In caustic ingestion injury, the urgent assessment of the airway is the first priority with a definitive airway secured in those with airway compromise. In those patients with a stable airway and no clinical or radiological sign of perforation, then medical therapy should be commenced and an urgent oesophagogastroduodenoscopy (OGD) is arranged and this should take place within the first 24 h to grade the degree of injury and establish long-term prognosis. In suspected perforation, a surgical opinion should be sought. For those adults who are asymptomatic following ingestion an OGD may not be necessary; however, asymptomatic paediatric patients should be treated with more caution and a period of observation is important. Those who are at risk of developing late complications must be followed up.
It is important that ENT surgeons are aware of the use of new oral anticoagulants, and have a departmental- and trust-based policy on their use and reversal in bleeding and surgical patients.
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