●Grade 0 – Normal
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●Grade 1 – Mucosal edema and hyperemia
●Grade 2A – Superficial localized ulcers, bleeding, exudates
Supportive care with pain control. A liquid diet may be initiated and the patient can be advanced to a regular diet in 24 to 48 hours.
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●Grade 2B – Deep focal or circumferential ulcers
●Grade 3A – Focal necrosis with multiple and deep ulcerations and small scattered areas of necrosis
●Grade 3B – Extensive necrosis
Endoscopic management – Most clinicians wait three to six weeks after the initial injury before attempting dilation and perform dilation slowly to minimize the risk of esophageal perforation
Surgical reconstruction – Patients with multiple failed attempts at endoscopic dilatations should be evaluated for reconstructive surgery. Most experts recommend delaying surgical reconstruction for six months to stabilize the injury.