ABSTRACT
Drooling and inability to swallow indicate severe posterior pharyngeal or upper oesophageal injury. Severe injuries can also result in oesophageal perforation with mediastinitis, shock and surgical emphysema in the neck and chest. In the presence of pharyngeal burns with stridor, early oesophagoscopy is contraindicated because of the risk of aggravating the airway obstruction. Chest and abdominal radiography are used as a baseline investigation in cases where either oesophageal or gastric perforation is suspected. Diagnostic thoracoscopy and laparoscopy may be used in suspected cases of oesophageal or gastric perforation. Technetium-labelled sucralfate radio-isotope scan of the oesophagus has been used as a screening device, with lack of sucralfate adherence indicating the absence of significant injury. Full-thickness injuries can result in perforation of both oesophagus and stomach and posterior fistula formation with either the trachea or the aorta. Stents have been used as a temporising measure in oesophageal fistulas prior to surgical repair or oesophageal bypass.
