What is new in esophageal injury (infection, drug-induced, caustic, stricture, perforation)?

Special Introduction by the Author
The article deals primarily with drug-induced esophageal damage and injuries due to caustic ingestion. The third topic is the chapter of infectious mucosal damage.

Caustic injury to the aerodigestive tract remains a significant medical and social concern despite various efforts to minimize the hazards of caustic household products. Agents with pH less than 2 or those with pH higher than 12 are extremely corrosive. Acutely, caustic damage to the gastrointestinal tract ranges from mild to extensive. In severe cases, organ perforation leading to death is possible. Long-term complica tions resulting from caustic ingestion include stricture formation and development of esophageal carcinoma. The extent of tissue destruction depends on the type of agent, its physical properties, concentration, duration of contact and amount of substance ingested. Alkaline material accounts for most cases of caustic ingestion in the developed world, whereas acid ingestion appears to be more common in developing countries, like India, where hydrochloric acid and sulphuric acid are easily accessibile. As far as drug-induced esophageal injury is concerned, more than 1000 cases of all cases due to nearly 100 different medications have been described during the last 10 years. However, the estimated case frequency is probably much higher and the related literature is of low quality, as cases are reported selectively and stimulated by clustering of cases, newly implicated pills or unusual complications.