Case challenge · Emergency / Toxicology / Gastroenterology · teaching

Caustic (Strong Acid/Alkali) Ingestion — Management Pathway · case challenge

Given a case, work through the care pathway step by step; the tool checks each choice and scores you. Decisions and basis are taken from this site's reviewed care pathways.

← View the full flowchartBased on Merck / WSES

Case #1Emergency / Toxicology / Gastroenterology

📋 Case data

Airway and symptomsAirway involvement/symptomatic/intentional ingestion

Data is taken from this pathway's reviewed node text. Work through the pathway step by step.

Step 1 / 1 · Airway and symptoms

Caustic ingestion — airway and symptoms?

💡 Strong acid (coagulation necrosis, mostly injures the stomach) vs strong alkali (liquefaction necrosis, penetrates deep, injures the esophagus, e.g. drain cleaner). Management is similar for both. Contraindications (the 'four nos'): no induced emesis, no gastric lavage, no neutralization (acid-base neutralization is exothermic and worsens injury), no activated charcoal (does not adsorb and obscures endoscopy; except with systemic toxicity such as zinc/mercury chloride). Milk/water dilution only in the first few minutes (controversial).

For teaching. Decisions and their basis are taken from this site's reviewed care pathways; for licensed clinicians/trainees, this does not replace clinical judgment or local protocols.