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[Ingestion of caustic substances in children: 3 years of experience]
María Losada M1, María Rubio M2, Jose Antonio Blanca G3
1Unidad de Gestión Clínica de Pediatría, Hospital Universitario Virgen Macarena, Sevilla, España.
Insights
Accidental caustic ingestion in children requires prompt endoscopic evaluation within 24 hours. Acid ingestions, even without initial symptoms, need careful follow-up due to potential delayed oesophageal and gastric lesions.
Area of Science:
- Paediatric Gastroenterology
- Toxicology
- Emergency Medicine
Background:
- Management of paediatric caustic ingestion lacks consensus.
- This study profiles children treated for caustic ingestion at a healthcare center.
Purpose of the Study:
- To characterize the paediatric population treated for caustic ingestion.
- To analyze ingestion types, symptoms, endoscopic findings, and complications.
Main Methods:
- A descriptive study of 12 paediatric patients treated between 2008-2011.
- All patients underwent endoscopy 12-24 hours post-ingestion.
Main Results:
- Majority of patients were male, with alkaline substances ingested more frequently than acids.
- Most children were asymptomatic or presented with vomiting; oral lesions were common (75%).
- Endoscopy revealed oesophagitis and gastritis in 41.6% of cases, with delayed complications in two patients.
Conclusions:
- Early endoscopic evaluation (within 24 hours) is crucial, especially for asymptomatic ingestions.
- Strict follow-up is recommended for acid ingestions due to the risk of delayed lesions.
Introduction:
There is no clear consensus on the management of accidental ingestion of caustic substances in paediatrics. The aim of this study was to determine the profile of the paediatric population treated due to caustic ingestion in a Healthcare Centre.
Patients And Method:
A descriptive study was conducted on patients treated for the ingestion of caustic substances in our hospital during the period 2008-2011.
Results:
A total of 12 patients were treated, with a mean age of 3.8 years (1-13 years), with the majority males (58.8%). An alkaline product was ingested by 58.3%, and an acid by 41.6%. The majority (58.3%) did not refer to symptoms and the remainder referred to vomiting (33.3%), odynophagia (16.6%), haematemesis (8.3%), hyper-salivation (8.3%) and shortness of breath (8.3%). Oral cavity lesions were observed in 75% of cases. All, except one, were accidental. An endoscopy was performed on all of them (100%) between 12 and 24hours post-ingestion, with pathological findings in 41.6%. In the group that ingested an alkali, 2 (16.6%) patients had lesions, one a grade 2B and one a grade 3 oesophagitis. In the acid ingestion group, 4 (33.3%) patients had lesions; one grade 1-2A oesophagitis, two acute non-erosive gastritis, and one acute haemorrhagic gastritis. A follow-up endoscopy was performed depending on the previous endoscopic findings. Only two patients presented with complications.
Conclusions:
Emphasis is placed on the endoscopic evaluation in the first 24hours of deliberate asymptomatic ingestions, as well as a strict follow-up in those that ingested acids, due to delayed associated lesions.