There are three clinical stages of esophageal burns:
1) dysphagia primary stage (acute stage),
2) the stage of an imaginary well-being (chronic esophagitis stage),
3) stage of secondary dysphagia (stricture formation stage).
Sometimes the fourth stage is highlighted - the stage of late complications (obliteration of the lumen, perforation of the esophagus wall, development of cancer).
According to the severity of acute clinical stage there are three degrees of esophagus burn: easy (damaged surface layers of the epithelium of the esophagus), moderate (with extensive necrosis of the epithelium) and heavy (necrosis captures mucosal, submucosal and muscle layers, spreading on paraesophageal tissue and neighboring organs).
Esophageal tissues are penetrated by nerve endings. Therefore, a burn of it, causes an intense pain. It is felt in the neck, behind the sternum and in upper abdomen. Traces of burn and edema and visible on the lips and in the oral cavity. As a result of the damage of the vocal cords by chemicals hoarseness appears. Tissue swelling occurs rapidly. As a result, the lumen of the esophagus becomes blocked and swallowing process gets impaired.
There comes a shortness of breath caused by swelling of larynx tissue. This is often accompanied by vomiting with mucus, blood and pieces of the affected mucosa of the esophagus and stomach.
Immediately after receiving corrosive agents firstly occurs mucous damage, and later the damage of esophagus with other layers. Chemicals destroy cells and cause tissue necrosis. The worst affected areas are places where esophagus has its narrowings.
If one gets burn of a 3rd degree a hole in a wall of esophagus may form. In severe cases the wall of the bronchus can be destroyed forming esophageal-tracheal fistula.
Among common symptoms of the body's destruction is a general intoxication of the organism. It is caused by poisoning, which occurs due to the accumulation of toxins - products of a tissue decay. Its symptoms are fever, severe weakness, nausea, cardiac activity.The severity of internal organs damage depends on the concentration and the amount of the chemical agents ingested.
Renal-hepatic failure may be the result of a damage of a body with toxins, when kidneys with liver, which are responsible for cleaning the blood from the decay products, are not able to cope with their task.
The final diagnosis is established when the degree of damage and complications appeared can be determined. X-ray study of the esophagus should not be made during first few days for it is necessary to stabilize the patient's condition. A few days after the burn swelling of the esophageal mucosa and local spasms may be noted with a concentrated X-ray examination.
In later periods, the information content of X-ray examination is much higher: it is possible to determine the locations, extent, and severity of scarring and esophageal constrictions. Esophagoscopy is contraindicated in first days, and is possible only in the period of scarring and epithelialization of the mucous membrane, thus it should be carried out with an extreme caution.
Esophagoscopy allows to define the length of lesions, to follow the dynamics of the process in a timely manner to identify emerging stricture, for they are often formed in the distal segment of the esophagus, above the cardiac sphincter, in pharyngoesophageal connection and at the level of the bifurcation of the trachea.