Department of Pediatric Oncology, Tehran University of Medical Sciences, IranFulltext PDF
Background: Corrosive ingestion can produce severe upper gastrointestinal tract injury with longlasting suffering and even death. Early assessment of the extent of damage is important for deciding about the necessity of hospitalization and type of treatment. The present study has investigated the clinical indicators of corrosive esophageal injury severity in children.
Methods: Data from children who accidentally ingested corrosive substance over a five-year period in two tertiary care university hospitals were reviewed. Patients were divided into two groups as low-grade and high-grade esophageal injuries according to the findings of endoscopic evaluation. Statistical correlations of common signs and symptoms and with low and high grade esophageal injury were analyzed.
Results: A total of 47 consecutive children with a caustic ingestion who underwent diagnostic endoscopy were included in our study. Endoscopies revealed low-grade injury in 80.9% of cases. There were no significant differences in age, sex and type of corrosive substance between low grade and high grade injury groups (p>0.05). The majority of patients (83%) had at least one symptom at the initial examination. Endoscopies in all of the asymptomatic patients revealed low grade injuries, but no significant relation was found between symptomatic and grading of the injury in endoscopic examination (p=0.323). The mean WBC counts did not differ significantly between the two grading groups.
Conclusion: Our study showed a significant correlation between having no clinical symptom and low grade esophageal injury in endoscopic examination of children with corrosive substance ingestion and appears to confirm that in limited resourced centers, endoscopy could be deferred in asymptomatic patients.
Corrosive; Esophagus; Caustic agent; Endoscope; Pediatric
Qmarsi R. The Relationship between Clinical Findings and Esophageal Injury Severity in Children with Unintentional Ingestion of Caustic Agents. J Gastroenterol Hepatol Endosc. 2019;4(5):1072..