Corrosive injury of the trachea in children

Goussard, Pierre; Mfingwana, Lunga; Morrison, Julie; Ismail, Zane; Wagenaar, Riegart; Janson, Jacques

doi:10.1002/ccr3.2395

Cited by 9 publications

(6 citation statements)

References 17 publications

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“…In particular, if aspiration pneumonia was observed on the initial chest CT after acid ingestion, it is necessary to mention even subtle airway changes in acute stage to recognize and reduce potential late complication of airway. Late airway complication detected on chest CT include airway luminal stenosis due to ongoing process of healing and fibrosis [ 3 , 8 ] Chest CT can evaluate extent and degree of airway stricture that is difficult to approach for bronchoscopy.…”

Section: Discussionmentioning

confidence: 99%

Case report of tracheobronchial injuries after acid ingestion: CT findings with serial follow-up

et al. 2020

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Rationale: Tracheobronchial injury from acid ingestion is a less reported clinical presentation than injury of the gastrointestinal tract, but it can occur due to direct exposure from acid aspiration and cause fatal complications. Patient concerns: A 43-year-old man presented to the emergency department after ingesting nitric acid complaining of chest pain and dyspnea. Diagnoses: The initial chest computed tomography (CT) images revealed an acute lung injury related to acid aspiration. The follow-up chest CT showed acute and late tracheobronchial injures. Interventions: Bronchoscopy showed deep caustic airway injuries consisting of hemorrhage, sloughing of the mucosa, and ulceration of the trachea and left-side bronchial tree. Outcomes: Progressive narrowing of the left main bronchus with total collapse of the left lung occurred as a late complication of acid ingestion. Lessons: Tracheobronchial injury should be considered in cases of aspiration pneumonia after acid ingestion; chest CT can be used to detect and assess acute and late complications of tracheobronchial injuries.

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Section: Discussionmentioning

confidence: 99%

Case report of tracheobronchial injuries after acid ingestion: CT findings with serial follow-up

et al. 2020

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“…Long-term severe complications include stricture of various parts of the GI tract, tracheoesophageal fistula, esophageal shortening, lower esophageal sphincter insufficiency, esophageal dysfunction, intramural false diuretic formation, and esophageal cancer [11][12][13][14][15][16]. The severity of corrosive ingestion varies depending on several factors, including the nature of the ingested substance, the amount consumed or its concentration, the form (solid or liquid), titratable acid or alkali reserve, duration of GI tissue exposure to the ingested substance, and individual characteristics of the body [17][18][19].…”

Section: Open Accessmentioning

confidence: 99%

Developing the minimum data set of the corrosive ingestion registry system in Iran

Mahmoudvand

Yazdani

Shafiee

et al. 2022

BMC Health Serv Res

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Background Corrosive ingestion is still a major health problem, and its outcomes are often unpredicted. The implementation of a registry system for poisoning with corrosive substances may improve the quality of patient care and might be useful to manage this type of poisoning and its complications. Therefore, our study aimed to establish a minimum data set (MDS) for corrosive ingestion. Methods This was an applied study performed in 2022. First, a literature review was conducted to identify the potential data items to be included in the corrosive ingestion MDS. Then, a two-round Delphi survey was performed to attain an agreement among experts regarding the MDS content, and an additional Delphi step was used for confirming the final MDS by calculating the individual item content validity index (CVI) and content validity ratio (CVR) and by using other statistical tests. Results After the literature review, 285 data items were collected and sent to a two-round Delphi survey in the form of a questionnaire. In total, 75 experts participated in the Delphi stage, CVI, kappa, and CVR calculation. Finally, the MDS of the corrosive ingestion registry system was identified in two administrative and clinical sections with 21 and 152 data items, respectively. Conclusions The development of an MDS, as the first and most important step towards developing the corrosive ingestion registry, can become a standard basis for data collection, reporting, and analysis of corrosive ingestion. We hope this MDS will facilitate epidemiological surveys and assist policymakers by providing higher quality data capture to guide clinical practice and improve patient-centered outcomes.

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“…The first step is always to prioritize airway, breathing and circulation. Patients presenting with respiratory difficulty, dysphonia or aphonia need urgent airway management like endotracheal intubation and ventilation[ 18 ]. Urgent steroids are indicated in life-threatening laryngeal edema.…”

Section: Dilemmas In Acute Corrosive Ingestion Managementmentioning

confidence: 99%

“…Another practice that is not recommended is the trial of neutralization with weak acid or base to decrease the effect of corrosive. The reaction of acid and alkali leads to an exothermic reaction which may cause added thermal burn to an already damaged tissue[ 18 ].…”

Section: Dilemmas In Acute Corrosive Ingestion Managementmentioning

confidence: 99%

Corrosive upper gastrointestinal strictures in children: Difficulties and dilemmas

Sarma¹,

Tripathi²,

Arora³

2021

WJCP

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Children constitute 80% of all corrosive ingestion cases. The majority of this burden is contributed by developing countries. Accidental ingestion is common in younger children (< 5 years) while suicidal ingestion is more common in adolescents. The severity of injury depends on nature of corrosive (alkali or acid), pH, amount of ingestion and site of exposure. There are multiple doubts and dilemmas which exist in management of both acute ingestion and chronic complications. Acute ingestion leads to skin, respiratory tract or upper gastrointestinal damage which may range from trivial to life threatening complications. Esophagogastroduodenoscopy is an important early investigation to decide for further course of management. The use of steroids for prevention of stricture is a debatable issue. Upper gastrointestinal stricture is a common long-term sequelae of severe corrosive injury which usually develops after three weeks of ingestion. The cornerstone of management of esophageal strictures is endoscopic bougie or balloon dilatations. In case of resistant strictures, newer adjunctive therapies like intralesional steroids, mitomycin and stents can be utilized along with endoscopic dilatation. Surgery is the final resort for strictures resistant to endoscopic dilatations and adjunctive therapies. There is no consensus on best esophageal replacement conduit. Pyloric strictures require balloon dilatation , failure of which requires surgery. Patients with post-corrosive strictures should be kept in long term follow-up due to significantly increased risk of carcinoma. Despite all the endoscopic and surgical options available, management of corrosive stricture in children is a daunting task due to high chances of recurrence, perforation and complications related to poor nutrition and surgery.

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Corrosive injury of the trachea in children

Cited by 9 publications

References 17 publications

Case report of tracheobronchial injuries after acid ingestion: CT findings with serial follow-up

Case report of tracheobronchial injuries after acid ingestion: CT findings with serial follow-up

Developing the minimum data set of the corrosive ingestion registry system in Iran

Corrosive upper gastrointestinal strictures in children: Difficulties and dilemmas

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