Caustic esophagitis in two siblings:Munchausen syndrome by proxy

Abstract

Background and aim: Recurrent corrosive esophagitis is a rare condition among children and may be due to child abuse. The Munchausen Syndrome by Proxy (MSBP) is special form of child abuse with variety of symptoms. It has challenging diagnostic process and needs a high clinical suspicion. When it is identified by physician, institutional child protection team must involve into the management of the case. Case report: We present the two siblings with recurrent esopahigitis. One of them died due to severe gastrointestinal bleeding. Other had severe esophageal stricture and oral lesions. Their mother fed both of them with caustic material at various time intervals. Both babies were treated in our hospital several times with the admission of their mother. Conclusion: This is the probably the first case report of Munchausen Syndrome by Proxy (MSBP) with caustic material ingestion of two siblings. Determining the exact cause of such cases is very difficult and physician must suspect child abuse in this situation.