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Caustic Agents Ingestion in Children: A 51-Year Retrospective Cohort Study

Artur Niedzielski1,2, Sylwia Greta Schwartz1,3, Kornela Partycka-Pietrzyk3

  • 1Independent Otoneurological Laboratory, Medical University of Lublin, Lublin, Poland.

Ear, Nose, & Throat Journal
|April 19, 2019
PubMed

Insights

Accidental caustic agent ingestion causes esophageal burns in children. Early endoscopy and prompt treatment are crucial for diagnosis, management, and reducing long-term complications like strictures.

Area of Science:

  • Pediatric Gastroenterology
  • Otolaryngology
  • Toxicology

Background:

  • Children are more susceptible to gastrointestinal tract injuries from caustic agents than adults.
  • Caustic ingestion in young children, particularly those under 5, is a significant concern.
  • Esophageal burns require prompt and accurate assessment for effective management.

Purpose of the Study:

  • To analyze diagnostic methods and treatment strategies for pediatric esophageal burns.
  • To correlate injury severity with clinical presentation and outcomes.
  • To evaluate the effectiveness of early endoscopic evaluation and pharmacological interventions.

Main Methods:

  • A retrospective cohort study of 150 children with chemical burns of the mouth, throat, larynx, and esophagus.
  • Inclusion criteria: patients admitted between 1967 and 2018.
  • Diagnostic tools included laryngological examination and endoscopy to determine injury grade (Zargar classification).

Main Results:

  • The majority of patients (65.3%) were male, with a median age of 4 years and 3 months.
  • Common symptoms included salivation, dysphagia, burning sensation, edema, and dyspnea.
  • Esophageal endoscopy revealed predominantly Zargar grade I burns (84.7%); 13.3% developed late sequelae (esophageal strictures).

Conclusions:

  • Early esophagus endoscopy is vital for grading esophageal burns in children.
  • Prompt diagnosis and immediate pharmacological treatment (antibiotics, PPIs, analgesics, IV fluids) are essential.
  • Timely intervention can significantly reduce the incidence of late complications such as esophageal strictures.
Abstract

Keywords:
caustic agentschildrenendoscopygastrointestinal tract injuries

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