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Corrosive Esophagitis with Benzalkonium Chloride in a Two Days Old Neonate
Hasret Ayyildiz Civan1, Didem Gulcu1, Tulay Erkan1
1Department of Pediatric Gastroenterology, Hepatology and Nutrition, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey.
Insights
Benzalkonium chloride (BAC) ingestion in a newborn caused esophageal injury. Conservative treatment led to significant recovery, highlighting a successful approach for this rare pediatric case.
Area of Science:
- Toxicology
- Pediatric Gastroenterology
Background:
- Benzalkonium chloride (BAC) is a widely used antiseptic and disinfectant.
- Ingestion of BAC can cause caustic injury to the gastrointestinal tract.
- Pediatric cases of BAC ingestion are rare, especially in neonates.
Observation:
- A two-day-old newborn presented with poor breastfeeding, uneasiness, and crying after ingesting 10% BAC solution for a cough.
- Initial laboratory tests were normal.
- Gastroscopy revealed esophageal hyperemia, edema, and distal ulceration.
Findings:
- The newborn was treated conservatively for 10 days.
- A follow-up gastroscopy showed near-complete improvement of the esophageal damage.
- This represents the youngest reported case of BAC-induced esophageal injury treated successfully.
Implications:
- Conservative management can be effective for neonatal benzalkonium chloride-induced esophageal injury.
- Prompt diagnosis and endoscopic evaluation are crucial in suspected cases.
- This case underscores the importance of safe storage and administration of household chemicals, especially around infants.
Abstract:
Benzalkonium chloride (BAC) is a caustic agent which is used in farms, homes and hospitals for cleaning skin and wounds as an antiseptic solution. It may lead to digestive system injuries in case of ingestion. We present a two-days-old newborn case which was carried to the emergency unit with complaints of poor breastfeeding, uneasiness and crying for 4-6 hours. Her mom confessed that she had given a spoon of 10% BAC solution for her cough. Initial laboratory tests were in normal ranges. A gastroscopy performed in the second hour of her admission revealed an hyperemic and edematous mucosa in the middle third of esophagus and a circumferential ulceration followed in the distal portion. Hereupon, a conservative treatment for 10 days was administered and the control gastroscopy demonstrated that the damage was almost totally improved. She was the youngest case with this etiology and successfully treated with conservative approach.
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