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The etching stage of the corrosive preparation is a crucial element of creating a high quality anatomical specimen, which can be a source of scientific knowledge and support the teaching process. Nowadays, thermal techniques such as microwave cooking, enzymatic corrosion, and chemical corrosion are used. Living organisms can also be used for tissue maceration. Interactions between the corrosive substance and the filler carry a risk of failure; thus, choosing the correct method is key to the success of this technique. In this paper, we have reviewed the latest literature in order to present the strengths and weaknesses of currently used corrosion techniques. We proposed a definition of an ideal corrosive medium and compared the available techniques of etching corrosive preparations with a hypothetical perfect medium.

Corrosive substance attacks have become a growing issue within the UK. Although most commonly occurring in gang-related offences, there are high profile instances where this type of attack has been used to attack women to disfigure and destroy livelihoods. Despite the increase in such attacks, there has been very little published research into the recovery of forensic evidence from items used in these crimes. The effect of corrosive substances on the recovery of different types of forensic evidence is unknown, and there is no guidance for laboratories processing exhibits contaminated with corrosive substances regarding optimum treatments. This pilot study focused on establishing the effectiveness of a range of fingermark visualisation processes in recovering fingermarks on surfaces exposed to concentrated sulfuric acid (acid) and potassium hydroxide (alkali). Results indicate that on non-porous surfaces vacuum metal deposition and powder suspensions remain effective, and on porous surfaces fingermarks could still be visualised with physical developer. Alkalis were found to be more detrimental than acid environments in this limited study. The results demonstrate that fingermark recovery is still feasible on surfaces exposed to corrosive substances and provides encouragement that treatment protocols could be developed for this type of exhibit.

The character of disturbance of oxidative stress markers and venous blood cells apoptosis in patients with corrosive substances poisoning in early stage was studied. In the first 5 days for the estimation of the oxidative stress severity the lipid peroxidation (LPO) products, antioxidant system (AOS) state and value of the platinum electrode open circuit potential (OCP) were determined. Apoptosis was studied by measuring of apoptotic lymphocytes and dead leukocytes concentration. It was found that in patients younger than 60 years in response to the intake of corrosive substance, peroxidation processes are the first to activate, as evidenced by the oxidative stress development and its increase in dynamics. The apoptosis processes are activated only as oxidative stress severity increase which indicates the development of an adequate reaction to the acute chemical trauma in persons of working age. Contrariwise, in patients older than 60 years apoptosis of venous blood lymphocytes is first activated followed by peroxidation processes activation. Moreover, the low activity of LPO/AOS system is noted in the whole. This fact indicates the absence of an adequate reaction to the intake of corrosive substance in this category of patients.

Background: Schizophrenia is a chronic mental illness that affects 20 million people worldwide. Patients diagnosed with paranoid schizophrenia are characterized by cognitive deficits and the so-called negative symptoms, which significantly lower their quality of life and have implications for their independence and ability to fulfill various social roles. Aim: This study aims to present the case of a 49-year-old woman who has been suffering from schizophrenia for a long time and, due to a psychotic exacerbation with delusions and auditory hallucinations in the form of ordering voices, attempted suicide by ingesting a highly corrosive chemical agent used for unblocking pipes (the so-called “mole”). Case report: The patient was admitted to the 1st Department of Psychiatry, Psychotherapy and Early Intervention of SPSK 1 in Lublin for psychiatric treatment, after being transferred from the SPSK 1 Surgery Clinic, where she was initially admitted after the suicide attempt. Discussion: The psychotic exacerbation in the patient could have resulted from sensory deprivation due to her feeling of loneliness and deep social isolation.

Background and study aims Esophageal burns due to ingestion of corrosive substances are frequently seen in both children and adults. However, there is no standard method of treatment to prevent associated mortality and morbidity. Therefore, this study aimed to evaluate the effects of known antioxidants, namely N-acetyl cysteine and ethyl pyruvate, on esophageal damage due to sodium hydroxide-induced corrosive burns. Materials and methods Thirty-five female rats were randomly assigned to five equal groups. Group 1 was the sham group, while Group 2 was the control group. Group 3 received N-acetyl cysteine, Group 4 received ethyl pyruvate, and Group 5 received both N-acetyl cysteine and ethyl pyruvate. Rats in the “burn” groups were gavage-fed with 0.2mL of 25% NaOH. All esophagi were extracted on day 4 for histopathological evaluation. Results Total histopathological damage scores were evaluated at the end of the study. Groups 3 and 5 were significantly different from the control group in terms of total histopathological scores (p = 0.001), while no significant difference was seen with Group 4. Stenosis index results in groups 3 and 5 were similar to those seen with total histopathological scores (p = 0.004). Conclusion N-acetyl cysteine, alone or in combination with ethyl pyruvate, may be useful in the treatment of esophageal damage associated with corrosive substances and in achieving histopathological improvement in an experimental setting.

A rise in the current trend of corrosive substance attacks have been reported in the UK, causing devastating effects on victims. The optimal management of these patients requires the specialist skills of the burn multidisciplinary team (MDT) to address the resulting physical and psychological trauma experienced. However, burn care must commence in the pre-hospital setting. The public and first responders are invaluable resources in helping to limit the adverse effects of burns. Challenges of burn care outside the Burns Unit are not limited to the treatment of the injured patient and the rehabilitation of survivors. These challenges also encompass better education of the public and allied health professionals, as well as planning strategies to reduce the incidence of acid attacks. Prevention is always better than cure. This paper discusses the broadening of the MDT to improve outcomes in acid attacks by exploring the wider roles of the public, media, emergency services, police, legislation and better education.

Diseñar una propuesta de un sistema globalmente armonizado de acuerdo a la normatividad vigente, el cual ayude a identificar la clasificación, almacenamiento, etiquetado de sustancias químicas con el fin de prevenir posibles accidentes o incidentes y enfermedades laborales en empresas floricultoras En esta investigación se analiza la importancia de contar con un sistema globalmente armonizado ya que en las empresas floricultoras de la sabana de occidente se manejan fertilizantes, plaguicidas y pesticidas entre otros productos químicos que generan un riesgo alto para la salud del trabajador. Debido a esto las sustancias penetran en el organismo por inhalación, absorción de la piel, por contacto, exposición ocular o ingestión. Lo cual pueden tener efectos como, corrosión, irritación, reacción alérgica, neumoconioticos, asfixia, anestésicos, narcóticos, cáncer, y tóxicos sistémicos. “Frente a una realidad que se buscó clasificar las sustancias químicas por un sistema completo” Villalba Garzón. (2018. p.6). por ende, el objetivo principal del documento se pretende tener una guía fácil de comprensión del sistema de comunicación de los peligros químicos su clasificación, almacenamiento y manipulación etiquetado de sustancias químicas donde el trabajador comprenda que debe prestar mucho cuidado a las instrucciones de manejo del químico, importancia de los EPP, etc. Con el fin de prevenir posibles accidentes o incidentes y enfermedades laborales, hasta la muerte, estableciendo con anterioridad las medidas de intervención, prevención y protección direccionadas a mejorar las condiciones de los trabajadores con el fin de dar cumplimiento a la normatividad colombiana y a los estándares internacionales SGA. Por ende, se entrega a las empresas la guía metodológica de acuerdo a la normatividad vigente la manera adecuada de realizar una implementación del sistema globalmente armonizado en las empresas floricultoras. This research will analyze the importance of having a globally harmonized system since in the flower companies of the western savannah, fertilizers, pesticides and pesticides are handled, among other chemical products that generate a high risk for the worker's health. Because of this, the substances enter the organism by inhalation, skin absorption, contact, eye exposure or ingestion. This can have effects such as corrosion, irritation, allergic reaction, neumoconiotics, asphyxia, anesthetics, narcotics, cancer and systemic toxicity. "Faced with a reality that sought to classify chemicals by a new, different, flexible, complete system and that takes information from previous systems of communication and identification of hazards when handling chemicals, it is proposed with this research work" Vialba Garzón. (2018. p.6). therefore, the main objective of the document is intended to have an easy to understand guide of the communication system of chemical hazards its classification, storage and handling labeling of chemicals where the worker understands that he/she must pay great care to the instructions for handling the chemical, importance of PPE, etc. In order to prevent possible accidents or incidents and occupational diseases, even death, establishing in advance the intervention, prevention and protection measures aimed at improving the conditions of workers in order to comply with Colombian regulations and international standards EMS. Therefore, the methodological guide is given to the companies according to the current regulations, the adequate way to carry out an implementation of the globally harmonized system in the flower growing companies.

Introduction Deliberate corrosive substance attacks (DCSA) have traditionally been associated with low- and middle-income countries (LMIC). However, the incidence of DCSA in certain geographical locations of the UK has increased in recent years. These attacks have a relatively low mortality rate but cause extensive life-changing injuries and the management from point of wounding to definitive care is challenging for all involved. Methods A systematic review was used to identify literature about DCSA and establish how much evidence about these attacks has been published over the last decade. Victim and perpetrator characteristics, substances used, injury patterns, mortality, pre-hospital and hospital-based management and complications associated with management were areas of interest. The review included any medical literature (case reports, letters, reviews) published within the last 10 years that described DCSA against human victims. Non-English language articles were excluded. Results Eighteen articles containing 762 victims of DCSA were included; seven victims had incomplete data. Articles were mostly from LMIC (Bangladesh, Columbia, Cambodia, India, Iran, Sri Lanka and Pakistan) but there were five articles were from the UK (three ‘Letters to Editors’, one survivor letter and one retrospective review of 21 victims). UK victim and perpetrator characteristics varied from those in LMIC. Seven papers described pre-hospital management and nine described hospital/surgical management. Conclusions The evidence base surrounding DCSA is limited especially in the UK setting. More research into the epidemiology and management of DCSA in the UK is warranted.

An important complication of corrosive ingestion is oesophageal stricture. Improvements in endoscopes and accessories have supported an increase in the number of patients who are conservatively treated with endoscopic dilations. In this study, we aimed to detect factors affecting the outcome of endoscopic dilatation for refractory post-corrosive oesophageal stricture. This study was carried out in the Paediatric Endoscopy Unit in the Children’s Hospital and included 100 children older than 2 years of age of both sexes who had an established diagnosis of post-corrosive oesophageal stricture on repeated endoscopic dilatation sessions. The duration of the condition was more than 6 months, and dilatation failed to achieve a diameter of 14 mm during the first five sessions at 2-week intervals (refractory), excluding other causes of oesophageal stricture. Males represented 63% of patients. The mean age of enrolled children was 5.9 ± 2.6 years; 90% of patients ingested an alkaline corrosive substance (potash). The total number of dilatation sessions ranged from 16 to 100, with a mean number of sessions ranging from 37.2 ± 14.9. Fifty-four patients (54%) were well controlled by regular endoscopic dilatation with good clinical and endoscopic outcomes, and no more dilatations were needed. Endoscopic dilation is an effective method for managing refractory post-corrosive oesophageal strictures that require a long follow-up period. There are a lot of factors affecting the outcome.

Acid attacks, or vitriolage, are defined as violent assaults involving the deliberate throwing of an acid or similarly corrosive substance with the intention to "maim, disfigure, torture or kill" [1]. The Acid Survivors Trust International suggest a prevalence of 1500 attacks reported worldwide per annum, although this is likely to be an underestimate by 40% [2]. The UK is thought to have one of the highest of rates of recorded corrosive attacks, with an increase from 228 attacks in 2012 to 601 in 2016. Most were reported by the London Metropolitan police force followed by Northumbria, Cambridgeshire, Hertfordshire, Greater Manchester and Humberside [[2]]. The chemical agents involved include acids, alkalis, oxidising and reducing agents, alkylating and chelating agents and solvents. They cause injury by producing a chemical interaction which can lead to extensive tissue destruction and extreme pain. Herein, we present a review on the changing epidemiology of corrosive attacks in the UK and currently employed management strategies.

Introduction:Caustic substance ingestion is a serious problem due to high morbidity and mortality. Chemical products used in homes are the source of accidental or deliberate caustic exposures that can be seen in people of different ages. The severity of the lesions produced by the caustic substances in the tissue depends on the type, amount and concentration of the caustic agent taken, as well as the time of contact with the mucosa. In this article, we aimed to evaluate the demographic characteristics, endoscopic results, clinical findings and complications of our patients admitted to our university hospital for corrosive substance ingestion.Methods:We retrospectively identified adult patients admitted to our hospital between 2013-2019 for corrosive substance ingestion. We examined the endoscopy findings and endoscopy requirement within 24 hours of ingestion in 75 adult patients with acute corrosive substance ingestion.Results:Forty-three patients (57%) were female and 32 (43%) were male. The mean age of the males was 39.3±14.50 years and the mean age of the females was 34.1±16.91 years. Sixteen corrosive substance ingestions (21.3%) were suicidal and 59 (78.6%) were accidental. Thirty-seven patients (49.3%) were asymptomatic and did not require endoscopy and seven patients (9.3%) were recommended endoscopy but they did not consent. Fifteen patients (20%) had normal endoscopic findings, nine (12%) had Los Angeles (LA) grade A esophagitis, five (6.6%) patients had LA Grade B esophagitis, and one patient (1.3%) had LA grade D esophagitis due to crystal drain opener ingestion. One patient (1.3%) with history of thinner ingestion had esophageal polyp and Schatzki ring. Regarding corrosive substances, 25 patients (33.3%) had bleach ingestion. There was no mortality due to corrosive substance ingestion.Conclusion:Caustic substance ingestion is often inadvertent and is accompanied by mild symptoms or esophageal damage. Endoscopy may not be performed, especially in asymptomatic people with bleach or softener ingestion. In suicidal ingestions, serious injuries may occur because patients ingest too much, and endoscopy is indicated for suicidal ingestion. Endoscopy should be used only to evaluate esophageal and gastric injury and to determine prognosis. A careful psychiatric evaluation should be performed for suicidal ingestion.

Objective: Corrosive substances are agents which ease our lives, but they can also make children’s’ lives completely difficult as a result of contact with gastrointestinal tract, respiratory tract and skin. Examinations and treatments of patients hospitalized in our clinic with the complaint of corrosive substance ingestion were examined. Methods: The records of 45 patients who were hospitalized in our clinic between May 2017 and December 2018 were examined retrospectively. The patients’ ages, genders, ingested corrosive substance, admission and discharge inflammatory markers were examined according to diagnosis and treatment type. Results: Of the 45 cases, 24 (53,3%) were male, while 21 (46,7%) were female. The youngest case was 9 months old, the oldest case was 168 months and average age of the cases was 24,7 months. The substances the cases were exposed to were bleacher in 20 patients (44,4%), dishwasher detergent in 11 patients (24,4%), rinse aid in 5 patients (11,1%), drain cleaner in 4 patients (8,9%), washing machine detergent in 3 patients (6,7%), decalcifier in 1 patient (2,2%) and surface cleaner (sodium hypochlorite) in 1 patient (2,2%). Endoscopy was performed on two patients with clinical symptoms who ingested drain cleaner. Statistically significant difference was found between the hospitalization and discharge white blood cell count×103/uL (WBC), lymphocyte count×103/Ul (LYM), platelet count ×103/uL (PLT), red blood cell width (RDW,%), mean platelet volume (MPV), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) values of the patients (p

BACKGROUND Video endoscopy, which remains the diagnostic gold standard after ingestion of a corrosive substance, is performed under general anesthesia in children, requires advanced technology, and is costly. Therefore, simple and accessible methods are needed to determine the need for endoscopy. The aim of this study was to evaluate the role of pH and specific gravity of ingested substance in determining endoscopy indications after corrosive ingestion. METHODS This prospective study included pediatric patients who presented after ingesting a corrosive substance from June 2018 to June 2019. Relationships between the extent of damage detected by endoscopy and the patient's age, physical examination findings, and the pH and specific gravity of the causative substance were evaluated. RESULTS The degree of damage detected on endoscopy was significantly milder for corrosive substances with pH between 2 and 12 (p=0.003). In addition, pH values between 2 and 12 were significantly more common among patients without physical examination findings (p=0.029). Specific gravity less than 1005 was associated with mild injury detected by video-endoscopy (p=0.011). Patients in whom severe injury was detected by endoscopy had marked findings on physical examination (p

Little previous research has considered why some people may carry corrosives while intending to potentially use them as a weapon. Prior research has identified several individual, interpersonal, community and societal risk factors linked to weapon carrying (such as offender demographics, peer influence, exposure to violence and availability of weapons). The perception of weapon availability, the extent that peers use weapons and the likelihood of the weapon offering protection against potential attack have also been noted as influential in decisions to carry. Focusing on data collected from police case files and interviews with 25 offenders convicted for crimes that involved a corrosive substance, this chapter identifies factors that shape decisions to carry corrosives. Five types of corrosive carriers are identified. Next, the factors that shape decisions to carry are analysed. These include (1) a number of weapon-specific factors that make corrosives attractive to carry and (2) the semiotics associated with corrosives that help to fulfil a number of offender needs. Although this is the first study to identify types of corrosive carriers and their reasons for carrying, the findings have relevance to other types of weapon carrying—particularly knives.

In this chapter, we outline the main findings of the published academic material that enhance the understanding of contemporary patterns of corrosive substance crime and why corrosives are used as a weapon. First, an overview of material relating to the harms, global patterns and motivations for acid attacks is offered. We identify that, although the previous research identifies the motivations for crime that uses corrosives (or what the desired outcomes for the offender are), explanations regarding why offenders choose to carry acid (in preference to other weapons) and why corrosives are used in a crime event (as opposed to other weapon types) are scarce. In establishing our understanding, we draw on some of the wider weapons literature to identify numerous risk factors associated with weapon carrying and develop some understanding regarding why offenders choose to carry and then use weapons. The chapter makes a novel contribution to the literature by consolidating the research on acid attacks and identifying where gaps exist. However, it also identifies a need for better understanding of the patterns of acid attacks, including why people may carry acid as a weapon of choice, and the transition from carrying or being in possession of a corrosive to using a corrosive in a crime event.

NGOs such as Acid Survivors Trust International (ASTI) have made considerable efforts to highlight the issue of acid violence globally and develop strategies to prevent acid violence. In this chapter, we identify possible solutions to prevent acid violence and the potential challenges. We begin by outlining a theory of corrosive substance carrying and throwing, developed from the analysis conducted in the preceding chapters, which identifies the factors that encourage offenders to carry corrosives and how these carriers then transition to users. The theory illuminates a number of areas where preventative interventions could be developed, including interventions that aim to control the availability/accessibility of corrosives, developing laws to deter potential offenders from possession/use, focusing on interventions that make individuals less receptive to the idea of carrying/using corrosives and developing approaches focused on communities where carrying and use is prevalent. The analysis presents evidence of how these interventions have been used previously in relation to corrosives and wider weapons use, the challenges with these interventions and, lastly, key concerns for any future efforts to prevent corrosive crime.

This chapter introduces the reader to the subject of acid attacks and corrosive substance crime. It begins by defining what acid attacks are and identifies there is some confusion over the concept. Attention then turns to historical perspectives and identifies that acid attacks or ‘vitriol throwing’ have featured regularly in news reports and literature for the best part of 200 years. We then move on to understand the development of acid attacks as a contemporary problem and review data on the number of attacks worldwide. Finally, an overview of the structure of the book and its main content is presented.

Background Corrosive ingestion is a significant challenge for healthcare systems. Limited data are available regarding the best treatments, and there remains a lack of consensus about the optimal surgical approach and its outcomes. This study aims to review the current literature and show a single institution's experience regarding the surgical treatment of esophageal stenosis due to corrosive substance ingestion. Methods A retrospective review that accounted for demographics, psychiatric profiles, surgical procedures, and outcomes was performed. A systematic review of the literature was performed using PubMed. Results In total, 27 surgical procedures for esophageal stenosis due to corrosive substance ingestion were performed from 2010 to 2019. Depression and drug abuse were diagnosed in 30% and 22% of the included patients, respectively. Esophagectomies and esophageal bypasses were performed in 13 and 14 patients, respectively. No 30-day mortality was recorded. Conclusion Surgical intervention either by esophagectomy or esophageal bypass results in durable relief from dysphagia. However, successful clinical outcomes depend on a high-quality multidisciplinary network of esophageal and thoracic surgeons, intensivists, psychologists, psychiatrists, and nutritional teams.

Introduction: The aim of this study is to highlight our experience in the management of long segment corrosive esophageal stricture using the left colon bypassing the strictured segment of the esophagus thereby maintaining continuity and restoring normal swallowing. Subjects and Methods: This was a retrospective study of patients with long-segment corrosive esophageal stricture who were managed by left colon bypass surgery in our center over a 5-year period between January 2012 and December 2016. Hospital records were reviewed and relevant information such as age, sex, clinical presentations, and operative procedure were obtained. The left colon grafts were taken under the pedicle of left colic artery in all cases, and three anastomoses were made at colocolic, cologastric, and colo-esophageal points. Feeding gastrostomy was done for all patients for early feeding. Results: There were 12 males (60%) and 8 females (40%) and age ranging from 2 years to 42 years; among them, there were 13 children (65%) and 7 adults (35%); caustic soda was the most common corrosive substance in 14 cases (70%) and acid in 2 cases (10%); the exact nature of the substances in 4 (20%) was not clear. Accidental ingestion was found in 90% of the cases. Psychiatric illness was associated in 2 adults (10%). Conclusion: The treatment of long segment corrosive esophageal stricture with left colon bypass graft surgery under the pedicle of the left colic artery is very effective with minimal postoperative complications; we, therefore, recommend this technique for relief of dysphasia from this form of injury.

Highlights • Swallowing corrosive substances leads to gastrointestinal stenosis due to scarification. • Bypass surgery was performed as adhesions posed risk of injury to adjacent organs. • Esophageal bypass with a “supercharged” pedicled jejunal flap was performed. • The technique creates anastomoses between jejunal and internal thoracic vessels. • It is an optimal technique for treatment of stenosis caused by corrosive esophagitis., Introduction Swallowing a corrosive substance causes delayed gastrointestinal stenosis due to scar formation. Here, we report on our use of esophageal bypass using a supercharged pedicled jejunal flap to treat cicatricial esophageal stenosis caused by corrosive esophagitis. Presentation of case Nineteen years before presentation, a 57-year-old man had swallowed a chemical cleaning agent, which caused extensive corrosive cicatricial stenosis from the thoracic upper esophagus to the gastric fornix. An enterostomy had been created, and the patient had since been subsisting on enteral nutrition. However, he wanted to be able to eat through his mouth again and was referred to our department for treatment. With the exception of the cervical esophagus, circumferential cicatricial stenosis was present throughout the esophagus and gastric fornix, with severe adhesions to the surrounding tissue. It was decided not to perform esophagectomy but to perform esophageal bypass surgery using a supercharged pedicled jejunal flap. Discussion Despite the extremely high risk of cancer in the stenotic esophagus due by corrosive esophagitis, indicating that esophagectomy should be performed if possible, we chose to perform bypass surgery because the severe adhesions posed a high risk of early injury to the surrounding organs. Conclusion We suggest that esophageal bypass using pedicled jejunal pull-up “supercharging” by creating anastomoses between the jejunal and internal thoracic vessels is the optimal procedure for patients with extensive cicatricial esophageal stenosis caused by corrosive esophagitis.

In general, a hazardous waste is any solid or liquid waste that is considered toxic, chemically reactive, flammable or corrosive. In terms of hazardous waste, something is considered toxic if it is harmful to human health when a person is exposed to the substance through inhalation, ingestion or touch. A substance is chemically reactive when it is unstable or could react when exposed to another compound. Hazardous waste that is considered chemically reactive is likely to explode or produce harmful fumes when exposed to other compounds. A flammable substance is anything that is likely to catch fire and a corrosive substance is something that can corrode or break down metals. The largest amount of hazardous waste is created in industry, in particular the petroleum and chemical industries, which produce around 70% of all hazardous waste in the United States. The most common examples of hazardous waste from industries in general include solvents used in cleaning, wastewater from petroleum refiners and ash produced from incinerators or coal-burning power plants. The most dangerous hazardous waste is the waste created by nuclear power plants and nuclear weapons facilities. Although industry creates a large amount of hazardous waste in the United States and other industrial countries, this waste is highly regulated and controlled. This chapter discusses various kinds of hazardous wastes, their sources and their end-of-pipe disposal.

Objective To evaluate the demographic characteristics, endoscopy results, emerging complications and the final status of caustic intake cases admitted to our emergency department. Method This study is a retrospective one concerning patients admitted to our emergency department due to caustic ingestion. Demographic characteristics of the patients, complaints while applying to the hospital, physical examination findings, the purpose of caustic intake, the characteristics of corrosive substance taken, times of endoscopy following admission to the emergency department, follow-up times in the emergency department, endoscopic staging and outcome. The data were analyzed through IBM SPSS Statistics Base 22.0 package program. Results Seventy four patients participated in the study. 83.8% of corrosive substance intake cases were accidental and 16.2% cases were suicidal intention. While 60.8% of the corrosive substances taken had alkaline property, 36.5% were acidic and 2.7% were found to be unknown substances. 50% of the corrosive substance intakes were sodium hypochlorite. It was seen that endoscopy was performed in 59 patients who accepted endoscopy within an average of 244.07 min after admission to the emergency department. While no damage could be seen in 55.9% of patients following endoscopy, the most common injury was Grade 1 (35.6%). Conclusion Corrosive substance intake is a rare but potentially devastating poisoning with high morbidity and mortality. Mucosal injury begins within minutes following corrosive intake. Therefore, early endoscopy is helpful in assessing the degree of injury and early discharge from hospital.

Ingestion of a corrosive substance can produce severe injury to the gastrointestinal tract and can even result in death. The degree and extent of damage depends on several factors like the type of substance, the morphologic form of the agent, the quantity, and the intent. In the acute stage, perforation and necrosis may occur. Long-term complications include stricture formation in the esophagus, antral stenosis and the development of esophageal carcinoma. Endoscopy should be attempted and can be safely performed in most cases to assess the extent of damage. Procedure related perforation is rare. Stricture formation is more common in patients with second and third degree burns. This review summarizes our current knowledge and evidence based management of this unique but not uncommon pathology of the upper gastrointestinal tract.

Ficus (FIC) leaf extract used as corrosion inhibitor for carbon steel alloy (C.S) in two corrosive environments (saline and acidic) with four concentrations (1, 2, 3 and 4 ppm) at varied temperature range between (298-328 K) using electrochemical polarization measurements. The importance of this work focused on the use the green chemistry that is far from the chemical materials effect. The results of polarization presented the FIC inhibitor consider a mixed type (anodic and cathodic) inhibitor. Tafel curve used to evaluate the corrosion inhibition activity. In a saline medium, the best inhibitor efficiency reaches to (87%) in 2 ppm and IE% reach to (99%) for HCl medium inhibited by 1ppm. Langmuir isotherm obeys the study by thermodynamic parameters and confirms the physical adsorption.

Background: Corrosive injury of the oesophagus and stomach is a cause of major morbidity and mortality and is usually seen in the younger age group. Although definitive surgical procedures are available, there is a considerable debate on the timing of a definitive surgery and its electiveness. This study aims to document the benefits of elective surgery and the outcomes of various surgical procedures.Methods: A retrospective observational study of 25 cases of corrosive stricture of upper gastrointestinal tract who underwent definitive surgical procedure was conducted in the department of general surgery at the new civil hospital and government medical college, Surat during a period of 60 months from July 2014 to July 2019. Patients were followed up till a period of 6 months post definitive surgical procedure and were evaluated.Results: Out of 25 patients in our study subjected to definitive surgical procedure in the form of either gastrojejunostomy (GJ) or colonic transposition, 18 patients (72%) could take fully oral and required no further intervention till 6 months post-operative follow up; 3 patients (12%) due to post-operative oesophageal stricture required serial 3 monthly oesophageal dilatation with controlled radial expansion (CRE) balloon; 4 patients (16%) had expired.Conclusions: The choice of definitive surgical procedure according to the level of oesophageal stricture and its optimal timing gives good outcomes with less morbidity and mortality in patients with corrosive substance ingestion.

Endoscopic dilatation is the recommended primary therapy for chronic corrosive esophageal strictures (ES), and surgery is reserved for failed dilatation. Through this study, we intend to analyze the efficacy and long-term outcomes of both endoscopic and surgical interventions in corrosive ES. A retrospective cohort analysis of patients with chronic corrosive ES, managed with endoscopic or surgical procedures at a tertiary teaching institute in North India from December 2009 to December 2016, was performed from a prospectively maintained database. The primary outcome measure was the absence of dysphagia following dilatation or surgery. During the study period, 64 patients with ES underwent surgical or endoscopic treatment. Associated gastric strictures and pharyngeal strictures were present in 39 (60%) and 22 patients (28.9%), respectively. The mean age was 28.8 years and mean BMI was 14.2 kg/m2. Acid was the most common corrosive substance. Endoscopic dilatation using Savary-Gilliard (SG) dilators was successful in achieving persistent symptom relief in 46 patients (71.8%) after a total of 358 sessions (mean number of dilatations were 5.2 ± 1.2) of dilatations over 2 years. The dilatation therapy failed in 18 patients (28.1%) including technical failures (15.6%), perforations (3.1%), refractory stricture (1.5%) and recurrent strictures (7.8%). Increasing stricture length (more than 6 cm) was associated with poor outcome of endoscopic dilatation (p

Corrosive injuries of the oesophagus are the major health and financial burden on society [1]. The nature, intent and incidence of ingestion of a corrosive substance vary considerably among developing and developed countries. It is difficult to provide an accurate estimate of the burden of corrosive injuries as the incidence of attempted suicide is under-reported and corrosive poisoning is clubbed with other forms of poisoning. However, the lower socioeconomic groups seem to be more prone to such an injury. It can occur accidentally in children and in adults. In adults, ingestion is more often with a suicidal motive and uncommonly due to forced ingestion with a homicidal intent. The injury to the oesophagus can be devastating in its acute form leading to the death of the individual but more commonly is associated with chronic sequelae such as stricture formation leading to varying degrees of dysphagia and malnutrition affecting the quality of life. Therefore, understanding the pathophysiology and management of such injuries is paramount to ensure a good long-term outcome. This chapter aims to cover various aspects of the diagnosis and management of corrosive injuries of the oesophagus and address some of the controversies.

Background and Aims: The aim of the study was to evaluate the etiology, treatment, and prognosis in children who had presented at our clinic with corrosive substance ingestion and comparison of our results with the literature. Materials and Methods: The patients were put on nil by mouth and broad-spectrum antibiotics were administered. Oral fluids were started for patients whose intraoral lesions resolved and who could swallow their saliva. Steroids were not given, a nasogastric catheter was not placed, and early endoscopy was not used. Results: A total of 968 children presented at our clinic for corrosive substance ingestion during the 22-year period. The stricture development rate was 13.5%. Alkali substance ingestion caused a stricture development rate of 23%. A total of 54 patients required 1-52 sessions (mean 15 ± 12) of dilatation. Conclusion: We do not perform early endoscopy, administer steroids, or place a nasogastric catheter at our clinic for patients who had ingested a corrosive substance. This approach has provided results similar to other series. We feel that determining the burn with early esophagoscopy when factors that prevent or decrease the development of corrosive strictures will be very important.

Chemical burns of the eye are one of the most common eye injuries. The extent of the ocular surface damage is influenced by the type, temperature, volume, and pH of the corrosive substance and duration of exposure. Limbal ischemia found on eye assessment is the primary determinant of eventual visual outcome. Eye irrigation must be instituted immediately at the scene of exposure and continued in the emergency department to reduce visual impairment. Traditionally lactated Ringer's and normal saline have been used as irrigation fluids, although one systematic review demonstrates similar outcomes with other irrigation fluids. The Morgan Lens is a device that can be utilized to allow the provider to perform "hands free" eye irrigation. Complications of chemical burns are more common with alkali burns as these substances destroy the corneal epithelium and allow this corrosive base substance to penetrate deeper into the cornea.

Purpose of the study Esophageal dilatation can be insufficient in the treatment of severe corrosive esophageal strictures. In this study, we aimed to present the efficacy of intralesional steroid injection as an adjunct to dilatation therapy. Materials and methods Retrospective analysis of children who underwent intralesional steroid injection between 2004 and 2014 was performed. Patients' age, type of corrosive substance, length of stricture, number of injection and dilatation sessions and complications were reviewed. The success was evaluated by the comparison of number, frequency, and requirement of dilatation therapy before and after injection. Results Intralesional steroid injection was performed to 32 children with a mean age of 3.6±2.5 years. The types of corrosive agents were alkali (24) or acid (8). Mean number of injection sessions was 2.5±1.1(1 to 6). Mean number of dilatation sessions was decreased from 10±8.8 to 5.4±4.6 after injection (P=0.003). Mean frequency of dilatations was extended from 3.6±0.9 weeks to 8.7±3.9 weeks (P=0.000). Dilatation treatment was successfully terminated in 25 of 27 children with short-segment strictures after injection (92%). Whereas all of the children with long-segment strictures could not resolved and finally required esophageal replacement (5 patients). One patient had transient cushingoid phenotype as a complication. There was not seen any major complication-like perforation. The mean follow-up period was 6±3 years. Conclusions Intralesional steroid injection is an effective adjunct to dilatation in most of the children with short-segment strictures. It should be performed as a safe and efficient treatment option in patients with short-segment corrosive esophageal strictures resistant to dilatation therapy.

The study presents a retrospective analysis of 64 cases of death resulting from ingestion of corrosive substances. The cases represented approximately 0.4% of all autopsies conducted and 13.6% of all fatal poisonings studied during the 10-year period from January 2005 to December 2014 at the Department of Forensic Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi. The data was analyzed with regard to age, sex, nature and source of corrosive substance used, survival period, cause and manner of death. Males (64.06%) outnumbered females (35.94%), with a male-to-female ratio of 1.78:1. The most common age group involved was 21-30 years (35.94%). Sulfuric acid (68.75%) presented as the most common corrosive substance ingested. Household cleaning substances (39.06%) were identified as a common source of such type of corrosive substance, but the exact source could not be identified in 56.26% of cases. In the majority of cases (46.88%) death was due to perforation peritonitis. Most of the victims (54.69%) succumbed to their injuries within a day of ingestion. In 87.5% of cases, the corrosive substance was consumed for suicidal purposes. A strict regulatory framework is required for the production, distribution, storage and use of corrosive substances. Preventive guidelines and creating awareness among the masses will go a long way towards curbing such unfortunate incidents.© The Author(s) 2016. Language: en