Grading of esophageal burns from caustic injury

Injury	Findings
Grade 0	Normal mucosa
Grade 1 (superficial)	Mucosal edema and hyperemia
Grade 2 (transmucosal)	Friability, hemorrhages, erosions, blisters, whitish membranes, and superficial ulcerations
Grade 2A	No deep focal or circumferential ulcers
Grade 2B	Deep focal or circumferential ulcers
Grade 3	Areas of multiple ulceration and areas of brown-black or greyish discoloration suggesting necrosis
Grade 3A	Small scattered areas of focal necrosis
Grade 3B	Extensive necrosis

This scheme for grading of esophageal burns was described by Zargar and colleagues in 1991. In a study of 81 patients (primarily adults) with corrosive esophageal burns, this scheme helped to predict complications. Early major complications occurred only in patients with grade 3 injury. Late complications including esophageal strictures were limited to patients with grade 2B or 3 injuries.

Reference: Zargar SA, Kochhar R, Mehta S, Mehta SK. The role of fiberoptic endoscopy in the management of corrosive ingestion and modified endoscopic classification of burns. Gastrointest Endosc 1991; 37:165.

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Grading of esophageal burns from caustic injury