Related Experiment Video
Updated: May 24, 2026
Establishment and Evaluation of a Risk Prediction Model for Pathological Escalation of Gastric Low-Grade Intraepithelial Neoplasia
Published on: February 16, 2024
Predictability of outcome of caustic ingestion by esophagogastroduodenoscopy in children
Abdulkerim Temiz1, Pelin Oguzkurt, Semire Serin Ezer
1Department of Pediatric Surgery, Baskent University, Faculty of Medicine, Adana Research And Educational Hospital, Seyhan 01150, Turkey. aktemiz@yahoo.com
Insights
Esophagogastroduodenoscopy (EGD) effectively identifies esophageal and gastric damage from caustic ingestion in children. This diagnostic tool helps avoid unnecessary treatments for patients with mild or no injuries, guiding appropriate care.
Area of Science:
- Pediatric Gastroenterology
- Toxicology
- Endoscopic Procedures
Background:
- Caustic ingestion in children poses significant risks of upper gastrointestinal injury.
- Early and accurate assessment is crucial for predicting outcomes and guiding management.
- Esophagogastroduodenoscopy (EGD) is a primary diagnostic tool in these cases.
Purpose of the Study:
- To evaluate the necessity and predictive value of esophagogastroduodenoscopy (EGD) in children following caustic ingestion.
- To correlate endoscopic findings with clinical outcomes and the need for interventions.
Main Methods:
- Retrospective analysis of 206 children who underwent EGD for caustic ingestion between 2005 and 2010.
- Classification of ingested substances (acidic, alkaline, bleach) and grading of esophageal and gastric injuries.
- Assessment of clinical findings, need for esophageal dilation, and hospitalization duration.
Main Results:
- Esophageal or gastric injury was present in a significant proportion of children, even those initially asymptomatic.
- Endoscopic findings ranged from no injury (grade 0) to severe injury (grade 3a), with higher grades requiring esophageal dilation.
- Acidic substances were associated with a higher rate of severe gastric injury compared to alkaline substances.
Conclusions:
- Esophagogastroduodenoscopy (EGD) is an effective method for diagnosing esophageal and gastric damage after caustic ingestion in children.
- EGD findings are critical for stratifying injury severity and determining the need for further treatment, such as esophageal dilation.
- The procedure helps prevent unnecessary interventions in children with minimal or no endoscopic evidence of injury.
Aim:
To assess the necessity of esophagogastroduodenoscopy (EGD) to predict the outcome of caustic ingestion in children.
Methods:
The study included 206 children who underwent EGD because of ingestion of caustic substances between January 2005 and August 2010. Retrospective analysis of data of the patients was performed.
Results:
The male/female ratio was 1.6 and mean age was 38.1 ± 28.8 mo. The caustic substances were acidic in 72 (34.9%) cases, alkaline in 56 (27.2%), liquid household bleach in 62 (30.1%), and unknown in 16 (7.8%). Fifty-seven (27.7%) patients were symptom-free. Significant clinical findings were observed in 149 (72.3%) patients. Upper gastrointestinal endoscopy findings of esophageal injury were grade 0 in 86 (41.7%) patients, grade 1 in 49 (23.8%), grade 2a in 42 (20.4%), grade 2b in 28 (13.6%), and grade 3a in 1 (0.5%) patient. 35 patients with grade 2a, 2b, and 3a injuries underwent esophageal dilation at second week of ingestion. Esophageal stricture, which necessitated a regular dilation program developed in 13 of the aforementioned 35 patients. There is no statistically significant difference in the rate of development of esophageal stricture between the patients who ingested acidic (15.3%) and alkaline (8.9%) substances (P = 0.32). Severe gastric injury was detected in 38 (18.5%) patients. The rate of development of gastric injury was significantly higher in the acidic group (14%) than in the alkaline group (2.9%) (P = 0.001). Out of 149 patients with clinical findings, 49 (32.9%) patients had no esophageal injury and 117 (78.5%) patients had no gastric lesion. Esophageal and severe gastric injuries were detected in 20 (35.1%) and 8 (14%) of patients with no clinical findings respectively. Pyloric stenosis developed in 6 patients. Pyloric obstruction improved with balloon dilation in 2 patients. Mean hospitalization time were 1.2 ± 0.5 d for grade 0 and 2.3 ± 5 d for grade 1 and 6.3 ± 6.2 d for grade 2a and 15.8 ± 18.6 d for grade 2b. It was significantly longer for patients with grade 2a and 2b injuries (P = 0.000).
Conclusion:
Endoscopy is an effective technique for determining the presence of esophageal and gastric damage and to avoid unnecessary treatment in patients with no or mild injury.
Related Concept Videos
01:29Endoscopic Procedures I: Esophagogastroduodenoscopy
During an EGD, the endoscope can be used to:
01:21Barrett Esophagus-I: Introduction
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more similar...
01:14Prevention of Further Absorption of Poison
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...
01:24Upper GI Series: Barium Swallow
Purpose and Procedure
Patients undergoing this procedure ingest a liquid containing barium sulfate with a chalky...
01:28Endoscopic Procedures III: Video Capsule Endoscopy