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[Caustic esophagitis in children]
L Suárez Cortina1, F Olivares de Miguel, C Camarero Salces
1Unidad de Gastroenterología, Servicio de Pediatría, Hospital Ramón y Cajal, Madrid.
Insights
Caustic ingestion in children can cause esophageal injury. Early endoscopy and treatment with high-dose steroids and nasogastric intubation may help prevent severe strictures, though further research is needed.
Area of Science:
- Pediatric Gastroenterology
- Otolaryngology
- Emergency Medicine
Context:
- Caustic ingestion in children presents significant management challenges.
- Esophageal injury from corrosive substances requires prompt and effective intervention.
- Optimal treatment strategies for pediatric caustic esophagitis remain debated.
Purpose:
- To evaluate the efficacy of a treatment protocol for caustic ingestion in children.
- To assess the outcomes of high-dose steroids, nasogastric intubation, and early esophagoscopy.
- To determine the role of early endoscopic evaluation in guiding treatment decisions.
Summary:
- Fourteen children with esophageal injury from caustic ingestion were treated with high-dose steroids, nasogastric intubation, and antibiotics, with early esophagoscopy.
- Four patients developed esophageal strictures; three were mild and successfully treated with dilatation.
- One patient required surgical referral, suggesting potential benefits of the conservative management approach.
Impact:
- Early esophagoscopy is valuable for assessing injury severity and treatment necessity.
- High-dose steroids and nasogastric intubation may be beneficial in managing pediatric caustic esophagitis.
- This approach may reduce the incidence of severe esophageal strictures and the need for surgery.
Abstract:
Treatment of caustic ingestion in children is a difficult and controversial problem which has not yet to be resolved. Here we report the evolution of fourteen children with esophageal injury after caustic ingestion that were treated with steroids at high-doses, nasogastric intubation and antibiotics. An early esophagoscopy was performed in all patients. Four patients developed esophageal strictures, three of which were mild and subsequent dilatation was successful. Only one patient was referred to surgery. We think that although it cannot be established, the use of high-dose of steroids and nasogastric intubation may be helpful for children with caustic esophagitis. We conclude that early endoscopy is useful to evaluate the severity of the lesions and to establish the necessity for treatment.