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Corrosive injuries of the esophagus in newborns
C Turan1, U Ozkan, B H Ozokutan
1Department of Pediatric Surgery, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
Insights
Corrosive esophageal injuries (CEI) in newborns are dangerous, causing significant harm and death. Early recognition and warnings to caregivers are crucial to prevent these severe outcomes in infants.
Area of Science:
- Neonatal Medicine
- Pediatric Gastroenterology
- Toxicology
Background:
- Corrosive esophageal injuries (CEI) in neonates are rare but severe.
- This study reviews CEI cases in newborns over a 10-year period.
Observation:
- Eight newborns (4.3%) ingested caustic substances (benzalkonium chloride or trichloroacetic acid).
- Diagnosis involved oropharyngeal examination and esophagoscopy, revealing hyperemia and fibrin plaques.
- Management included intubation, antibiotics, corticosteroids, and parenteral nutrition.
Findings:
- Neonatal CEI resulted in 62.5% morbidity (pneumonia, sepsis, stenosis) and 12.5% mortality.
- Two neonates developed esophageal stenosis requiring dilatations.
Implications:
- Neonatal corrosive ingestion leads to high rates of morbidity and mortality.
- Increased awareness among parents and healthcare providers is essential for prevention.
- Prompt medical intervention is critical for managing these severe injuries.
Abstract:
To evaluate the morbidity and mortality of corrosive esophageal injuries (CEI) in the neonatal period, the records of 184 children hospitalized following caustic ingestion over a 10-year period from January 1987 to November 1997 were reviewed. Eight (4.3%) were newborns (5 boys and 3 girls). The mean age of the newborns was 12 days (range 1-28). The ingested caustic materials were benzalkonium chloride in six patients and trichloroacetic acid in two. Oropharyngeal examination and esophagoscopy were performed for diagnosis. Hyperemia and fibrin plaques were present in the oropharynx in all patients. The management consisted of endotracheal intubation, antibiotics, corticosteroids, and total parenteral nutrition. Pneumonia and sepsis developed in three patients and one died of sepsis. Stenosis developed in two patients, who were treated three times with antegrade dilatations. The morbidity was 62.5% (five patients) and the mortality was 12.5% (one) in newborns with CEI. These results indicate that ingestion of a caustic substance results in high morbidity and mortality in newborns. Parents and nurses should be warned about this risk.