High Doses of Methylprednisolone in the Management of Caustic Esophageal Burns

Usta, Merve; Erkan, Tülay; Çokuğraş, Fügen; Urgancı, Nafiye; Önal, Zerrin; Gülcan, Mahir; Kutlu, Tufan

doi:10.1542/peds.2013-3331

Cited by 75 publications

(56 citation statements)

References 15 publications

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“…Methylprednisolone at a dose of 1 g/1.73 m 2 per day for 3 d showed benefit in reducing stricture development[25]. Likewise, dexamethasone (1 mg/kg per day) was shown to be better than prednisolone (2 mg/kg per day) in preventing stricture formation (38.9% vs 66.7%) and severe stricture development (27.8% vs 55.6%)[26].…”

Section: Managementmentioning

confidence: 99%

Management of esophageal caustic injury

Lusong

Timbol

Tuazon

2017

WJGPT

120

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Ingestion of caustic substances and its long-term effect on the gastrointestinal system maintain its place as an important public health issue in spite of the multiple efforts to educate the public and contain its growing number. This is due to the ready availability of caustic agents and the loose regulatory control on its production. Substances with extremes of pH are very corrosive and can create severe injury in the upper gastrointestinal tract. The severity of injury depends on several aspects: Concentration of the substance, amount ingested, length of time of tissue contact, and pH of the agent. Solid materials easily adhere to the mouth and pharynx, causing greatest damage to these regions while liquids pass through the mouth and pharynx more quickly consequently producing its maximum damage in the esophagus and stomach. Esophagogastroduodenoscopy is therefore a highly recommended diagnostic tool in the evaluation of caustic injury. It is considered the cornerstone not only in the diagnosis but also in the prognostication and guide to management of caustic ingestions. The degree of esophageal injury at endoscopy is a predictor of systemic complication and death with a 9-fold increase in morbidity and mortality for every increased injury grade. Because of this high rate of complication, prompt evaluation cannot be overemphasized in order to halt development and prevent progression of complications.

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Section: Managementmentioning

confidence: 99%

Management of esophageal caustic injury

Lusong

Timbol

Tuazon

2017

WJGPT

120

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“…1,7,10 Çocuklarda korozif madde içimi kazaları gelişmekte olan ülkelerde gelişmiş ülkelere nazaran çok daha fazla görülmektedir. 2,4,7,[10][11][12][13][14][15][17][18][19][20][21][22][23][24] Gelişmekte olan ülkelerde yasal yaptırımların yeterince uygulanmaması nedeni ile korozif maddeler çocukların kolaylıkla açabileceği kaplarda satılmaktadır. Koruyucu hekimlik, bu kazaları etkili bir şekilde azaltmada yetersiz kalmaktadır.…”

Section: Korozi̇f Maddelerunclassified

“…[1][2][3][4][5][6][7][8][9][10] Bu kazalar, çocuk ve çocuk cerrahisi alanlarıyla doğrudan ilgili olmasının yanı sıra, toplum sağlığı ve koruyucu hekimlik açısından da ciddi bir konudur. 4,7,[11][12][13] Çocuklarda Korozif Madde İçimi:…”

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Corrosive Substance Ingestion in Children: A Current Evaluation and Treatment Approach

Uygun¹

2018

Turkiye Klinikleri J Pediatr

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RESİM 1: Bazı açıkta satılan tehlikeli korozif maddeler (A-F). (A): su kaplarına konularak açıkta satılan sıvı korozif maddeler; (B, C): Mahalle pazarlarında (B) orijinal sirke ruhu (C1) ve hakiki Siirt sirkesi gibi isimlerle satılan ve turşu yapımında kanunen yasak olmasına karşın kullanılan asetik asit (C1 ve C2) normal pet şişe suyuna (C3) çok benzemektedir; (D): Sülfürik asit içeren çocuk korumalı kapaksız akü asidi (D1) ile akü için saf su (D2) yanyana satılmaktadır; (E): Korozifler gıdalar ile birlikte pet su şişesinde; E1: kireç çözücü; E2: çamaşır suyu; E3: deterjan, (F): Kostik etiketi ile merdiven altı üretilmiş güçlü alkali sodyum hidroksit içeren yağ çözücü.

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“…The duration of total parenteral nutrition was shorter in the steroid intervention group compared with the control group (p = 0.001). The authors concluded that high doses of methylprednisolone used for the management of grade II-b oesophageal caustic burns may reduce the risk of stricture [40][41][42].…”

Section: Treatmentmentioning

confidence: 99%

Caustic Ingestion in Children

Larrosa‐Haro¹,

Sánchez-Ramírez²,

MMesa-Magaña³

et al. 2017

Esophageal Abnormalities

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Caustic ingestion (CI) is an unfortunate event that occurs in families with a poor prevention culture. Its prevalence is unknown in developing countries; it occurs mainly in children < 5 years and is more common in boys. The chemical caustic agents are alkaline (85%) or acid products stored in food or beverage containers without warning labels and safety caps. The immediate symptoms include salivation, oropharyngeal burns, vomiting and oropharyngeal/retrosternal pain. Upper endoscopy is the irst-line tool to identify the type and extension of oesophageal and gastric damage. A barium swallow performed 2-3 weeks after the CI may identify oesophageal stricture. Dysphagia occurs in about one-third of cases. Regarding the nutritional status, children with dysphagia and/or oesophageal strictures may have lower fat reserves or muscle mass than the cases without these complications, meaning impaired nutritional status. All patients should be hospitalized for evaluation and treatment. Hemodynamic stabilization and adequacy of the patient's airway are priorities; vomiting induction and gastric lavage are contraindicated. Methylprednisolone in II-b oesophageal burns for 3 days diminishes the risk of stricture. Selected cases will require oesophageal dilatations, gastrostomy or oesophageal replacement by colon or stomach. There are other promising agents in the management of caustic oesophageal strictures.

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High Doses of Methylprednisolone in the Management of Caustic Esophageal Burns

Cited by 75 publications

References 15 publications

Management of esophageal caustic injury

Management of esophageal caustic injury

Corrosive Substance Ingestion in Children: A Current Evaluation and Treatment Approach

Caustic Ingestion in Children

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