Page 80 - Ebook-Book JCMS 2025

Esophagogastroduodenoscopy Versus Thoracic Computed
Tomography in Prediction of Caustic Stricture
Amonpon Kanlerd1*, Thanyaporn Suksumek2, Piyapong Boonyasatid1, Chompoonut Achavanuntakul1
,
Karikarn Auksornchart1, Wichet Piyawong3, Wirana Angthong3, Prasit Mahawongkajit1
1 Department of Surgery, Faculty of Medicine, Thammasat University
2 Thammasat University Hospital
3 Department of Radiology, Faculty of Medicine, Thammasat University
*Corresponding Author E-mail: amonponk@hotmail.com
Background: Methods: Abstract
Luminal stricture is the most common delayed complication following corrosive ingestion.
Currently, chest computed tomography is increasingly used in the initial phase of injury
compared to endoscopic examination. However, the ability to predict the stricture of com-
puted tomography remains unclear.
A prospective study of adult caustic injury patients (> 18 years) who were admitted within
24 hours after corrosive ingestion was conducted. All patients were evaluated with
computed tomography and esophagogastroduodenoscopy within 48 hours after injury. The
severity grading of both studies was collected and compared with the barium study at 3
weeks post-injury. Receiver-operating characteristic values were constructed to evaluate
the predictability of computed tomography and esophagogastroduodenoscopy on caustic
strictures.
Results: 23 patients were enrolled. Caustic stricture was detected in 5 of 12 patients (41%) who
completed follow-up. The median time from injury to computed tomography was 5
hours compared to 18 hours in esophagogastroduodenoscopy. Computed tomography
severity grading score ≥ IIb resulted in 80% sensitivity and 86% specificity. Meanwhile,
esophagogastroduodenoscopy Zagar severity classification ≥ 2B resulted in 80% sensitivity
and 71% specificity. The area under the receiver operating characteristic (AUROC) curve for
both studies in predicting caustic stricture was similar (0.97 vs 0.91, p=0.55).
Conclusion: The AUROCs of thoracic computed tomography and esophagogastroduodenoscopy
were comparable. However, computed tomography has a shorter timeframe and is more
accessible. Thoracic computed tomography can be considered an alternative to caustic
stricture prediction.
78 Joint Conference in Medical Sciences 2025