P1.093. Case Series Review: Nutritional Management of Caustic Ingestion Injuries Requiring Surgical Intervention

Abstract

Abstract Topic Esophageal Cancer: Caustic Ingestion of the Esophagus Background Intentional caustic ingestion represents a rare but severe form of self-harm, resulting in extensive upper gastrointestinal injury, high morbidity, and prolonged hospitalisation. This case series describes three adult patients (mean age 36 years; two males) who required complex surgical and nutritional management following ingestion of caustic substances. Methods A retrospective review was undertaken of the admissions for caustic ingestion injury to a tertiary referral centre (Royal Surrey County Hospital, Guildford, UK) between January 2023 & February 2026. 3 cases were highlighted and their nutritional management investigated. Results All patients sustained severe gastrointestinal injury requiring major surgery, including pharyngolaryngoesophagectomy with colonic interposition, emergency oesophagectomy with oesophagostomy and PEG, and distal gastrectomy with pancreaticoduodenectomy and feeding jejunostomy. Postoperatively, all required prolonged nil-by-mouth periods and advanced nutritional support, including total parenteral nutrition, enteral feeding via NJ, PEG or jejunostomy, and supplemental parenteral nutrition, with gradual transition to oral intake where possible. Dietetic involvement was intensive, with 25–122 registered dietitian contacts per patient. Two patients experienced significant weight loss (−15.4 kg and −19.6 kg), while one maintained relative weight stability. Length of stay ranged from 65 to 328 days. Outcomes varied: one patient achieved nutritional rehabilitation and oral intake though did not attend follow-up, one remained fully enterally fed and died awaiting reconstructive surgery, and one experienced significant functional decline requiring transfer to a local hospital for ongoing care. Conclusion This series highlights the profound physiological and nutritional consequences of intentional caustic ingestion. It underscores the necessity for early, sustained multidisciplinary management, with dietitians playing a central role in mitigating malnutrition, supporting recovery, and guiding complex feeding strategies. Despite intensive intervention, outcomes remain poor, demonstrating the need for early intervention and long-term support strategies in this high-risk patient group.