Esophageal Injury and Trauma in Children

Your child's esophagus can become damaged if they ingest toxic chemicals or foreign objects, or if they experience physical trauma to this organ. Ingestion of caustic substances, such as oven and drain cleaners, lye, laundry and dishwasher detergents and batteries are common causes of esophageal injury in children. Depending on the substance and the amount of the substance ingested, children can develop esophageal burns, esophageal strictures and esophageal perforation (a hole in the esophagus).

What are the symptoms of esophageal injury?

Some children may not show any symptoms after swallowing a caustic substance or object. However, damage to the esophagus can still occur, regardless of whether or not your child exhibits symptoms. In other words, symptoms may not reflect the severity of the injury. When symptoms do occur, they may include:

  • dysphagia (difficulty swallowing)
  • drooling
  • abdominal or chest pain
  • refusal to eat
  • breathing problems

Injury from caustic substances tends to worsen over time. Some symptoms may not develop until a few hours after ingestion. Strictures are the main complication of esophageal injury and develop in up to half of people who have esophageal burns as the result of caustic substance ingestion. Children who ingest caustic substances may also be at increased risk for esophageal cancer later in life.

What causes esophageal injury?

Ingestion of caustic substances is a major cause of esophageal injury. Common harmful products include oven and drain cleaners, toilet bowl cleaners, swimming pool products, hair relaxers, lye, laundry and dishwasher detergents, disk batteries, battery acid and bleach. Both acidic and alkaline substances can damage the esophagus, although alkaline substances (such as batteries and lye) appear to cause more severe injuries.

Other causes of esophageal injury include:

  • Previous surgery on the esophagus
  • Physical trauma to the esophagus or chest
  • Ingestion of foreign objects
  • Chronic gastroesophageal reflux 
  • Severe vomiting
  • Tumors

How we care for esophageal injury and trauma

Ingestion of caustic substances is an emergency that requires immediate medical attention. If your child develops esophageal burns, strictures or perforation, they will need follow up and treatment by a specialist. The skilled clinicians in the Esophageal and Airway Treatment Center at Boston Children's Hospital use the latest diagnostic tests and therapeutic approaches to evaluate and treat esophageal injury so that your child can regain the ability to swallow normally.