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Upper airway lesions in children after accidental ingestion of caustic substances
Insights
Accidental ingestion of caustic substances in children can cause upper airway lesions, particularly in those under 2 years old. While most recover without respiratory issues, some develop esophageal stenosis.
Area of Science:
- Pediatric Gastroenterology
- Pediatric Pulmonology
- Emergency Medicine
Background:
- Accidental ingestion of caustic substances is a significant pediatric emergency.
- Upper airway injury can lead to acute respiratory distress and long-term complications.
Purpose of the Study:
- To investigate the incidence and characteristics of upper airway lesions in children following caustic ingestion.
- To identify risk factors associated with respiratory tract involvement.
Main Methods:
- Retrospective review of 33 children admitted within 24 hours of accidental caustic ingestion.
- Direct laryngoscopy was performed to assess for upper airway lesions.
- Correlation analysis between age, severity of esophagitis, and respiratory tract lesions.
Main Results:
- 42.5% of children (14/33) presented with upper airway lesions.
- Younger children (<2 years) had a significantly higher incidence of upper airway lesions (9/13 vs. 5/20, P<0.01).
- Severe esophagitis correlated with a higher frequency of respiratory tract lesions (11/17 vs. 3/16, P<0.025).
Conclusions:
- Upper airway lesions are common after caustic ingestion in children, especially in the youngest age group.
- Respiratory symptoms and lesions are more frequent in cases of severe esophagitis.
- Prompt laryngoscopy is crucial for evaluating airway involvement in pediatric caustic ingestions.
Abstract:
Of 33 children admitted within 24 hours after accidental ingestion of a caustic substance, 14 (42.5%) had evidence of upper airway lesions on direct laryngoscopy. Three patients, 10 to 12 months old, needed endotracheal intubation for acute respiratory obstruction; four patients younger than 2 years had severe dyspnea without obstruction; seven patients had mild or no respiratory symptoms. All were discharged without respiratory sequelae, although esophageal stenosis developed in six patients. Nine of 13 patients younger than 2 years, compared to five of 20 patients older than 2 years, had upper airway lesions (P less than 0.01). The frequency of respiratory tract lesions was higher in patients with severe esophagitis. Eleven of 17 patients with severe esophagitis, compared to three of 16 with mild inflammation, had respiratory tract lesions (P less than 0.025). No specific caustic substance predisposed to upper airway lesions.