Clinical and endoscopic findings of children hospitalized in Qa'em Hospital of Mashhad due to caustic ingestion (2011-2013)

Sabzevari, Alireza; Maamouri, Gholamali; Kiani, Mohammad Ali; Saeidi, Masumeh; Kianifar, Hamidreza; Jafari, Seyed Ali; Ahanchian, Hamid; Jarahi, Lida; Roudi, Elham; Sharafkhani, Mohammad

doi:10.19082/4248

Cited by 6 publications

(7 citation statements)

References 7 publications

(19 reference statements)

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“… 5 In another study done from 2011 to 2013, 30.8% of the caustic ingestion was alkali material. 6 As a result, we see a decreasing trend of caustic ingestion with alkali material during 2006-2016.…”

Section: Discussionmentioning

confidence: 85%

Caustic Ingestion in Children in South of Iran: A Two-Year Single Center Study

Dehghani¹,

Bahmanyar²,

Javaherizadeh³

2018

Middle East J Dig Dis

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BACKGROUND Caustic ingestion is one of the most important injuries during childhood, which leads to serious sequel. In this study, we evaluated the clinical manifestations, endoscopic appearance, complications, and treatment results in patients with caustic ingestion in our hospital. METHODS Hospital chart of patients with caustic ingestion who admitted to Nemazee Teaching Hospital affiliated to Shiraz University of Medical Sciences during a 2-year period (2015-2016) were reviewed retrospectively. The age, sex, nature of the caustic agent, clinical presentations, grade of injury in endoscopy, degree of parents’ education, site of ingestion, accidental or intentional attempts, complications, and outcomes were reviewed. RESULTS In this study the charts of 41 patients (26 boys and 15 girls) with caustic ingestion over the 2-year period were reviewed. The mean age of the patients was 4.4 year. Of them, 95.1% had ingested the materials accidentally, and 2 (4.9%) patients had ingested unknown substances for suicidal attempt. Of all cases, 68.3% of caustic ingestion occurred in the kitchen. 19 (46.3%) agents were acidic substances and 17 (41.5%) were alkali agents. 5 (12.1%) patients ingested unknown substances. 24.3% of the patients were asymptomatic and the most common presentation was drooling (34.14%). 26.8% of the patients had dysphagia, and 24.3% presented with oral ulcer. 7.3% had abdominal pain, 4.8% had fever, and 2.4% had hematemesis. 14 (34.1%) patients had normal feature, 6 (14.6%) had grade I injury, 12 (29.3%) had grade II injury, and 8 (19.5%) had grade III injury in endoscopic evaluation. CONCLUSION Most of the caustic ingestion occurred in kitchen. Male was the dominant sex in the caustic injury.

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Section: Discussionmentioning

confidence: 85%

Caustic Ingestion in Children in South of Iran: A Two-Year Single Center Study

Dehghani¹,

Bahmanyar²,

Javaherizadeh³

2018

Middle East J Dig Dis

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“…Emesis pH was 9.0 (Johnson and Bruno 2018). Sabzevari et al (2017) performed a retrospective cross-sectional study of 54 children who ingested corrosive substances during 2011-2013. Acidic chemical substances were ingested by 36 children and base substances were ingested by the remaining 16.…”

Section: Pediatric Patientsmentioning

confidence: 99%

“…No one particular symptom or symptom/sign set reliablyespecially the presence or absence of oropharyngeal lesions can predict the severity of the tissue injury following corrosive ingestion (Cello et al 1980;Gaudreault et al 1983;Crain et al 1984;Satar et al 2004;Wax and Yarema 2007;Lupa et al 2009;Riffat and Cheng 2009;Millar and Cox 2015;Sabzevari et al 2017). Therefore, the "gold standard" for determining the extent of tissue injury is esophagogastroduodenoscopy (EGD), generally referred to as "endoscopy" in this review (Wax and Yarema 2007;Cheng et al 2008;Riffat and Cheng 2009).…”

Section: Introductionmentioning

confidence: 98%

“…The extent of the tissue injury is dependent on such factors as the physical form of the ingested chemical substance, the type, amount, and concentration, the pre-ingestion condition of the tissues, and the duration of contact (Poley et al 2004;Cheng et al 2008;Betalli et al 2009;Chibishev et al 2013). Storage of corrosive chemical substances in water or soft drink containers in the home is a risk factor for accidental corrosive ingestion in children, particularly those less than 5 years of age (Botwe et al 2015;Sabzevari et al 2017).…”

Section: Introductionmentioning

confidence: 99%

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Corrosive substances ingestion: a review

Hall

Jacquemin²,

Henny³

et al. 2019

Critical Reviews in Toxicology

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Corrosive chemical substance ingestions are a major problem, especially in developing countries, but also in developed countries such as the United States, France, and Belgium. Ingestions may be deliberate as suicide attempts (mostly in adolescents and adults) or accidental (mostly in children). The results can be devastating in terms of individual suffering and disability, but also in terms of resource utilization and costs. In developing countries, outcomes may be worse because of limited medical/surgical resources. Common sequelae include gastrointestinal (GI) tract (esophagus, stomach, pylorus, and duodenum) stricture formation, GI tract perforation, and hemorrhage. Systemic effects may also occur, such as disseminated intravascular coagulation (DIC), multi-organ system failure, and sepsis. Various interventions in the acute phase to reduce the severity of injury have been attempted, but there are no large controlled clinical trials to demonstrate efficacy. Dilation therapy in various forms is commonly used for the treatment of strictures and a variety of surgical procedures including esophagectomy and delayed replacement may be required in severe corrosive injury cases.

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“…In developing countries, the incidence of corrosive ingestion is significantly higher and, in most cases, remains unreported [2]. Their actual prevalence cannot be assumed from random observations and personal judgments of healthcare professionals [10]. Various chemical products stored in homes are the source of accidental or intentional exposures that can be observed in people of different ages [11,12].…”

Section: Introductionmentioning

confidence: 99%

Assessing the Degree of Acute Esophageal Injury Secondary to Corrosive Intake: Insights From a Public Sector Hospitals of a Developing Country

Ain

Jamil

Safian

et al. 2020

Cureus

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Background Caustic ingestion continues to be a significant problem worldwide especially in developing countries and particularly in the age group of under six years. Ingestion of caustic substances is a medical emergency in both the adult and pediatric population and is associated with high morbidity and mortality. The ingestion of caustic substances induces an extensive spectrum of injuries to the aerodigestive tract, which includes extensive necrosis and perforation of the esophagus and stomach. Objectives The main aims were to determine upper and lower esophageal injuries associated with corrosive intake and to compare esophageal injury with age and gender. Rationale Once we'll find the extent and severity of esophageal injury associated with corrosive intake within 24 hours, we'll be able to manage the case timely and to limit further complications and disabilities. Materials and Methods This descriptive cross-sectional study was conducted on 150 patients who presented with corrosive ingestion and underwent urgent endoscopic evaluation. Data were collected using self-designed pro forma. Endoscopic findings were classified according to the Zargar classification. A descriptive analysis of study variables was performed using SPSS v.21.0 (IBM Corp., Armonk, NY, USA). The chi-square test was used, and a p-value of less than 0.05 was considered statistically significant. Results Out of 150 patients under study, 103 (68.7%) were females and 47 (31.3%) were males. The most prevalent age group presenting with corrosive intake was found to be between 21 and 34 years of age (43.3%) in both genders. The most common part of the esophagus prone to corrosive insult is the upper esophagus (99.3%), whereas, regarding severity, the lower esophagus has more severe injuries (predominant being stage 2B, i.e., 32%). There are no statistically significant differences in esophageal injuries in different age groups (upper esophageal injury: 0.319; lower esophageal injury: 0.696) and genders (upper esophageal injury: 0.769; lower esophageal injury: 0.752). Conclusions Most of the patients under study belong to the female gender and teen and younger age group. The predominant upper esophageal injury as a result of corrosive intake is stage 0 injury, and the least common is found to be stage 1 injury. The predominant lower esophageal injury as a result of corrosive intake is stage 2B injury, whereas the least common is found to be stage 4 injury.

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Clinical and endoscopic findings of children hospitalized in Qa'em Hospital of Mashhad due to caustic ingestion (2011-2013)

Cited by 6 publications

References 7 publications

Caustic Ingestion in Children in South of Iran: A Two-Year Single Center Study

Caustic Ingestion in Children in South of Iran: A Two-Year Single Center Study

Corrosive substances ingestion: a review

Assessing the Degree of Acute Esophageal Injury Secondary to Corrosive Intake: Insights From a Public Sector Hospitals of a Developing Country

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