Current practices in the management of corrosive ingestion in children: A questionnaire-based survey and recommendations

Bolia, Rishi; Sarma, Moinak Sen; Biradar, Vishnu; Sathiyasekaran, Malathi; Srivastava, Anshu

doi:10.1007/s12664-021-01153-z

Cited by 7 publications

(10 citation statements)

References 25 publications

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Section: Dilemmas In Acute Corrosive Ingestion Managementmentioning

confidence: 99%

“…Gastric lavage and induction of vomiting are common practices after accidental ingestion of corrosive[ 4 , 5 ]. In a survey performed recently in India, it was found that 57% of referred cases had history of induced emesis by the primary physicians[ 5 ]. Any effort of induced vomiting will lead to re-exposure of esophageal mucosa to the corrosive and increased risk of aspiration.…”

Section: Dilemmas In Acute Corrosive Ingestion Managementmentioning

confidence: 99%

“…Antacids, H2 receptor blockers and proton pump inhibitors (PPIs) are prescribed in acute ingestion but their efficacies are not proven[ 2 , 19 ]. PPI is used in the majority of cases and may help by decreasing acid exposure to damaged tissue and prevention of stress ulcer formation[ 5 ]. Sucralfate which needs an acidic medium to activate provides a protective coating over the ulcers and may aid in delaying stricture formation[ 20 ].…”

Section: Dilemmas In Acute Corrosive Ingestion Managementmentioning

confidence: 99%

“…The introduction of corrosives as household cleaning purposes has led to a rapid rise in accidental and suicidal ingestion in children. Majority are accidental[ 2 , 3 ] especially in children younger than 5 years who constitute 60%-80% of all pediatric corrosive ingestion cases[ 4 , 5 ]. Corrosives include both acidic and alkali substances.…”

Section: Introductionmentioning

confidence: 99%

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Corrosive upper gastrointestinal strictures in children: Difficulties and dilemmas

Sarma¹,

Tripathi²,

Arora³

2021

WJCP

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Children constitute 80% of all corrosive ingestion cases. The majority of this burden is contributed by developing countries. Accidental ingestion is common in younger children (< 5 years) while suicidal ingestion is more common in adolescents. The severity of injury depends on nature of corrosive (alkali or acid), pH, amount of ingestion and site of exposure. There are multiple doubts and dilemmas which exist in management of both acute ingestion and chronic complications. Acute ingestion leads to skin, respiratory tract or upper gastrointestinal damage which may range from trivial to life threatening complications. Esophagogastroduodenoscopy is an important early investigation to decide for further course of management. The use of steroids for prevention of stricture is a debatable issue. Upper gastrointestinal stricture is a common long-term sequelae of severe corrosive injury which usually develops after three weeks of ingestion. The cornerstone of management of esophageal strictures is endoscopic bougie or balloon dilatations. In case of resistant strictures, newer adjunctive therapies like intralesional steroids, mitomycin and stents can be utilized along with endoscopic dilatation. Surgery is the final resort for strictures resistant to endoscopic dilatations and adjunctive therapies. There is no consensus on best esophageal replacement conduit. Pyloric strictures require balloon dilatation , failure of which requires surgery. Patients with post-corrosive strictures should be kept in long term follow-up due to significantly increased risk of carcinoma. Despite all the endoscopic and surgical options available, management of corrosive stricture in children is a daunting task due to high chances of recurrence, perforation and complications related to poor nutrition and surgery.

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Section: Dilemmas In Acute Corrosive Ingestion Managementmentioning

confidence: 99%

Section: Dilemmas In Acute Corrosive Ingestion Managementmentioning

confidence: 99%

Section: Dilemmas In Acute Corrosive Ingestion Managementmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Corrosive upper gastrointestinal strictures in children: Difficulties and dilemmas

Sarma¹,

Tripathi²,

Arora³

2021

WJCP

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“…Accidental intake due to improper storage or lack of "child-proof" containers are most common reasons but the consequences of esophageal injury can be devastating. Bolia and colleagues from All India Institute of Medical Sciences, Rishikesh, India, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India, Deenanath Mangeshkar Hospital and Research Center, Pune, India and Kanchi Kamakoti CHILDS Trust Hospital, Apollo and SMF Hospital, Chennai, India report a questionnaire-based study of 98 gastroenterologists who had managed a total of 2600 corrosive ingestions in previous 5 years [17]. Majority considered performing a chest X-ray (83.3%) and endoscopy (79.7%) in the early (first 5 days) after ingestion.…”

Section: Current Practices In the Management Of Corrosive Ingestion In Children: A Questionnaire Based Survey And Recommendationsmentioning

confidence: 99%

Editorial commentary on the Indian Journal of Gastroenterology– May–June 2021

Limdi

2021

Indian J Gastroenterol

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Serum C-reactive protein and neutrophil to lymphocyte ratio as predictors of survival in cirrhotic patients with systemic inflammatory response syndrome and bacterial infection Patients with liver cirrhosis are at risk of significant morbidity and mortality from infectious complications [1]. Data on biochemical surrogates as predictors of infection are scarce. Tapadia et al. from Gleneagles Global Health City, Chennai, India assessed the predictive value of C-reactive protein (CRP) and the neutrophil-lymphocyte ratio (NLR) alone and in combination in predicting infection in a cohort of 208 consecutive hospitalized patients with cirrhosis [2].In addition to standard assessments (laboratory, ultrasound and appropriate cultures), CRP and NLR were also obtained. Investigators noted an infection rate of 62% with 58.5% culture positivity and mortality of 30.8%. Optimal cut-off values for NLR and CRP to predict infection were 5.86 and 33.7, respectively. One-month mortality risk was 2-3 times with NLR and CRP above these cut-off values. The combination of NLR + CRP (≥5.86 and ≥ 33.7) increased specificity and diagnostic accuracy for infection suggesting that these may have a role in predicting infection and even culture positivity. Prospective controlled studies are needed to validate this interesting observation.

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Colon patch esophagoplasty for esophageal strictures refractory to multi-modal treatment revisited

et al. 2022

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Current practices in the management of corrosive ingestion in children: A questionnaire-based survey and recommendations

Cited by 7 publications

References 25 publications

Corrosive upper gastrointestinal strictures in children: Difficulties and dilemmas

Corrosive upper gastrointestinal strictures in children: Difficulties and dilemmas

Editorial commentary on the Indian Journal of Gastroenterology– May–June 2021

Colon patch esophagoplasty for esophageal strictures refractory to multi-modal treatment revisited

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