Effectiveness of endoscopic balloon dilatation in grade 2a and 2b esophageal burns in children

Taşkınlar, Hakan; Bahadır, Gökhan Berktuğ; Yiğit, Doğakan; Erdoğan, Cankat; Avlan, Dinçer; Naycı, Ali

doi:10.1080/13645706.2017.1298621

Cited by 7 publications

(6 citation statements)

References 26 publications

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“…However, Taşkınlar et al . reported no significant relationship between the acidity or alkalinity of the causative agent and the grade of resulting injury in their study of patients with Grade 2A and Grade 2B esophageal injury after caustic ingestion 17 . In our study, we determined that patients in Grade 2A and Grade 2B, which were the most severely affected groups, accounted for 89% of pH group A (pH ˂ 2), 16% of pH group B (2 < pH < 12), and 36% of pH group C (pH > 12).…”

Section: Discussionmentioning

confidence: 94%

pH and specific gravity of corrosive agents as indicators in caustic injuries

İsbir

Kıllı

Taşkınlar

et al. 2022

Pediatrics International

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Background Video endoscopy, which remains the diagnostic gold standard after ingestion of a corrosive substance, is performed under general anesthesia in children, requires advanced technology, and is costly. Simple and accessible methods are therefore needed to determine the need for endoscopy. The aim of this study was to evaluate the role of the pH and specific gravity of ingested substance in determining endoscopy indications after corrosive ingestion. Methods This prospective study included pediatric patients who presented after ingesting a corrosive substance from June 2018 to June 2019. Relationships between the extent of damage detected by endoscopy and the patient's age, physical examination findings, and the pH and specific gravity of the causative substance were evaluated. Results The degree of damage detected on endoscopy was significantly milder for corrosive substances with a pH between 2 and 12 (P = 0.003). In addition, pH values between 2 and 12 were significantly more common among patients without physical examination findings (P = 0.029). Specific gravity less than 1,005 was associated with mild injury detected by video‐endoscopy (P = 0.011). Patients in whom severe injury was detected by endoscopy had marked findings on physical examination (P < 0.001). There was no significant relationship between physical examination findings and the specific gravity of the substance involved (P = 0.087). Conclusions The results of this study suggest that conservative treatment options can be used without performing endoscopy in patients who have no physical examination finding after corrosive ingestion and where the pH of the substances is between 2 and 12 and the specific gravity of the substances is less than 1,005.

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Section: Discussionmentioning

confidence: 94%

pH and specific gravity of corrosive agents as indicators in caustic injuries

İsbir

Kıllı

Taşkınlar

et al. 2022

Pediatrics International

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“…Strictures are hardly seen in grade 1 esophageal injury. Esophageal stricture rates in grades 2a, 2b and 3 are < 5%, 15%-68% and 75%-90% respectively[ 16 , 17 ]. Diverticulae and deeper damage in the esophagus may result in tracheo-esophageal fistulae.…”

Section: Clinico-pathological Issuesmentioning

confidence: 99%

“…There are no head-to-head comparative studies between balloon and bougie. Balloon dilatation is found safe with variable success of 14%-100%[ 17 , 30 ]. Successful dilatation with bougie is 50%-96%[ 29 , 31 ].…”

Section: Difficulties In Management Of Corrosive Strictures In Childrenmentioning

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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“…Those who developed esophageal strictures were treated with endoscopic balloon dilation. The duration of treatment for children with grade 2a lesions was an average of 7 balloon dilations over a period of 15 months and those with grade 2b lesions had balloon dilation treatment over a period of 18.8 months (Taşkinlar et al 2017).…”

Section: Pediatric Patientsmentioning

confidence: 99%

Corrosive substances ingestion: a review

Hall

Jacquemin²,

Henny³

et al. 2019

Critical Reviews in Toxicology

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Corrosive chemical substance ingestions are a major problem, especially in developing countries, but also in developed countries such as the United States, France, and Belgium. Ingestions may be deliberate as suicide attempts (mostly in adolescents and adults) or accidental (mostly in children). The results can be devastating in terms of individual suffering and disability, but also in terms of resource utilization and costs. In developing countries, outcomes may be worse because of limited medical/surgical resources. Common sequelae include gastrointestinal (GI) tract (esophagus, stomach, pylorus, and duodenum) stricture formation, GI tract perforation, and hemorrhage. Systemic effects may also occur, such as disseminated intravascular coagulation (DIC), multi-organ system failure, and sepsis. Various interventions in the acute phase to reduce the severity of injury have been attempted, but there are no large controlled clinical trials to demonstrate efficacy. Dilation therapy in various forms is commonly used for the treatment of strictures and a variety of surgical procedures including esophagectomy and delayed replacement may be required in severe corrosive injury cases.

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Effectiveness of endoscopic balloon dilatation in grade 2a and 2b esophageal burns in children

Abstract: Initial endoscopy for caustic ingestion and esophageal injury grading may help to provide healthcare givers with information about future stricture formation and management.

Cited by 7 publications

References 26 publications

pH and specific gravity of corrosive agents as indicators in caustic injuries

pH and specific gravity of corrosive agents as indicators in caustic injuries

Corrosive upper gastrointestinal strictures in children: Difficulties and dilemmas

Corrosive substances ingestion: a review

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