Caustic ingestion in adults ? A retrospective observational study of clinical and endoscopic findings in a Hispanic population

Caustic ingestion in adults is an infrequent but potentially life-threating condition, commonly associated with intentional ingestion and severe gastrointestinal injury. Data describing the clinical and endoscopic characteristics of adult caustic ingestion in Hispanic population are limited. The aim of this study was to describe the epidemiological, clinical, and endoscopic characteristics of adult patients with caustic ingestion and to explore associations between clinical presentation and endoscopic severity. We conducted a retrospective observational study including adults admitted with caustic ingestion at tertiary referral center in northern Mexico between January 2016 and July 2025. Demographic, clinical, and endoscopic data were obtained from medical records. Upper endoscopy was performed within the first 24 hours whenever feasible, and lesions were classified according to Zargar classification. Thirty-five patients were included, with a median age of 27 years and male predominance. Most ingestions were intentional, and acid agents were the most frequently involved substances. Esophageal lesions were identified in most patients, followed by gastric and duodenal involvement. The most frequent esophageal injuries corresponded to moderate and severe grades. Clinical findings such as sialorrhea and aspiration of secretions and need for orotracheal intubation were associated with gastric involvement. In-hospital mortality was 5.7%, and only one (2.8%) patient developed an esophageal stricture. In this Hispanic cohort, adult caustic ingestion predominantly affected young men and was mainly intentional. Severe esophageal injury was frequent, and specific clinical findings at presentation were associated with advanced endoscopic damage, supporting their role as early indicators of severity and the need for prompt endoscopic evaluation.