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Early and late term management in caustic ingestion in children: a 16-year experience

F Gün1, L Abbasoğlu, A Celik

  • 1I.U. Istanbul School of Medicine, Department of Pediatric Surgery, Istanbul, Turkey.

Acta Chirurgica Belgica
|April 5, 2007
PubMed

Insights

Early esophageal rest and supportive care after corrosive ingestion in children significantly improve outcomes and reduce stricture development. Prompt management is crucial for preventing serious complications and promoting recovery.

Area of Science:

  • Pediatric Gastroenterology
  • Gastrointestinal Surgery
  • Toxicology

Background:

  • Accidental corrosive ingestion is a common cause of esophageal strictures in children.
  • Acute phase management critically influences the development of esophageal strictures.
  • Effective treatment strategies during the acute phase are essential for preventing long-term complications.

Purpose of the Study:

  • To present clinical experience in managing pediatric caustic ingestion, focusing on acute phase interventions.
  • To compare outcomes of immediate versus delayed treatment for corrosive esophageal strictures.
  • To evaluate the efficacy of esophageal rest and supportive care in preventing stricture formation.

Main Methods:

  • Retrospective analysis of 296 children with caustic ingestion from 1990-2005.
  • Study group comprised 91 patients with esophageal strictures requiring dilatation.
  • Comparison of outcomes between patients treated immediately (Group A) and those treated later (Group B).
  • Acute management included esophagoscopy, esophageal rest via nasogastric tube for severe lesions, IV fluids, antibiotics, steroids, and ranitidine.

Main Results:

  • Higher response rates to dilatation treatment were observed in Group A (immediate treatment).
  • Group B (delayed treatment) showed increased rates of esophageal perforation.
  • Sixty percent of Group A patients recovered within the first year, compared to none in Group B.

Conclusions:

  • Esophageal rest combined with supportive medical treatment in the acute phase is effective in preventing stricture development after caustic ingestion.
  • Early intervention and management are critical for improving recovery rates and reducing complications in pediatric corrosive esophagitis.
  • Delayed treatment is associated with poorer outcomes and higher complication rates, including perforation.

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