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[Long-term follow-up of children with esophageal caustic stenosis]
P S Ganga-Zandzou1, C Devulder, L Michaud
1Unité de gastroentérologie, hépatologie et nutrition, Hôpital Jeanne-de-Flandre, CHRU, Lille, France.
Insights
Long-term follow-up of children with esophageal caustic stenosis reveals significant psychological and social challenges, including anxiety, depression, and scholastic difficulties, necessitating ongoing multidisciplinary care.
Area of Science:
- Pediatric Gastroenterology
- Otolaryngology
- Child Psychology
Context:
- Esophageal caustic stenosis in children often results from accidental ingestion of corrosive substances.
- Limited data exists on the long-term functional, organic, psychological, and social outcomes for affected children.
Purpose:
- To investigate the long-term consequences of esophageal caustic stenosis in a pediatric cohort.
- To identify key medical, nutritional, psychological, and social factors impacting recovery and quality of life.
Summary:
- A longitudinal study followed 34 children with esophageal caustic stenosis, analyzing treatment outcomes (dilations vs. surgery), functional symptoms like dysphagia, nutritional status, and psychosocial impacts.
- While nutritional status was generally unaffected, significant psychological and social sequelae were observed, including scholastic difficulties, anxiety, severe depression, and one case of suicide.
Impact:
- Highlights the critical need for extended, multidisciplinary follow-up for children with esophageal caustic stenosis.
- Emphasizes the importance of addressing not only physical recovery but also the profound psychological and social well-being of affected children.
Background:
Long term follow-up of children with esophageal caustic stenosis is not well known. The aim of the present study was to describe functional, organic and psychological, as well as social consequences.
Patients And Methods:
Thirty-four children with a mean age of 3 years and 7 months +/- 3 years and 2 months (ranges: 1 month-14 years and 3 months) were included in a longitudinal study. Various parameters have been studied: treatment, functional symptoms, nutritional status (weight/height, body composition) and psychological and social consequences. chi 2 and Mann-Whitney tests were used for statistical analysis.
Results:
Twenty-one patients have been treated by mechanical dilatations whereas surgery was performed in 12 children; the mean number of dilatations per child was higher in patients treated by dilatations (21 +/- 17 vs 14 +/- 16; P < 0.05). The frequency of dysphagia was not different in patients with colon interposition or not (69% vs 53%; P = 0.1). Nutritional status was not affected by the presence of esophageal caustic stenosis. Psychological and social consequences were characterized by scholastic difficulties, anxiety and severe depression. One case of suicide was observed.
Conclusion:
Children with caustic stenosis should be followed for a long period of time. A multidisciplinary approach is necessary, taking into account medical, social and psychological consequences.