Features and management of esophageal corrosive lesions in children in Sierra Leone: lessons learned from 175 consecutive patients

Contini, Sandro; Scarpignato, Carmelo; Rossi, Angelo; Strada, Gino

doi:10.1016/j.jpedsurg.2011.03.017

Cited by 17 publications

(4 citation statements)

References 31 publications

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“…33 What's more, the frequency of perforation after EBD is higher in the case of poisoning with caustic substances than in case of esophageal strictures formed in another mechanism. 34 Due to the significant percentage of failures after EBD, it should only be used for a limited number of children with postoperative esophageal stenosis. 35 In contrast to EBD, mechanical expansion (bougie) seems to be more useful in the case of heavy, long, scarred, and serious scars that arise as a result of poisoning with caustic substances.…”

Section: Discussionmentioning

confidence: 99%

Caustic Agents Ingestion in Children: A 51-Year Retrospective Cohort Study

et al. 2019

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Objectives: Children experience serious gastrointestinal tract injuries due to consumption of caustic agents more often than adults. The aim of the study was to analyze diagnostic methods and treatment of children with esophageal burns according to the degree of the injury. Methods: Our one-center population-based retrospective cohort study included 150 children admitted between 1967 and 2018 to Clinic of Pediatric Otolaryngology, Phoniatrics and Audiology of University Children’s Hospital in Lublin, Poland, due to the chemical burn of the mouth, throat, larynx, and esophagus. Each patient underwent a thorough laryngological examination and endoscopy to assess the place and degree of injury. Results: Of 150 patients, 65.3% were male and 34.7% female. The median age was 4 years and 3 months. Salivation, dysphagia, burning sensation, edema, and whitish coating on the oral mucosa, palate, and throat were the most common clinical symptoms. In addition, dyspnea and chest pain were observed in 30% of patients. Esophagus endoscopy results were: Zargar grade I burn (84.7%), grade IIA (8%), grade IIB (2.6%), grade III (0%), and grade 0 (4.7%). Treatment included antibiotics, proton pump inhibitors, analgesics, and intravenous fluid therapy. Late sequelae (scarred esophageal strictures) developed in 20 (13.3%) patients. Conclusions: Accidental intake of caustic agents is observed in young children, especially younger than the age of 5. Early esophagus endoscopy should be performed in all patients to assess the grade of injury, plan initial treatment, and predict the risk of developing complications. Early diagnosis and immediate pharmacological treatment reduce the number of late sequelae.

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Section: Discussionmentioning

confidence: 99%

Caustic Agents Ingestion in Children: A 51-Year Retrospective Cohort Study

et al. 2019

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“…Although the main complication of EBD is esophageal perforation, the risk is relatively low (0%-31%). The mortality rate in the previous decade was close to zero; however, it must be diagnosed earlier [15] .…”

Section: -Through-the-scope Balloon Dilator (Cre Balloon Dilator)mentioning

confidence: 87%

Caustic esophageal stricture from diagnosis untill cure

Abdelhay

Moussa

Elsherbeny

2020

CSRC

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Background: The diagnosis of esophageal stricture after caustic ingestion is based on clinical symptoms of dysphagia, regurgitation and chocking that is evident initially in the acute stage. These symptoms may ameliorate by time or proceed to evident stricture due to fibrosis. This will need either dye esophagogram or Esophagoscopy which is better to be done not before the lapse of at least 6 weeks from injury. Esophageal dilatation using wire-guided dilators is the cornerstone of treatment. The frequency of dilatation is based on recurrence of dysphagia and in multiple strictures, repeated sessions with multi-level injection of steroids and graded dilatation is needed. Failure of dilatation or occurrence of complications may necessitate esophageal replacement and usually we prefer the transverse colon based on the left colic vessels in retrosternal position to treat the condition. We aimed to review the management of caustic esophageal strictures based on what is known and adding our experience in this aspect. Methods: We reviewed the articles discussing management of caustic esophageal strictures in the last twenty years. We added our experience of more than forty years managing an average of thirty new cases every year. Results: Management of caustic esophageal strictures has changed in the last years. Advanced endoscopic techniques of dilatation reduced the need for esophageal replacement. Conclusions: Caustic esophageal strictures could be managed successfully with advanced techniques of endoscopic dilatation.

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“…In three publications, Contini et al (2007Contini et al ( , 2009bContini et al ( , 2011) described the features and management of corrosive substance lesions in 175 consecutive pediatric patients from Sierra Leone. Of these, 57.7% were admitted to hospital at >1 month after ingestion.…”

Section: Pediatric Patientsmentioning

confidence: 99%

“…However, maintenance of a satisfactory luminal diameter was not possible in 15 patients (8.5%). Only 52.7% of patients were available for follow-up for a median of 7 months (range: 1-36 months) and long-term success of dilation (ability to swallow, improved nutritional status with weight gain, sustained esophageal patency) was only noted in 16% of patients Contini et al 2007Contini et al , 2009bContini et al , 2011. Tewfik and Schloss (1980) reviewed 86 pediatric cases of corrosive substance ingestion admitted to the Montreal, Quebec, Canada Children's Hospital over a 10-year period.…”

Section: Pediatric Patientsmentioning

confidence: 99%

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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Features and management of esophageal corrosive lesions in children in Sierra Leone: lessons learned from 175 consecutive patients

Cited by 17 publications

References 31 publications

Caustic Agents Ingestion in Children: A 51-Year Retrospective Cohort Study

Caustic Agents Ingestion in Children: A 51-Year Retrospective Cohort Study

Caustic esophageal stricture from diagnosis untill cure

Corrosive substances ingestion: a review

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