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Low stricture rate with protocol-driven management of deep caustic esophageal burns in children: a prospective cohort

Valentina V Sarsenova1, Bauyrzhan N Bissaliyev2, Assylbek B Tussupkaliyev1

  • 1Department of Pediatric Surgery, West Kazakhstan Marat Ospanov Medical University, 68 Maresyev Street, 030019, Aktobe, Kazakhstan.

Pediatric Surgery International
|May 24, 2026
PubMed

Insights

A standardized protocol for deep caustic esophageal burns in children significantly reduced stricture formation to 9.7%. This approach offers favorable early outcomes, avoiding perforation or surgery.

Area of Science:

  • Pediatric Gastroenterology
  • Esophageal Injury Management
  • Toxicology

Background:

  • Deep caustic esophageal burns in children are associated with high rates of stricture formation.
  • Previous management strategies have yielded variable and often poor outcomes.

Purpose of the Study:

  • To evaluate early clinical outcomes and stricture formation in children with deep caustic esophageal burns.
  • To assess the efficacy of a standardized, injury-adapted management protocol.

Main Methods:

  • Prospective single-center study of children with Zargar grade IIB-IIIA esophageal burns.
  • Protocol included early endoscopy, controlled feeding, corticosteroids, and avoidance of routine dilation.
  • Primary outcome was clinically significant esophageal stricture.

Main Results:

  • 31 children were included; 9.7% developed clinically significant strictures, significantly lower than historical rates (40-70%).
  • All strictures occurred within five weeks and were successfully treated with endoscopic dilation.
  • No esophageal perforations, emergency surgeries, or mortality were observed.

Conclusions:

  • Protocol-driven early management is associated with a low stricture rate in pediatric caustic esophageal injuries.
  • Standardized care and endoscopic surveillance may improve outcomes for these severe injuries.
Abstract

Keywords:
Caustic ingestionEndoscopyEsophageal stricturePediatricProtocol-driven management

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