Zagar classification for corrosive ingestion

    Park KS, Evaluation and Management of Caustic Injuries from Ingestion of Acid or Alkaline Substances, Clinical Endoscopy 2014; 47(4): 301-307 De LusongMA, Management of esophageal caustic injury, World J Gastrointest Pharmacol Ther, 2017 May 6; 8(2): 90–98

    (A) Grade 1 indicates only slight swelling and redness of the mucosa.

    (B) Grade 2A indicates the presence of superficial ulcers, bleeding, and exudates.

    (C) Grade 2B indicates local or encircling deep ulceration.

    (D) Grade 3A indicates focal necrosis. White arrows indicate focal necrosis.

    (E) Grade 3B indicates extensive necrosis.


    Initial treatment

    •Medicine: Corticoid, PPI, antibiotic depending on grade

    •Intravenous dexamethasone at high dose (1 g/1.73 m2 per day) for 3 days in IIb esophagitis

    •Esophageal dilatation or surgery for stricture