Chest and abdominal radiographs should be ordered routinely for patients who have ingested these agents. Chest films may reveal a dilated esophagus or evidence of esophageal perforation. Abdominal films may show pneumoperitoneum secondary to gastric perforation. If perforation is suspected, the study should be followed up by a water-soluble contrast study. In the acute phase, esophagrams may show abnormal esophageal motility with diffuse spasms and poor primary peristalsis. On double contrast studies, shallow ulcers may appear as punctuate, linear, or serpiginous collections of barium. In severe cases, the esophagus may show diffuse narrowing with an irregular contour. Chronically, cicatrisation and fibrosis may lead to the development of strictures 1 to 3 months after the injury. The strictures typically appear as areas of smooth, tapered narrowing in the cervical or upper thoracic esophagus.
Corrosive esophagitis is caused by swallowing caustic chemicals such as acid or lye. This can happen accidentally or in an attempt at suicide. Reflux esophagitis is also known as gastroesophageal reflux disease (GERD). It is caused by a malfunction of the sphincter muscle between the esophagus and the stomach, which allows stomach acids to enter the esophagus. It can also be caused by excessive vomiting. Infectious esophagitis is caused most frequently by Candida, herpes and other viruses when the immune system is compromised. Chronic non-specific disease typically follows corrosive and reflux esophagitis. Other causes include radiation injury and obstruction of the esophagus