Corrosive Ingestion In Children Research Articles

Pyloric stenosis in a Bangladeshi child due to corrosive ingestion

Accidental corrosive ingestion in children is one of the common problems of childhood trauma worldwide. Gastric outlet obstruction is rare, but it is a well-known complication of corrosive acid ingestion. It mostly occurs at the pylorus and antrum due to the pooling of the corrosive agent. This report presents an experience with a 7-year-old Bangladeshi boy with gastric outlet obstruction after an accidental corrosive ingestion.

Corrosive ingestion in a 4 days old newborn

Background: Corrosive ingestion in children is very important and sensitive issue which result in lot of morbidity and mortality corrosive ingestion is mostly in form of acid or alkali chemical. 5000 to 15000 caustic ingestion cases are reported annually in United States. Majority of cases are accidental and can occur in any age of children but in new born it occur very rarely. Case Presentation: we are presenting a case of corrosive ingestion in 04 days old new born who was given a liquid bleed mixed with formula milk by mother considering the liquid bleed as water for the dilution of milk. Conclusion: We conclude that legislation should be done for authorizes sale of corrosive chemical and awareness campaign should be lounge through social, print and electronic media about hazards of corrosive ingestion.

Sequelae of Corrosive Injury in Children: An Observational Study.

Aim:This study aims to determine the sequelae of corrosive ingestion in children.Methods:A retrospective study was conducted in the Department of Pediatric Surgery at a Tertiary Center. The children presenting between January 2015 and December 2020 with a history of ingestion of caustic agents were included in the study.Results:A total of 26 children were included in the study. The children with suicidal attempts were significantly older than those who ingested the corrosive agents accidentally (14.2 ± 1.9 years vs. 6 ± 3.3 years; P < 0.01; Student's t-test). Sixteen (62%) children had esophageal strictures, 8 (31%) had pyloric strictures, and a child (4%) had both esophageal and gastric strictures. Eight (31%) children required an initial feeding jejunostomy and 6 (23%) required a feeding gastrostomy as they had significant weight loss on presentation. Eleven (65%) esophageal strictures responded to the dilatation regimen and are symptom-free on follow-up. Three (18%) children with esophageal stricture underwent esophageal replacement. Eight (31%) children had a pyloric stricture and all of them were treated with a modified Billroth I gastro-duodenostomy. The children who presented after 2 months were found to have a significantly increased need for esophageal replacement (3/9 vs. 0/17; P = 0.03; Fischer's exact test).Conclusion:The corrosive ingestion in children is associated with higher morbidity. The sequelae include esophageal and antro-pyloric strictures. A feeding gastrostomy or jejunostomy was required in more than half of the patients. The children presenting after 2 months of ingestion were associated with an increased need for esophageal replacement.

Pyloric stricture after corrosive ingestion in children: an attempt to address the optimum management of this rarity

Corrosive ingestion in pediatric population can have devastating consequences. Pyloric stricture which is a rarer complication has not been discussed in details in existing literature. Whereas the presentation is more or less similar, a “case specific” approach may be required for the best outcome. We analyzed our series of eight patients to formulate a suitable approach to its management. This was a prospective observational study in the department of Pediatric Surgery in a tertiary health care centre in central India. Eight (n=8) patients with corrosive injuries exclusive to the pyloric antrum were analyzed with respect to the corrosive ingested, symptomatology, nutritional status, investigation findings, surgery undertaken and follow up. Total number of patients in our study were eight. Male -7 and female-1, mean age of 6.8 years, ranging from 4 and 10 years, most common agent was acid, ingested accidentally. Period of development of gastric outlet obstruction was 23 days, range between 11 days and 33 days. Initially presented with odynophagia but later developed features of gastric outlet obstruction. Procedure performed were Heineke Mickulicz pyloroplasty and Billroth I gastroduodenostomy with FJ depending on the intra operative findings. No significant post operative complications were encountered on follow up, all the patients had improved general condition and gained adequate weight. No re do surgeries were performed. Corrosive injury of the UGI tract is not uncommon in children. Pyloric stricture as a complication is relatively rare. Parents may seek consultation late only after the child has lost reasonable amount of weight. UGI Endoscopy and UGI contrast study are indispensable to evaluate the severity of damage and formulate the optimum plan of surgery. Early surgical intervention gives excellent result. Both Pyloroplasty and Billroth I anastomosis are safe with low morbidity and excellent long term outcome.

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

Corrosive ingestion causes significant morbidity in children with no standard guidelines regarding management. This survey aimed to understand practices adopted by gastroenterologists, identify lacunae in evaluation and management and suggest a practical algorithm. Indian gastroenterologists participated in an online survey (65 questions) on managing corrosive ingestion. When ≥ 50% of respondents agreed on a management option, it was considered as 'agreement'. Ninety-eight gastroenterologists (72 pediatric) who had managed a total of ~ 2600 corrosive ingestions in the last 5 years responded. The commonest age group affected was 2-5 years (61%). Majority of ingestion was accidental (89%) with 80% due to improper corrosive storage. Ingestion ofalkali and acid was equally common (alkali 41%, acid 39%, unknown 20%). History of inducing-vomiting after ingestion by community physicians was present in 57%.There was an agreement on 77% of questions. The respondents agreed on endoscopy (70%) and chest X-ray (67%) in all, irrespective of symptoms. Endoscopy was considered safe on days 1-5 after ingestion (91%) and relatively contraindicated thereafter. The consensus was to use acid suppression, always (59%); steroids, never (68%) and antibiotics, if indicated (59%). Feeding was based on endoscopic findings: oral in mild injuries and nasogastric (NG) in others. Eighty percent placed a NG tube under endoscopic guidance. Stricture dilatation was considered safe after 4 weeks of ingestion. Agreement on duration of acid suppression and stricture management (dilatation protocol and refractory strictures) was lacking. Corrosive ingestion mostly affects 2-5-year olds and is accidental in majority. It can be potentially prevented by proper storage and labelling of corrosives. An algorithm for management is proposed.

Presentation and management outcome of childhood corrosive oesophageal injury in Benin City.

Background:Corrosive ingestion in children occurs usually at home and frequently results in debilitating strictures. Prevention and early intervention programs are very important for good outcomes.Aims and Objectives:This study aims at examining the immediate causative factors and problems of this subset of patients with a special focus on treatment and outcome. This study was to audit the management of patients in the paediatric age group who presented for treatment with history and sequelae of corrosive ingestion seen by the cardiothoracic unit of the University of Benin Teaching Hospital from January 2005 till December 2018.Materials and Methods:This is a 14year retrospective study of patients that presented with oesophageal burn injuries from ingestion of corrosive agents to the Cardiothoracic Unit at the University of Benin Teaching Hospital between January 2005 and December 2018. Essentially the first 5years were retrospectively included but the subsequent years were prospective. All available medical data on these patients were retrieved and studied for epidemiological, clinical and operative procedures and outcome.Results:A total of 49 patients were seen and admitted during the period under review. Male (29) : Female (20) ratio was 1:1.4 Mean age was 4.7±4.8 years with a range of 1-16years, The males presented earlier and had worse strictures as well as more surgical procedures. Caustic soda preparations ingested more (93.9%), all ingestions were within the household setting, and all had first aid given by way of oral palm oil. Only two (4.1%) ingested acids with only one flat battery ingestion. 45.5% of the patients had dilatation only and of these 50% recovered after 3 sessions and required no more sessions. A further 50% were lost to follow up. 38.8% had oesophageal replacement with colon following oesophagectomy.Conclusion:In conclusion, corrosive oesophageal stricture is a debilitating disease in children and affects males more, but it is treatable by multiple dilatations and oesophageal replacement with colon. Prevention should be actively pursued as well as early intervention.

Role of Speech-Language Pathologist in Pediatric Corrosive Ingestion in Zagazig University Children Hospital

Background: Pediatric corrosive ingestion injuries represent a significant proportion of total ingestion injury annually. Medical and surgical advancements over the past five decades led to significant reductions in mortality. Optimal treatment of children with ingestion injuries requires a multi-skilled team approach. Objective: The aim of the work was to assess the effects of corrosive ingestion in children and to determine the role of speech-language pathologist. Patients and methods: This cross section study was conducted on 52 patients with corrosive ingestion. The patients were admitted at Zagazig University Children Hospitals from February 2018 to February 2019. Results: Our results showed that there was high significant relation between impaired oral intake and period of admission, PICU admission, days to initiate oral feeding and grade of mucosal injury. Also, there was high significant relation between fluid, semisolid and solid dysphagia and oropharyngeal mucosal injury. Also, there was a high significant relation between oesphageal mucosa grading of injury and oropharyngeal mucosal injury. Conclusion: Children admitted to hospital with severe ingestion injury to the oral cavity, oropharynx and esophagus had significant and sustained delay in the recovery of effective PO intake milestones, with many requiring ongoing gavage feeding at hospital discharge.

Role of Speech-Language Pathologist in Pediatric Corrosive Ingestion in Zagazig University Children Hospital

Background: Pediatric corrosive ingestion injuries represent a significant proportion of total ingestion injury annually. Medical and surgical advancements over the past five decades led to significant reductions in mortality. Optimal treatment of children with ingestion injuries requires a multi-skilled team approach. Objective: The aim of the work was to assess the effects of corrosive ingestion in children and to determine the role of speech-language pathologist. Patients and methods: This cross section study was conducted on 52 patients with corrosive ingestion. The patients were admitted at Zagazig University Children Hospitals from February 2018 to February 2019. Results: Our results showed that there was high significant relation between impaired oral intake and period of admission, PICU admission, days to initiate oral feeding and grade of mucosal injury. Also, there was high significant relation between fluid, semisolid and solid dysphagia and oropharyngeal mucosal injury. Also, there was a high significant relation between oesphageal mucosa grading of injury and oropharyngeal mucosal injury. Conclusion: Children admitted to hospital with severe ingestion injury to the oral cavity, oropharynx and esophagus had significant and sustained delay in the recovery of effective PO intake milestones, with many requiring ongoing gavage feeding at hospital discharge.

A common public health problem: corrosive ingestion in children

A common public health problem: corrosive ingestion in children

Pattern of corrosive ingestion in southwestern Saudi Arabia

Background/Aims:Ingested corrosive material is a major pediatric emergency all over the world. The corrosive material can cause damage to the digestive tract, ranging from minor injury to strictures, and sometimes even death. We aimed to review the pattern of corrosive ingestion in children who had been admitted to Aseer Central Hospital in the Southwestern region of Saudi Arabia.Methods:This is a retrospective study of all children who had been admitted with a history of corrosive ingestion to Aseer Central Hospital over a period of five years period from 1990 to 1995. The records of 72 patients (38 males and 34 females) were reviewed. The data included age, sex, time lapse till admission, action taken by parents, presenting symptoms, general management given to the child, barium study, endoscopy, and the postcorrosive ingestion outcome of the child.Results:The mean age of the pediatric patients was 28 ± 20 months. Different types of corrosives were encountered. The most common type was 5.25% hypochlorite in 36 patients (50%), kerosene in 12 patients (16.7%), caustic soda in nine patients (12.5%), hydrogen chloride and N-alkyl dimethyl benzyl ammonium chloride (HC and ADB) in eight patients (11.1%), and other material in seven patients (9.7%). Endoscopy was done in 30 patients (31.7%), 14 of whom were abnormal. Barium swallow was performed in 11 patients; five of them showed strictures that required frequent dilatation whereas one needed interposition surgery.Conclusion:Corrosive injury is still a major pediatric emergency among young children. It carries a major risk of complications (mainly stricture) and requires standardized management based on evidence-based medicine.

Usefulness of early endoscopy for predicting the development of stricture after corrosive esophagitis in children

Purpose: This study was performed to demonstrate the usefulness of early endoscopy for predicting the development of stricture following corrosive ingestion in children. Methods: We conducted a retrospective study on 34 children who were brought to Seoul National University Childrens Hospital and Seoul National University Bundang Hospital for corrosive ingestion from 1989 to 2007. Results: The corrosive burns were classified as grade 0 in 8 patients, grade 1 in 2, grade 2a in 7, grade 2b in 13, and grade 3 in 4. There was no significant correlation between the presence of esophageal injury and symptoms including vomiting, dysphagia, and drooling. There was a statistically significant relation between the presence of oropharyngeal injury and esophageal injury (P=0.014). There were no complications including hemorrhage and perforation related to endoscopy. Strictures of the esophagus or the stomach developed in 12 patients (36.4%). Esophageal stricture was observed in 11 patients and pyloric stenosis in 1 patient. The endoscopic grade of mucosal injury was significantly related to the frequency of development of esophageal stricture (P=0.002). Two of eleven patients with esophageal stricture responded to repeated dilation. The remaining seven patients underwent surgery. Conclusion: Early esophagogastroduodenoscopy is not only a safe and useful diagnostic tool for children with accidental caustic ingestion but also a necessity for determining the degree and the extent of caustic burns and for predicting the development of late complications. (Korean J Pediatr 2009;52:446-452)

A different aspect of corrosive ingestion in children: Socio-demographic characteristics and effect of family functioning

Corrosive ingestion is thoroughly investigated in terms of its complications and treatment modalities but to date family functioning, behavior, attitude and knowledge of mothers of children who ingested corrosives has not been investigated and socio-demographic data has rarely been mentioned. Therefore a study was planned to investigate the socio-demographic data, family functioning, knowledge, behavior and attitude of mothers of children who ingested corrosive materials. The mothers of 50 children who ingested corrosive materials and 60 controls were asked to answer a questionnaire which included socio-demographic data and questions about their attitude, behavior and knowledge of corrosive ingestion. The mothers were also asked to reply family assessment device (FAD) and parental attitude research instrument (PARI). The average ages of the children were 5.31+/-2.32 in the corrosive group with an M:F ratio of 1:1. The level of education of both mothers (p=0.000) and fathers (p=0.000) in the corrosive group were lower than that of the controls. There was no difference between the two groups in terms of number of working mothers (p=0.085). In the corrosive group the families used to have three or more children (42%) and the socioeconomic status of this group was lower than the controls (p=0.001). In the corrosive group these substances were purchased unlabeled (64%) and kept mainly in coke bottles. The affective involvement dimension of the FAD and the attitude of over-parenting and democratic attitude dimensions of the PARI tests were significantly different in the corrosive group among mothers from lower educational level whereas no difference was detected among mothers from higher educational level in this regard. It was found that both level of education of the parents and socioeconomic factors played important role in shaping the habits that might lead to corrosive ingestion in children. For the prevention of corrosive ingestion broad based strategies including education are required.

A standardised protocol for the acute management of corrosive ingestion in children: Baskin D, Urganci N, Abbasoglu L, et al. Pediatr Surg Int 2004 (November);20:824-828

A standardised protocol for the acute management of corrosive ingestion in children: Baskin D, Urganci N, Abbasoglu L, et al. Pediatr Surg Int 2004 (November);20:824-828

A standardised protocol for the acute management of corrosive ingestion in children

Oesophageal strictures developing after caustic ingestion in children are a serious problem, and several protocols to prevent stricture formation have been proposed. A prospective clinical trial was conducted for preventing strictures in caustic oesophageal burns in a single clinic, and the results are presented. All children with caustic ingestion who had oesophagoscopy for diagnosing the severity of the burn were included in the study. Eighty-one children were included in the series, with ages ranging between 3 months and 12 years. The patients were given nothing by mouth until oesophagoscopy. IV fluids, broad-spectrum antibiotics, ranitidine, and a single-dose steroid were given. Oral burns were positive in 66 patients. Oesophagoscopy revealed a normal oesophagus in nine patients, grade 1 burn in 24, grade 2a in 21, grade 2b in 23, grade 3a in two, and grade 3b in one. Patients with grade 1 and 2a burns were discharged after oesophagoscopy. Patients with grade 2b and all grade 3 burns were given nothing by mouth for a week except water when swallowing their saliva, and were fed via total parenteral nutrition. After the 1st week, if there was no problem with swallowing, liquid foods were introduced. No intraluminal tubes were used. At the end of the 3rd week, a barium meal was administered and an upper gastrointestinal series taken. Dilatation was performed at 2-week intervals for strictures, which developed in one grade 2a patient, six grade 2b patients, and the grade 3b patient. Only one of these patients is currently on an oesophageal dilatation program. Limiting oral intake and avoiding foreign bodies in the oesophagus seem to provide a good success rate; however, further prospective studies are needed to decrease the incidence of corrosive oesophageal strictures.

Corrosive ingestion in children: A.H.B. Fyfe and A.W. Auldist. Z Kinderchir 39:229–233, (August), 1984

Corrosive ingestion in children: A.H.B. Fyfe and A.W. Auldist. Z Kinderchir 39:229–233, (August), 1984

Corrosive ingestion in children.

In the 31-year-period 1950-80 there were 560 children admitted following possible ingestion of corrosive substances. 99% being under the age of 5 years, 6 children were admitted with late complications of corrosive ingestion. Of the 554 admitted in the acute phase, 149 had burns in the mouth, and 79 of these had burns in the oesophagus which were deep circumferential in 36. These children were commenced on a regime of antibiotics, corticosteroids and daily bouginage in an attempt to prevent stricture formation. Some narrowing of the oesophagus occurred in 15 and was severe in 8.