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Importance of early endoscopic and clinical evaluation of children with caustics ingestion
Enory Almanza-Miranda1, Gerardo Blanco-Rodríguez1, Jaime Penchyna-Grub1
1Servicio de Cirugía de Tórax y Endoscopia, Hospital Infantil de México Federico Gómez.
Insights
Accidental caustic ingestion in children can cause severe esophageal injuries. More than four symptoms, oral lesions, sialorrhea, and vomiting indicate a higher risk of serious esophageal damage in pediatric patients.
Area of Science:
- Pediatric Gastroenterology
- Toxicology
- Emergency Medicine
Background:
- Accidental caustic ingestion is a common pediatric issue leading to severe esophageal injuries.
- Esophageal damage can necessitate long-term rehabilitation programs for affected children.
Purpose of the Study:
- To describe the medical care experience of children who ingested caustic substances.
- To identify factors associated with esophageal injury severity in pediatric caustic ingestion cases.
Main Methods:
- A descriptive and analytical study was conducted.
- Data from 336 children with caustic ingestion history were reviewed.
- Clinical, endoscopic, and radiological findings were analyzed.
Main Results:
- The median age of patients was 1.7 years, with males predominant.
- Caustic soda was the most frequently ingested substance.
- Over four symptoms, oral lesions, sialorrhea, and vomiting correlated with esophageal injury severity (p < 0.001 and p < 0.05).
- Forty percent of patients had normal gastrointestinal endoscopy findings.
Conclusions:
- Upper gastrointestinal endoscopy within 72 hours is crucial for evaluating caustic ingestion lesions in children.
- Presence of multiple symptoms and specific oral findings predict esophageal injury severity.
Background:
Accidental ingestion of caustics in pediatrics continues to be a frequent problem that can lead to severe injuries and permanent sequelae that require esophageal rehabilitation programs. This study aimed to describe the medical care experience of children who ingested caustic substances in a tertiary hospital in Mexico City.
Methods:
We conducted a descriptive and analytical study. We described age, sex, type of caustics, clinical and endoscopic findings, and the radiological evolution of 284 patients who arrived during the acute phase.
Results:
The records of 336 children with a history of caustic ingestion were reviewed. The median age was 1.7 years, and the predominant sex was male. Caustic soda was the most accidentally ingested substance. We found an association between the severity of the esophageal injury with the presence of more than four symptoms at diagnosis (χ², p < 0.001) and with the finding of oral lesions, sialorrhea, and vomiting (χ², p < 0.05). Forty percent (n = 114) showed normal gastrointestinal endoscopy.
Conclusions:
In children with caustic ingestion, upper gastrointestinal endoscopy should be performed within 72 hours to evaluate the extent of the lesions. In this study, we found that more than four symptoms at admission, and oral lesions, sialorrhea, and vomiting are associated with the severity of the esophageal injury.
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