The diagnosis is often confirmed by a history of accidental ingestion of caustic chemicals and a physical examination, with follow-up tests to determine the severity of the disease. For example, barium oesophagogram or iodine oil contrast imaging can determine the site and extent of oesophageal stricture; oesophagoscopy can assess the extent and degree of injury and grade the extent of oesophageal damage; chest and abdominal X-ray can help diagnose oesophageal or gastric perforation, pneumonia and pleural effusion.