DX: Esophageal calcification after corrosive injury

Sorry for the delay. This couple of months have been quite diffucult but we are still making some noise. Anyways here is the conclusion of this case.

We inquire if patient had a history of caustic ingestion (sodium hydroxide) and he did a couple of months ago. He accidentally swallowed this corrosive but induced himself vomiting shortly after ingestion.

Relevant findings are as described:

There was no adenopathy or infiltration to surrounding tissues.

Primary DD is Leiomyoma.

The course of corrosive damage to the intestinal tract can be divided in three phases:

1) 1.4 days after ingestion, acute necrosis with intensive inflamatory reaction in surrounding tissue occurs,.
2) 3-5 days after ingestion, in wich sloughing of necrotic tissue occurs and repair begins with fibroblastic activity.

3) 3-4 weeks after ingestion, when the fibrous tissue begins to contract and the inflammatory reaction subsides. Contraction and adhesion between granulating areas in the lumen lead to stricture formation.

Stricture formation is the leading radiological feature of the chronic phase of corrosive esophageal injury with prestenotic dilation of the esophagus as in this case. Stricture has benign characteristics with smooth, concentric tapering of the esophageal wall at the margins. Calcifications are unusual.Here is an article that explains this unusual characteristic:

http://www.springerlink.com/content/h071q457134h1311/


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