Korean J Pediatr.  2009 Apr;52(4):446-452. 10.3345/kjp.2009.52.4.446.

Usefulness of early endoscopy for predicting the development of stricture after corrosive esophagitis in children

• Park JY
• Shin JY
• Yang HR
• Ko JS
• Kim WS
• Seo JK

• KMID: 2281744
• DOI: http://doi.org/10.3345/kjp.2009.52.4.446

Abstract

PURPOSE
This study was performed to demonstrate the usefulness of early endoscopy for predicting the development of stricture following corrosive ingestion in children. METHODS: We conducted a retrospective study on 34 children who were brought to Seoul National University Childrens Hospital and Seoul National University Bundang Hospital for corrosive ingestion from 1989 to 2007. RESULTS: The corrosive burns were classified as grade 0 in 8 patients, grade 1 in 2, grade 2a in 7, grade 2b in 13, and grade 3 in 4. There was no significant correlation between the presence of esophageal injury and symptoms including vomiting, dysphagia, and drooling. There was a statistically significant relation between the presence of oropharyngeal injury and esophageal injury (P=0.014). There were no complications including hemorrhage and perforation related to endoscopy. Strictures of the esophagus or the stomach developed in 12 patients (36.4%). Esophageal stricture was observed in 11 patients and pyloric stenosis in 1 patient. The endoscopic grade of mucosal injury was significantly related to the frequency of development of esophageal stricture (P=0.002). Two of eleven patients with esophageal stricture responded to repeated dilation. The remaining seven patients underwent surgery. CONCLUSION: Early esophagogastroduodenoscopy is not only a safe and useful diagnostic tool for children with accidental caustic ingestion but also a necessity for determining the degree and the extent of caustic burns and for predicting the development of late complications.

Keyword

Burns; Chemical; Caustics; Esophagitis; Esophagoscopy; Esophageal stenosis; Child

MeSH Terms

Burns
Caustics
Child
Constriction, Pathologic
Deglutition Disorders
Eating
Endoscopy
Endoscopy, Digestive System
Esophageal Stenosis
Esophagitis
Esophagoscopy
Esophagus
Hemorrhage
Humans
Pyloric Stenosis
Retrospective Studies
Sialorrhea
Stomach
Vomiting
Caustics