Evaluation of esophageal injuries secondary to ingestion of unlabeled corrosive substances: pediatric case series

Küçük, Gönül; Göllü, Gülnur; Ateş, Ufuk; Çakmak, Zeynep; Koloğlu, Meltem Bingöl; Yağmurlu, Aydın; Aktuğ, Tanju; Dindar, Hüseyin; Çakmak, Ahmet

doi:10.5546/aap.2017.eng.e85

Cited by 3 publications

(4 citation statements)

References 9 publications

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“…In the study by Kucuk and co-workers on 154 children with caustic ingestion, 20 (12.98%) children developed esophageal stricture. 9 In the study by Karaman and others,10 stricture development rate was 13.5%, which is similar to our study. In the study by Honar and colleagues, 20% of children developed esophageal stricture during the follow-up period.…”

Section: Discussionsupporting

confidence: 92%

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Caustic Ingestion in Children in South of Iran: A Two-Year Single Center Study

Dehghani¹,

Bahmanyar²,

Javaherizadeh³

2018

Middle East J Dig Dis

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BACKGROUND Caustic ingestion is one of the most important injuries during childhood, which leads to serious sequel. In this study, we evaluated the clinical manifestations, endoscopic appearance, complications, and treatment results in patients with caustic ingestion in our hospital. METHODS Hospital chart of patients with caustic ingestion who admitted to Nemazee Teaching Hospital affiliated to Shiraz University of Medical Sciences during a 2-year period (2015-2016) were reviewed retrospectively. The age, sex, nature of the caustic agent, clinical presentations, grade of injury in endoscopy, degree of parents’ education, site of ingestion, accidental or intentional attempts, complications, and outcomes were reviewed. RESULTS In this study the charts of 41 patients (26 boys and 15 girls) with caustic ingestion over the 2-year period were reviewed. The mean age of the patients was 4.4 year. Of them, 95.1% had ingested the materials accidentally, and 2 (4.9%) patients had ingested unknown substances for suicidal attempt. Of all cases, 68.3% of caustic ingestion occurred in the kitchen. 19 (46.3%) agents were acidic substances and 17 (41.5%) were alkali agents. 5 (12.1%) patients ingested unknown substances. 24.3% of the patients were asymptomatic and the most common presentation was drooling (34.14%). 26.8% of the patients had dysphagia, and 24.3% presented with oral ulcer. 7.3% had abdominal pain, 4.8% had fever, and 2.4% had hematemesis. 14 (34.1%) patients had normal feature, 6 (14.6%) had grade I injury, 12 (29.3%) had grade II injury, and 8 (19.5%) had grade III injury in endoscopic evaluation. CONCLUSION Most of the caustic ingestion occurred in kitchen. Male was the dominant sex in the caustic injury.

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Section: Discussionsupporting

confidence: 92%

“…4 In another study from Turkey, male sex was the predominant sex with slight difference. 9 In the study by Riffat and Cheng, of 50 cases, 28 were male, which is similar to other studies. 7 In the study by Karaman and others, male was also the dominant sex.…”

Section: Discussionsupporting

confidence: 87%

Caustic Ingestion in Children in South of Iran: A Two-Year Single Center Study

Dehghani¹,

Bahmanyar²,

Javaherizadeh³

2018

Middle East J Dig Dis

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“…Esophageal injury followed by caustic agent ingestion, also known as erosive material ingestion, is among the most challenging and prevalent problems, particularly in developing countries[ 1 , 2 ]. Complications vary from an asymptomatic effect to drastic outcomes such as esophageal stricture or perforation, which can be potentially fatal[ 3 - 5 ].…”

Section: Introductionmentioning

confidence: 99%

Utilization of chest tube as an esophagus stent in pediatric caustic injuries: A retrospective study

Salimi¹,

Shahriarirad²,

Esfandiari³

et al. 2022

WJCP

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BACKGROUND The management of caustic esophageal burns in the pediatric population has changed over the years, while the most optimal management with regards to effectiveness, availability, and cost-beneficent stays controvertible. AIM To describe how to utilize a chest tube for esophageal stenting in pediatrics. METHODS Data regarding the etiology, treatment, and complications of caustic injury in pediatrics over 10 years was collected retrospectively. Furthermore, data regarding the patient's follow-up who underwent esophageal chest tube (ECT) were collected. The ECT was prepared by carving a narrowed section in the chest tube while maintaining the radiopaque section. The ECT will then be positioned from the cricopharyngeal and exited through the nostril and fixed on the patient's cheek. RESULTS During the period of our study, data from 57 patients with an average age of 2.5 years (range 1-12; SD = 1.7) were obtained. The results showed that 89% of esophageal injury was due to alkaline and 9.4% were caused by acidic agents. The treatment methods showed that 29 patients (50.8%) recovered with dilatation alone. In 16 patients (28.06%), the esophageal repair was performed by using the colon, and in 5 patients (8.7%), other surgical methods were used and in 7 patients (12.2%), the ECT stents were used. ECT was inserted in 7 cases with a mean age of 2 (range: 1.5-3) years who were classified as grade IIB or III. Grading was performed by endoscopy assessment on the first day. Antibiotics and corticosteroids were administrated as initial medical management for all patients. ECT implantation was done during the first 8 d for 5 out of 7 cases (mean: 3.8 d). For the 2 patients, ECT was used after 27 (patient 6) d and 83 (patient 7) d. The reason for late stenting in these patients was a postponed referral to our center, in which patient 7 even received 4 dilation episodes before visiting our center. ECT was removed after an average of 44 d in the first 5 patients, while in the other 2 patients (6 and 7) was 2 and 1 wk, respectively. There was no complication related to, or failure of, stent placement. It is worth mentioning that none of the 7 ECT cases required gastrostomy or jejunostomy. CONCLUSION The ECT method introduced in our study can be used as a broadly available, economic, and easy-use facility for esophageal stenting, particularly in developing countries and emergency departments which have limited access to modern equipment. Further multicenter studies with higher volume patients are required for further deployment of this method.

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“…Экспериментальные модели химического ожога пищевода (ХОП) щелочами мало изучены и не имеют четкого морфологического подтверждения. На современном этапе одной из основных проблем при выполнении эксперимента является сложность дозировки химического агента и, как следствие, большой процент гибели животных на этапе нанесения травмы [6][7][8].…”

Section: Introductionunclassified

Experimental modeling of chemical burning of the esophagus using different concentrations of alkali solution

Карпова

Перетягин

Орлинская

et al. 2021

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The purpose and objectives of the study: is to create an experimental model of a chemical burn of the esophagus with alkali to study the pathological transformation of the tissues of the upper gastrointestinal tract.Materials and methods. On the basis of the Department of Experimental Medicine with a vivarium of the Privolzhsky Research Medical University, the study of a chemical burn of the esophagus was carried out on 15 sexually mature male Wistar rats. The burn was simulated by exposure to caustic soda (NaOH) with a concentration of 20 %, 15 %, 10 % and 5 % in a volume of 1 ml. As part of the morphological study, the experimental material was fixed in 10 % formalin. After fixation, the preparations were sent to a standard histological wiring using an Excelsior ES apparatus (Thermo Scientific). Pouring into paraffin blocks using the “HistoStar” filling station (Thermo Scientific), staining with hematoxylin and eosin. For morphometric processing and creation of a video archive of the obtained material, a Leica 2500 microscope, ×4, ×10, ×20, ×40, objective, ×10 eyepiece based on the morphology department of NIITO PIMU was used.Results. Seeding with a 20 % alkali solution for animals turned out to be incompatible with life, since a day after the injection of the substance, 3 rats died, 2 were in an agonal state. Morphological examination revealed total necrosis (100 %) of the epithelial lining up to the muscle layer and partially in the muscle layer. When burned with a 15 % NaOH solution, the males were in a very serious condition, out of 5 inoculated in 2 cases, a lethal outcome was noted on the 1st day. Histological examination revealed massive necrosis (70 %) of the epithelial lining. The effect of 10 % alkali on the general condition of the animals did not show a pronounced severity of injury. Necrosis was diagnosed on 15 % of the area of the epithelial lining. A burn with 5 % sodium hydroxide solution did not provoke a severity incompatible with life. In this condition, focal necrosis was revealed, occupying about 5 % of the organ area.Conclusion. Seeds with 10 % and 5 % caustic solutions are relevant for further experimental research, since they make it possible to test different methods of diagnostics, treatment and prevention of scarring at different depths and morphological features of damage.

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Evaluation of esophageal injuries secondary to ingestion of unlabeled corrosive substances: pediatric case series

Cited by 3 publications

References 9 publications

Caustic Ingestion in Children in South of Iran: A Two-Year Single Center Study

Caustic Ingestion in Children in South of Iran: A Two-Year Single Center Study

Utilization of chest tube as an esophagus stent in pediatric caustic injuries: A retrospective study

Experimental modeling of chemical burning of the esophagus using different concentrations of alkali solution

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