Phosphides are widely used as fumigants and rodenticides in developing countries. Ingestion is often fatal. Survivors may experience a number of complications, including structural damage of the esophagus.
In the series of Jain et al about a third of survivors developed an esophageal complication.
A survivor of phosphide ingestion who presents with esophageal complaints should be carefully evaluated. This may include:
(1) endoscopic exam of the esophagus
(2) barium swallow (with precautions if a tracheoesophageal fistula is possible)
(3) CT or MRI
A patient who presents with unexplained esophageal stricture or fistula should be evaluated for phosphide ingestion since this would be associated with other issues.
In theory the patient may be at increased risk for esophageal cancer in later life.
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