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Sequelae of Corrosive Injury in Children: An Observational Study
Veerabhadra Radhakrishna1, Nitin Kumar1, Bahubali Deepak Gadgade1
1Department of Pediatric Surgery, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India.
Insights
Corrosive ingestion in children causes significant morbidity, including esophageal and pyloric strictures. Delayed presentation (over 2 months) increases the need for esophageal replacement surgery.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Toxicology
Background:
- Corrosive ingestion in children can lead to severe gastrointestinal complications.
- Understanding the long-term sequelae is crucial for effective management and prevention.
Purpose of the Study:
- To determine the sequelae of corrosive ingestion in pediatric patients.
- To analyze the types of strictures and treatment outcomes.
Main Methods:
- Retrospective study of 26 children with corrosive ingestion between January 2015 and December 2020.
- Analysis of patient demographics, stricture types, interventions, and follow-up outcomes.
Main Results:
- Esophageal strictures (62%) and pyloric strictures (31%) were common sequelae.
- Over half of the patients required feeding jejunostomy or gastrostomy.
- Delayed presentation (>2 months) significantly increased the need for esophageal replacement (P=0.03).
Conclusions:
- Corrosive ingestion in children is associated with high morbidity, including esophageal and antro-pyloric strictures.
- Early intervention is critical to minimize the need for complex surgical procedures like esophageal replacement.
Aim:
This study aims to determine the sequelae of corrosive ingestion in children.
Methods:
A retrospective study was conducted in the Department of Pediatric Surgery at a Tertiary Center. The children presenting between January 2015 and December 2020 with a history of ingestion of caustic agents were included in the study.
Results:
A total of 26 children were included in the study. The children with suicidal attempts were significantly older than those who ingested the corrosive agents accidentally (14.2 ± 1.9 years vs. 6 ± 3.3 years; P < 0.01; Student's t-test). Sixteen (62%) children had esophageal strictures, 8 (31%) had pyloric strictures, and a child (4%) had both esophageal and gastric strictures. Eight (31%) children required an initial feeding jejunostomy and 6 (23%) required a feeding gastrostomy as they had significant weight loss on presentation. Eleven (65%) esophageal strictures responded to the dilatation regimen and are symptom-free on follow-up. Three (18%) children with esophageal stricture underwent esophageal replacement. Eight (31%) children had a pyloric stricture and all of them were treated with a modified Billroth I gastro-duodenostomy. The children who presented after 2 months were found to have a significantly increased need for esophageal replacement (3/9 vs. 0/17; P = 0.03; Fischer's exact test).
Conclusion:
The corrosive ingestion in children is associated with higher morbidity. The sequelae include esophageal and antro-pyloric strictures. A feeding gastrostomy or jejunostomy was required in more than half of the patients. The children presenting after 2 months of ingestion were associated with an increased need for esophageal replacement.
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