Clinical characteristics and complications in oral caustic ingestion in children

M Rafeey1, M Shoaran

  • 1Liver and Gastrointestinal Disease Research Center, Tabriz University (Medical Sciences), Tabriz, Iran.

Insights

Caustic ingestion in children often causes severe gastrointestinal lesions. Early endoscopy aids in predicting outcomes and managing complications like esophageal stricture and gastric outlet obstruction.

Area of Science:

  • Pediatric Gastroenterology
  • Toxicology
  • Endoscopic Surgery

Background:

  • Caustic ingestion is a significant cause of pediatric gastrointestinal injury.
  • Accurate assessment of lesion severity and prediction of long-term outcomes are crucial for effective management.

Purpose of the Study:

  • To determine the prevalence of gastrointestinal symptoms in pediatric caustic ingestion.
  • To evaluate the severity of esophageal and gastric lesions.
  • To assess the role of early endoscopy in predicting patient outcomes.

Main Methods:

  • A cross-sectional study involving 51 children (≤12 years) hospitalized for caustic ingestion.
  • Evaluation included clinical history, endoscopic findings, treatment methods, and complications.
  • Follow-up assessments were conducted to monitor outcomes.

Main Results:

  • Alkaline substances were ingested by 43 children, while 8 consumed acidic materials.
  • Endoscopic findings revealed 38% grade 1 and 62% grade 2 or higher esophageal burns.
  • Complications included esophageal stricture (5 cases) and gastric outlet obstruction (1 case), with higher incidence in acid ingestion. One fatality occurred.

Conclusions:

  • Early endoscopic evaluation in pediatric caustic ingestion is safe and provides critical prognostic information.
  • Endoscopic findings correlate with the development of complications, guiding treatment strategies.
  • Prevention through public health initiatives is essential to reduce the incidence of caustic ingestion.

Related Concept Videos

Prevention of Further Absorption of Poison01:14

Prevention of Further Absorption of Poison

In cases of acute poisoning, the primary objective is to prevent further absorption of the toxic substance into the body. Immediate interventions using various decontamination techniques targeting the gastrointestinal (GI) tract can achieve this. Decontamination is crucial to prevent poison from entering the systemic circulation, which involves washing affected areas with water and mild soap and removing contaminated clothing. Once external decontamination is done, attention must be turned to...
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
Peptic Ulcer01:27

Peptic Ulcer

Peptic ulcers are erosive lesions of the gastric or duodenal lining, most commonly caused by Helicobacter pylori infection. This Gram-negative, helical bacterium has adapted to survive the stomach’s acidic environment by producing urease, which converts urea into ammonia and carbon dioxide. The ammonia neutralizes gastric acid in the bacterium’s immediate environment, allowing colonization of the gastric mucosa. H. pylori attaches to mucus-secreting epithelial cells, penetrates the mucus...
Peptic Ulcer Disease III: Clinical Manifestations and Complications01:25

Peptic Ulcer Disease III: Clinical Manifestations and Complications

Duodenal UlcersDuodenal ulcers are the most common form of peptic ulcer disease, presenting with chronic, intermittent epigastric pain. Pain typically appears 2–3 hours after meals, especially when the stomach is empty, often waking patients at night. It is characteristically relieved by food or antacids (“pain–food–relief”). Some patients remain asymptomatic until complications like bleeding or perforation emerge, particularly with NSAID or anticoagulant use.Gastric UlcersGastric ulcers share...
Esophageal Perforation-II: Clinical Manifestations and Management01:28

Esophageal Perforation-II: Clinical Manifestations and Management

Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Esophageal Strictures-I: Introduction01:30

Esophageal Strictures-I: Introduction

Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
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...