performed if perforation is suspected and may show features of mediastinitis or gas under the diaphragm. Strong analgesics should be administered for pain.

    Severe abdominal or chest pain, abdominal distension, shock or acidosis may indicate perforation and should prompt an urgent CT scan of chest and abdomen and surgical review. In the absence of perforation, drooling, dysphagia, stridor or oropharyngeal burns suggest possible severe oesophageal damage and early endoscopy by an experienced operator should be considered. Delayed endoscopy(e.g. after several days) may carry a higher risk of perforation.