Caustic Ingestion

The ingestion of caustic chemicals may cause tissue injury on contact with the oropharynx, esophagus, stomach, and duodenum. Accidental ingestion of these caustic or corrosive substances is most frequent in small children and inebriated individuals. Intentional ingestion occurs more commonly in persons who are suicidal.

Caustic substances can be divided into acids and alkalis. Many household and industrial products contain acids or alkalis in liquid or solid form (Tables 16-1 and 16-2).

I. ALKALI INGESTION.

Alkalis (e.g., lye-sodium or potassium hydroxide) are ingested more frequently than acids. Alkalis produce injury by liquefaction necrosis, which allows deep penetration into the tissues, resulting in full-thickness tissue burns.

TABLE 16-1 Common Alkalis

Sodium or potassium hydroxide (lye)
	Detergents and washing powders
	Paint removers
	Drain cleaners (Drano [granular and liquid], Liquid Plumr, Plunge, Open-Up)
	Oven cleaners (Easy-Off, Mr. Muscle)
	Clinitest tablets
	Denalan denture cleanser (NaOH is formed in vivo)
Sodium hypochlorite
	Bleaches (Clorox)
	Cleansers
Sodium borates, carbonates, phosphates, and silicates
	Detergents
	Electric dishwashing preparations
	Water softeners
	Purex bleach
Ammonia
	Toilet bowl cleaners (Lysol)
	Metal cleaners and polishers
	Hair dyes and tints
	Antirust products
	Jewelry cleaners
Sodium permanganate
	Illegitimate abortifacient medical applications (topical)
Phosphorus
	Matches
	Rodenticides
	Insecticides
	Fireworks
NaOH, sodium hydroxide.

TABLE 16-2 Common Acids

Hydrochloric acid (muriatic acid)
	Metal cleaners (Quaker House Steam Iron Cleaner)
	Toilet bowl cleaners (Lysol liquid toilet bowl cleaner, Sno Bol)
	Swimming pool cleaners
Sulfuric acid
	Battery acid
	Drain cleaners (Mister Plumber, Rooto)
Sodium bisulfite
	Toilet bowl cleaners (Sani Flush [granular], Varnish [granular])
Oxalic acid
	Disinfectants
	Furniture polish
	Zud Rust and Stain Remover (granular)
Hydrofluoric acid
	Antirust products
Formaldehyde (formic acid)
	Deodorizing tablets
	Plastic menders
	Fumigants
	Embalming agents
Carbolic acid (phenol-creosol, creosote)
	Antiseptics
	Preservatives