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c. Evaluation of Endoscopy
i. Endoscopic Stages of Esophageal Injuries
Table 10.3 presents the endoscopic stages of esophageal injuries, along
with information about treatment and outcome.
Table 10.3. Endoscopic Stages of Esophageal Burns
Grade of
Injury
Effect of
Injury
Injury Treatment
and Outcome
Normal No erythema No healing time.
First degree Mucosal erythema Consistently heals
uneventfully.
Second degree Mucosal erythema
Noncircumferential
exudate
Occasionally forms
strictures.
Third degree Mucosal erythema
Circumferential
exudate.
Most form strictures.
Fourth degree Mucosal erythema
Circumferential exudate
Esophageal wall
perforation
Carries the additional
risk of sepsis and
mediastinitis. Small
perforations may be
treated conservatively.
Larger perforations with
surrounding necrosis
may require resection
with reanastomosis.
Source: Flint et al., Figure 211-2.
ii. Tracheoscopy
Tracheoscopy should be included to examine the posterior tracheal wall
for all third- and fourth-degree injuries.
iii. Abortion of Endoscopic Evaluation
Endoscopic evaluation should be aborted when there is no definable
lumen.
iv. Type of Esophagoscope
Rigid and flexible esophagoscopes may both be used. However, a
flexible esophagoscope is needed to adequately visualize the stomach.