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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...
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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...
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Treatment strategies for poisoning are a critical aspect of emergency medicine, focusing on preventing the absorption of toxins and enhancing their elimination. When a poisoning incident occurs, the first response is to halt exposure and decontaminate the patient, particularly through gastrointestinal (GI) methods if the poison was ingested.Gastrointestinal Decontamination Techniques:Activated charcoal is the cornerstone of GI decontamination. It works through adsorption, binding the toxin to...
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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.
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Related Experiment Video

Updated: Mar 1, 2026

Handheld Metal Detector Screening for Metallic Foreign Body Ingestion in Children
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Caustic ingestion in children-A review.

Marion Arnold1, Alp Numanoglu1

  • 1Division of Paediatric Surgery, University of Cape Town, Red Cross War Memorial Children's Hospital, Cape Town, South Africa.

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Summary

Chemical ingestion causes severe upper aerodigestive tract burns, particularly in children. Early endoscopy is crucial for predicting esophageal strictures, with serial dilation as the primary treatment.

Keywords:
Caustic ingestionCorrosiveOesophageal stricturePaediatric

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Area of Science:

  • Gastroenterology
  • Toxicology
  • Otolaryngology

Background:

  • Chemical ingestion is a significant cause of upper aerodigestive tract burns.
  • Accidental ingestion disproportionately affects unsupervised preschool children, especially in developing nations.
  • External signs are unreliable indicators of burn severity.

Purpose of the Study:

  • To review the diagnosis and management of upper aerodigestive tract burns from chemical ingestion.
  • To emphasize the importance of early diagnosis and appropriate therapeutic interventions.
  • To highlight the long-term risks and surveillance needs following such injuries.

Main Methods:

  • Review of diagnostic modalities including radio-nuclear imaging and esophago-gastroduodenoscopy.
  • Discussion of therapeutic strategies such as serial dilation, esophageal replacement, intra-lesional steroids, and mitomycin C.
  • Emphasis on the necessity of long-term surveillance for secondary esophageal carcinoma.

Main Results:

  • Early esophago-gastroduodenoscopy is the standard for predicting stricture formation.
  • Serial dilation is the primary treatment for esophageal strictures.
  • Intra-lesional therapies may reduce dilation frequency, but long-term effects are uncertain.
  • Long-term surveillance is essential due to the risk of secondary esophageal cancer.

Conclusions:

  • Prompt diagnosis and management are critical for preventing long-term complications of chemical-induced aerodigestive tract burns.
  • While serial dilation is effective, severe cases may require esophageal replacement.
  • Further research is needed on the long-term efficacy and safety of intra-lesional therapies.