[Caustic burns of the esophagus in children. Apropos of initial endoscopy and routine sizing]

The advantages and indications for initial endoscopy in esophageal caustic burns in children are discussed in relation to 37 such cases, 13 of which were severe lesions. However, the procedure does not provide initial valid assessment of prognosis in severe 2nd and 3rd degree burns. The definite advantages of early and prolonged esophageal stenting in burns liable to provoke stenosis are emphasized: the esophagus is kept at rest and alimentation by the natural pathways can be maintained. Tubage also avoids gastrostomy or other early surgical procedure in the children, with a subsequent more satisfactory course during dilatations, their frequency thus being diminished. The usual inocuity of sodium hypochlorite after accidental ingestion does not justify endoscopic exploration but esophageal and gastric endoscopic examinations should be performed in all children after ingestion of major caustic agents (soda, acids), whether it is certain or simply suspected that ingestion has occurred, even when clinical signs are absent.