Corrosive esophagitis in children: a 30-year review
Related Experiment Video
Updated: Oct 9, 2026
Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
Published on: December 14, 2020
A L de Jong1, R Macdonald, S Ein
1The Department of Otolaryngology, The Hospital for Sick Children, 555 University Avenue, Ont., M5G 18X, Toronto, Canada.
Insights
Pediatric caustic ingestion causes varied corrosive esophagitis, leading to severe esophageal strictures and significant socioeconomic impact. Optimal management and the role of esophageal stents require further investigation.
Area of Science:
- Pediatric Gastroenterology
- Otolaryngology
- Trauma Surgery
Background:
- Caustic ingestion in children results in corrosive esophagitis with diverse presentations and outcomes.
- Optimal management strategies for pediatric corrosive esophagitis remain controversial.
- The socioeconomic and psychological impact on affected children and families is often underreported.
Purpose of the Study:
- To review aerodigestive tract caustic injuries in a pediatric population over 30 years.
- To analyze early and late complications, including esophageal strictures and surgical interventions.
- To evaluate the socioeconomic, psychological, and economic consequences of these injuries.
Main Methods:
- Retrospective review of 80 pediatric patients with aerodigestive tract caustic injuries.
- Analysis of medical complications, esophageal strictures, and treatment modalities (dilatation, gastrostomy, surgery).
- Assessment of hospital costs, parental work absenteeism, job relocation, and psychological impacts.
Main Results:
- 29% of patients experienced medical complications; 20% developed severe esophageal strictures.
- 11 children required gastrostomy, stringing, retrograde dilatation, and ultimately esophageal replacement surgery.
- Significant socioeconomic burdens, including substantial hospital costs and parental work disruption, were documented.
Conclusions:
- Caustic ingestion in children leads to severe esophageal damage requiring complex interventions and causing profound socioeconomic and psychological distress.
- Esophageal replacement surgery is a significant consequence for a subset of patients.
- Further research into esophageal stents for recalcitrant strictures and comprehensive management protocols is warranted.
Abstract:
Caustic ingestion with resultant corrosive esophagitis in the pediatric population comprises a heterogeneous group in terms of offending agent, location of burn and the degree of damage. Consequently, the treatment of these injuries has also varied over the years and the optimal management remains controversial. Another area of concern that is seldom reported in the otolaryngology literature is the socioeconomic impact of such injuries both on the child and on the family. We report a 30-year retrospective review of aerodigestive tract caustic injuries at The Hospital for Sick Children. Eighty patients were identified with an age range from 1 month to 16 years. Early and late complications are reviewed including 23 patients (29%) that developed medical complications and 16 patients (20%) that developed severe esophageal strictures. Five of these children required repeat prograde dilatation, while 11 children required gastrostomy and stringing with subsequent retrograde dilatation. All the 11 children required esophageal replacement surgery. The economic and social consequences to the child and family were also noted with particular attention to hospital costs, parental absenteeism from work, and the need for job relocation. A partial cost analysis using a child with a severe injury is presented as an example. Psychological aspects such as attempted murder, jail terms and attempted suicides are also documented. We also present an analysis of those children requiring esophageal replacement surgery, and examine the possible role of esophageal stents in recalcitrant strictures.
Related Concept Videos
01:26Esophageal Strictures-II: Clinical Features and Management
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
01:30Esophageal Strictures-I: Introduction
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
01:25Gastroesophageal Reflux Disease
01:21Barrett Esophagus-II: Clinical Manifestations and Management
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure entails...
01:28Esophageal Perforation-II: Clinical Manifestations and Management
Clinical Manifestations:
01:29Gastroesophageal Reflux Disease II: Clinical Features and Management
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...