Related Experiment Video
Updated: Feb 10, 2026
Induction of Intestinal Graft-versus-host Disease and Its Mini-endoscopic Assessment in Live Mice
Published on: February 11, 2019
Correlation of 99mTc sucralfate scan and endoscopic grading in caustic oesophageal injury
Babalwa B Nondela1, Sharon G Cox2, Anita Brink2,3
1Division of Paediatric Surgery, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa. bbnondela@gmail.com.
Insights
The 99mTc sucralfate scan can help identify children with low-grade caustic esophageal injury, potentially avoiding the need for invasive endoscopy. High-grade adhesion on the scan warrants further endoscopic evaluation to prevent complications like strictures.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Imaging
- Toxicology
Background:
- Caustic esophageal injury in children necessitates accurate assessment of severity.
- Endoscopy is the gold standard but is invasive and carries risks.
- Non-invasive imaging modalities are sought to complement or replace endoscopy.
Purpose of the Study:
- To evaluate the correlation between 99mTc sucralfate scan findings and endoscopic grading of esophageal injury in pediatric caustic ingestion.
- To determine if 99mTc sucralfate scan can predict the absence of severe injury, thus avoiding endoscopy.
Main Methods:
- Observational analytic study of 40 children with caustic esophageal injury who underwent both 99mTc sucralfate scan and endoscopy.
- Esophageal injury was graded using a modified Zargar endoscopic classification and adhesion degree on 99mTc sucralfate scan.
- Data collected between January 2009 and September 2016.
Main Results:
- A statistically significant correlation (p=0.0014) was found between 99mTc sucralfate scan and endoscopic findings.
- All 27 children with low-grade adhesion on sucralfate scan had low-grade endoscopic injury and no residual pathology.
- Of 13 children with high-grade adhesion, 5 had high-grade endoscopic injury, and 3 developed esophageal strictures.
Conclusions:
- Low-grade 99mTc sucralfate scan findings may obviate the need for invasive endoscopy in children with caustic esophageal injury.
- This could reduce procedure-related morbidity, hospitalization, and costs.
- Mandatory endoscopy is recommended for children with high-grade adhesion on 99mTc sucralfate scan, pending larger prospective studies.
Purpose:
To determine a correlation between the 99mTc sucralfate scan and the endoscopy findings in children with caustic oesophageal injury.
Methods:
This is an observational analytic study of children who had both 99mTc sucralfate scan and endoscopy after caustic substance ingestion at our institution in a period between January 2009 and September 2016. The oesophageal injury was classified into low grade and high grade according to the degree of adhesion on 99mTc sucralfate scan and modification of Zargar endoscopic grading.
Results:
Out of a total of 197 children, 40 children were identified who had both investigations done on average 26 h post-injury. Low-grade adhesion on 99mTc sucralfate scan was found in 27 children (68%), and all had low-grade Zargar's oesophageal injuries. None of these subsequently developed residual pathology. Thirteen had high-grade adhesion and five of these had high-grade injury on endoscopy. Three (23%) developed oesophageal strictures. Correlation of 99mTc sucralfate and endoscopic findings reached statistical significance with a p value of 0.0014. No morbidity was associated with either the scan or endoscopy.
Conclusions:
We concluded that low-grade sucralfate scan finding has the potential to successfully eliminate the need for invasive endoscopy under general anaesthesia and thereby reducing procedure-related morbidity, hospitalization and associated costs. However, mandatory endoscopy is required in children with high-grade adhesion seen on 99mTc sucralfate scan. This requires confirmation using a larger prospective study.
Related Concept Videos
02:20Correlations
01:27Correlation and Causation
Correlation versus Causation
If the dependent variable increases or decreases when the independent variable increases, there is a positive or negative...
01:19Graded Potential
Graded potentials fall into two categories: depolarizing and hyperpolarizing. Depolarizing graded potentials typically occur when sodium (Na+) or...
01:09Correlation
Two variables, for example, a and b, are said to be positively correlated if both variables move in the same direction. In other words, a positive correlation exists between two variables, a and b, if:
02:28Leaky Scanning
01:15Types of Aggregate Grading
Well-graded aggregates include a complete range of necessary size fractions that fit together to create a dense matrix with minimal voids, represented by a smooth, continuous gradation curve. This type of grading ensures good...