Accidental Caustic Ingestion in Children and its Sequalae in Esophagus; One Year Fallow Up

Objective:Accidental caustic ingestion can result in severe gastrointestinal injury, especially in esophagus, that has thinnest and most sensitive tissue with most contact in caustic ingestion. Endoscopy is the most direct equipment in evaluation of patients. The aim of this study was to evaluate the severity of esophageal injury due to different substances in children aged 1-6 yr at the Children's Medical Center in Tehran.
Material & Methods: In a prospective study (Oct 2002 - Apr2003), 100 children were admitted because of accidental caustic ingestion. The ingested materials, their quantities, early symptoms and endoscopic findings were prospectively analyzed.
Findings: Forty-two of 100 patients had ingested stronger materials, of these, 37 had esophageal burns higher than grade I; 58 patients ingested weaker materials, which had none or only grade I burn. Of 44 symptomatic patients, 37 had important burns. Between substance property and quantity and early symptoms with esophageal burns was coherence (P<0.05). Totally 76/100 patients were symptomatic, and 39 patients had grade I, 17 grade IIa, 12 grade IIb, 4 grade IIIa, and 4 grade IIIb burns. Seventeen (17%) patients that developed esophageal stricture had all grade IIb burns.
Conclusion:Esophageal injury happens after caustic ingestion with different severity. The stronger the ingested material, the severer the damage to esophagus and the more long time sequelae (stricture) is to expect.

Keywords
Caustic ingestion , Esophageal burns , Endoscopic data , Accidental ingestion , Gastrointestinal injury