Optimal times for diagnosis of esophageal caustic injury
DOI: 10.32364/2587-6821-2026-10-5-2
Optimal times for diagnosis of esophageal caustic injury
A.V. Makarov1, E.A. Zhirkova1, P.A. Yartsev1, S.S. Petrikov1, Yu.S. Teterin1, M.M. Potskhveriya1, A.Yu. Simonova1,2
1 N.V. Sklifosovskiy Research Institute for Emergency Medical Aid, Moscow, Russian Federation
2 Russian Medical Academy of Continuous Professional Education, Moscow, Russian Federation
Background: videoesophagoscopy (VES) is the gold standard for diagnosis of esophageal caustic injury (ECI). Endoscopic follow-up examination including endoscopic ultrasonography (EUS) clarify depth of esophageal wall injury. However, optimal times for delayed endoscopic diagnosis have not been determined. In addition, according to modern literature data, endoscopic diagnosis should be avoided from Day 5 to Day 15 due to high risk of iatrogenic perforation of the esophagus.
Aim: to determine optimal times of endoscopic diagnosis of ECI.
Materials and Methods: from 2021 to 2023, 258 patients aged 18 to 94 years poisoned with corrosive substances asked for medical help in N.V. Sklifosovskiy Research Institute for Emergency Medical Aid. Endoscopic diagnosis of ECI was divided into early and delayed ones. Early diagnosis was performed in all patients within the first 24 hours after the poisoning, and delayed one was dedicated to grade ECI finally.
Results: among 258 patients, ECI was graded exactly in 166 (64.3%) subjects on Days 2–3 and in 194 (75.2%) subjects on Days 4-5, respectively. The latter was significantly higher than the former (p=0.006). On Days 4-5, probability of ECI grading was 1.6 times higher than that on Days 2–3 (p=0.010). The authors believe that this is related to decreased mucosal edema improving imaging of superficial lesions.
EUS was performed to enable differential diagnosis of ECI (grades 3-4) in 64 patients. EUS resulted in exact ECI grading in 7 (33.3%) patients and in all patients on Days 4–6 and on Days 7-10, respectively. Thus, proportion of correctly diagnosed cases on Days 7–10 was 3 times higher than on Days 4–6 (p<0.001). On Days 5-15, 358 endoscopic examinations were carried out. They did not reveal iatrogenic perforation of the esophagus.
Conclusion: a prospective cohort study demonstrated that Days 4–5 after the poisoning are optimal times for delayed VES, and Days 7–10 are perfect times for exact grading of the injury depth by EUS. In the study cohort, a meaningful result represented demonstration of the endoscopy safety on Days 5-15.
Keywords: videoesophagoscopy, endoscopy, endoscopic ultrasonography, endosonography, esophageal caustic injury, necrosis, ulcer, perforation, alkali, acetic acid.
For citation: Makarov A.V., Zhirkova E.A., Yartsev P.A., Petrikov S.S., Teterin Yu.S., Potskhveriya M.M., Simonova A.Yu. Optimal times for diagnosis of esophageal caustic injury. Russian Medical Inquiry. 2026;10(5):263–270 (in Russ.). DOI: 10.32364/2587-6821-2026-10-5-2
About the authors:
Alexey V. Makarov — C. Sc. (Med.), Endoscopist at the Department of Endoscopy and Intraluminal Surgery, N.V. Sklifosovskiy Research Institute for Emergency Medical Aid; 3, bldg. 1, Bolshaya Sukharevskaya sq., Moscow, 129090, Russian Federation; ORCID iD 0000-0001-7388-7077
Elena A. Zhirkova — C. Sc. (Med.), Leading Scientific Officer at the Department of Acute Thermal Injuries, N.V. Sklifosovskiy Research Institute for Emergency Medical Aid; 3, bldg. 1, Bolshaya Sukharevskaya sq., Moscow, 129090, Russian Federation; ORCID iD 0000-0002-9862-0229
Pyotr A. Yartsev — Dr. Sc. (Med.), Professor, Head of the Center for Emergency and Specialized Surgical Care, N.V. Sklifosovskiy Research Institute for Emergency Medical Aid; 3, bldg. 1, Bolshaya Sukharevskaya sq., Moscow, 129090, Russian Federation; ORCID iD 0000-0003-1270-5414
Sergey S. Petrikov — Academician of the Russian Academy of Sciences, Dr. Sc. (Med.), Professor, Director of the N.V. Sklifosovskiy Research Institute for Emergency Medical Aid; 3, bldg. 1, Bolshaya Sukharevskaya sq., Moscow, 129090, Russian Federation; ORCID iD 0000-0003-3292-8789
Yuryi S. Teterin — Dr. Sc. (Med.), Head of the Department of Endoscopy and Intraluminal Surgery, N.V. Sklifosovskiy Research Institute for Emergency Medical Aid; 3, bldg. 1, Bolshaya Sukharevskaya sq., Moscow, 129090, Russian Federation; ORCID iD 0000-0003-2222-3152
Mikhail M. Potskhveriya — Dr. Sc. (Med.), Head of the Center for Acute Poisoning, N.V. Sklifosovskiy Research Institute for Emergency Medical Aid; 3, bldg. 1, Bolshaya Sukharevskaya sq., Moscow, 129090, Russian Federation; ORCID iD 0000-0003-0117-8663
Anastasia Yu. Simonova — C. Sc. (Med.), Leading Scientific Officer, N.V. Sklifosovskiy Research Institute for Emergency Medical Aid; 3, bldg. 1, Bolshaya Sukharevskaya sq., Moscow, 129090, Russian Federation; Chief Freelance Toxicologist of the Moscow Healthcare Department; Deputy Head of the Department of Clinical Toxicology, Russian Medical Academy of Continuous Professional Education; 2/1, Barrikadnaya str., Moscow, 125993, Russian Federation; ORCID iD 0000-0003-4736-1068
Contact information: Alexey V. Makarov, e-mail: AVMakarov21021@mail.ru
Financial Disclosure: the work was carried out with the support of the Autonomous Non-profit Organization Moscow Center for Innovative Technologies in Healthcare (Agreement No. 1209-2/25).
There is no conflict of interest.
Received 05.02.2026.
Revised 03.03.2026.
Accepted 27.03.2026.
This work is licensed under a Creative Commons «Attribution» 4.0 License.
