Abstract
Corrosive substance ingestion is a seriouspublic health hazard. Mostly, children are victim due to accidental ingestion occurring commonly in less than five years. Whether acid or alkali, the ingestion may have catastrophic effects and the outcomes can vary from minimal injury to perforation and death. Esophagogastroduodenoscopy should be done 12-24 hours of ingestion in order to assess the extent of mucosal injury. Esophageal stricture remains one of the major sequel usually seen after three weeks of ingestion. Endoluminal dilatation is current recommendation for initial treatment of stricture and surgery should follow for strictures refractory to dilatation. We here present a case of a five year old child with accidental corrosive ingestion at her school which led to esophageal stricture. She underwent multiple dilatation of stricture followed by esophageal corrective surgery which again led to post-surgical stricture requiring further dilatations.
Highlights
Corrosives are a group of chemicals that have the capacity to tissue injury on contact by a chemical reaction most commonly affecting gastrointestinal tract, respiratory system and eyes[1]
Accidental ingestion of corrosive substances is more commonly seen in early childhood with children younger than five years being more prone to such ingestion[1,2,3,4,5,6]
Esophageal injury after corrosive ingestion is endoscopically graded with a score of 0 for no injury to IIIb for significant circumferential injury with ulcers and necrosis[2]
Summary
Corrosives are a group of chemicals that have the capacity to tissue injury on contact by a chemical reaction most commonly affecting gastrointestinal tract, respiratory system and eyes[1]. A five years old girl from Baglung district had accidental ingestion of corrosive, namely Methyl orange at her school 16 months back Soon after ingestion she was noted with swelling of lips and tongue followed by drooling and acute onset of epigastric pain. Guide wire was placed and NJ tube inserted for feeding She underwent multiple esophageal dilatations of stricture after that. UGI endoscopy revealed anastomotic site narrowing, again requiring esophageal dilatation She underwent multiple dilatations in 15 days interval. Our patient is the first to undergo esophageal dilatation for stricture in children in our country At present, she has good oral intake and is asymptomatic with weight gain of three kilograms
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