Zargar Classification of Caustic Esophageal Injury

Zargar’s Classification is the most widely used endoscopic grading system for assessing the severity of esophageal injury after a corrosive ingestion.¹²
Increasing grades of injury correlate well with an increased risk of complications (such as a stricture).³
- Grade 0: Normal
- Grade 1: Superficial mucosal edema and erythema
- Grade 2: Defined by the presence of ulcerations
  - 2A: Superficial ulcerations, erosions, exudates.
  - 2B: Deep or circumferential ulcerations.
- Grade 3: Defined by the presence of necrosis
  - 3A: Focal necrosis.
  - 3B: Extensive necrosis.
- Grade 4: Perforation

Zargar’s Classification

Grade	Features
Grade 0	Normal
Grade 1	Superficial mucosal edema and erythema
Grade 2	Ulcerations present
2A	Superficial ulcerations
2B	Deep or circunferential ulcerations
Grade 3	Necrosis present
3A	Focal necrosis
3B	Deep necrosis
Grade 4	Perforation

Zargar, Showkat Ali, et al. “Ingestion of corrosive acids: spectrum of injury to upper gastrointestinal tract and natural history.” Gastroenterology 97.3 (1989): 702-707. ↩
Zargar, S A et al. “The role of fiberoptic endoscopy in the management of corrosive ingestion and modified endoscopic classification of burns.” Gastrointestinal endoscopy vol. 37,2 (1991): 165-9. doi:10.1016/s0016-5107(91)70678-0 ↩
De Lusong, Mark Anthony A., Aeden Bernice G. Timbol, and Danny Joseph S. Tuazon. “Management of esophageal caustic injury.” World journal of gastrointestinal pharmacology and therapeutics 8.2 (2017): 90. ↩

Last updated October 01, 2022