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Corrosive Substance Ingestion: When to Perform Endoscopy?
Ufuk Ateş1, Gülnur Göllü1, Ergun Ergün1
1Faculty of Medicine, Department of Pediatric Surgery, Ankara University, Ankara, Turkey.
Insights
For paediatric patients ingesting corrosive substances, endoscopy is not necessary unless both hypersalivation and dysphagia are present. This approach streamlines management for corrosive ingestion cases.
Area of Science:
- Pediatric Gastroenterology
- Toxicology
- Emergency Medicine
Background:
- Corrosive substance ingestion presents a significant clinical challenge in pediatric emergency care.
- Effective management and follow-up protocols are crucial for affected children.
Purpose of the Study:
- To introduce a treatment and follow-up algorithm for pediatric patients with corrosive ingestion.
- To refine diagnostic approaches for corrosive ingestion in children.
Main Methods:
- A retrospective analysis of 172 pediatric patients admitted for corrosive ingestion between July 2015 and December 2021.
- Comparative analysis of endoscopy indications before and after January 2020, shifting focus to patients with hypersalivation and dysphagia.
Main Results:
- Endoscopy in 19 patients with hypersalivation showed varying degrees of esophageal corrosion (Grade I, II-A, II-B).
- Dysphagia assessment in 14 patients revealed similar corrosion grades, with most having normal endoscopic findings.
- Pediatric patients without hypersalivation and dysphagia experienced no long-term complications or need for further treatment.
Conclusions:
- Endoscopic evaluation is not routinely required for all pediatric corrosive ingestion cases.
- The presence of both hypersalivation and dysphagia simultaneously is a key indicator for endoscopy in high-risk ingestions.
Aim:
Ingestion of corrosive substances is a difficult and important medical problem to manage. The aim of this study is to present an algorithm that will regulate the treatment and follow-up of paediatric patients with corrosive ingestion.
Methods:
Children who were admitted to the paediatric emergency department with corrosive substance ingestions between July 2015 and December 2021 were included. Between July 2015 and January 2020, endoscopy was performed on all patients. After January 2020, endoscopy was performed only for patients presenting with hypersalivation and dysphagia.
Results:
172 patients were followed up and treated in our clinic due to corrosive substance ingestion. Endoscopic evaluation of 19 patients with hypersalivation revealed oesophageal corrosion stages as follows: grade I in 5 patients, grade II-A in 1 patient, grade II-B in 3 patients, and normal findings in the remaining patients. Of the 14 patients with dysphagia, 1 had grade I, 2 had grade II-A, and 4 had grade II-B corrosion, and the remaining patients had normal endoscopic findings. In the long-term follow-up of the patients without hypersalivation and dysphagia, no complications developed and no additional treatment was required.
Conclusions:
In patients presenting with suspicion of ingestion of high risk corrosive substances, there is no need for endoscopy unless hypersalivation and dysphagia are present simultaneously.
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