Ingestion Of Corrosive Substances Research Articles

Surgical management of upper cervical esophagus stricture caused by ingestion of corrosive substances – a single-center experience

Introduction and aim. Corrosive strictures of the upper cervical esophagus and hypopharynx are hard to treat in the operating room because there is a high chance of aspiration during swallowing after a high-up or proximal esophageal anastomosis. In this cases, we aimed to evaluate the role of intraoperative dilatation of the proximal hypopharyngeal and cervical esophageal stumps during surgery. Material and methods. Patients who underwent surgery and had upper cervical esophageal and hypopharyngeal strictures from corrosive substance ingestion were included. Results. Out of total 27 patients, 10 had a cricopharyngeal or proximal cervical esophageal stricture with a long segment tho racic esophageal stricture that was treated with intra-operative dilatation (IOD) of the proximal hypopharyngeal stump. IOD was done in two cases with Hegar’s dilator and in three cases with wire-guided Savary Gillard dilators. In 74% (20/27) of the cases, the colon was frequently used as an esophageal substitute, while the stomach was only used in 10 cases. On follow-up, none of them developed repeated aspirations or required a tracheotomy. Conclusion. IOD of the proximal hypopharyngeal and cervical esophageal stumps during surgery for corrosive upper cervi cal esophageal or cricopharyngeal strictures helps to save the proximal stump and avoid frequent hospital stays and multiple surgeries.

Pediatric endoscopy in times of pandemic: A nationwide retrospective analysis

BackgroundGastrointestinal endoscopy is a procedure that carries an increased risk of transmission of SARS-CoV-2 infection to medical staff. In patients, COVID-19 is a risk factor for adverse events of medical procedures. This study analyzed the real-life risk of, and factors contributing to, infection transmission to endoscopic personnel, and possible adverse events of the endoscopy procedure and anesthesia in children with COVID-19. MethodsNationwide retrospective analysis of medical records of children with confirmed SARS-CoV-2 infection who underwent gastrointestinal endoscopy in Poland between February 2020 and February 2022. ResultsFifty-eight patients were included in the analysis, 35% of whom had COVID-19 symptoms at the time of endoscopy. The dominant indications for endoscopy were foreign body or corrosive substance ingestion and gastrointestinal bleeding. Nine cases of virus transmission were registered among endoscopic personnel. In all of these cases, the endoscopy team was unaware of the patient's infection (p < 0.01), although symptoms were present in 78% of the children. Lack of use of personal protective equipment was the strongest predictor of SARS-CoV-2 transmission (p < 0.01). The risk of infection was not statistically significantly dependent on the method of anesthesia, intubation or the type of endoscopy. No statistically significant correlation was found between symptomatic infection and adverse events of endoscopy or anesthesia occurrence. There was one reported anesthesia-related adverse event involving extubation difficulties due to worsening respiratory infection symptoms. ConclusionsThe risk of transmitting SARS-CoV-2 to endoscopic personnel during procedures in children is low and depends on compliance with infection prevention and control measures. Performing gastrointestinal endoscopy in children with COVID-19 does not appear to be associated with an increased risk of adverse events.

Gastrointestinal mucosal damages caused by ingestion of corrosive substances: A case study of hydrochloric acid and sodium hydroxide.

Ingestion of corrosive substances is most common in children, while in adults causes more severe damages. Massive ingestion of corrosive substances results in severe damage to the gastrointestinal tract and oropharynx if not treated properly. Corrosive substances with pH<2 or >12 can result in severe esophageal damage with either colliquative (alkaline) or coagulative (acidic) necrosis and, at the same time various gastrointestinal injuries could lead to late post-corrosive complications. The aim of the case study was to report the gastrointestinal mucosal damages due to hydrochloric acid (HCl) and sodium hydroxide (NaOH) ingestion. A 55-year-old male patient was presented to the emergency room with a chief complaint of vomiting an hour before admission. Continuous vomiting with a volume of approximately 10-20 cc per vomit. The vomit was initially bluish and turned in to blackish brown over time. Other complaints included nausea, rapid breathing, heartburn, and burning mouth and throat, and had weakness and dizziness. The patient accidentally drank floor cleaning liquid containing HCl. The patient was diagnosed with hematemesis due to ulceration of esophageal, gastric, and duodenal mucosa induced by HCl. Tracheoesophageal fistula developed later in the patient as a long-term complication. Another a 22-year-old male patient was presented to the emergency room with chief complaints of nausea and vomiting an hour before admission. Headache and slight tightness were also experienced. The patient mouth felt burned pain in the solar plexus and frothy saliva. An hour earlier, the patient attempted suicide by drinking two bottles of floor cleaning liquid due to economic problems. The patient was diagnosed with erosive mucosal esophagogastroduodenum induced by NaOH. These cases highlight that intoxication with corrosive substances can complicate damage to the gastrointestinal mucosal and damage features depend on the type of substance concentration and quantity of the corrosive substance.

Diagnosis dan Tatalaksana Esofagitis Korosif

Introduction: Corrosive esophagitis is inflammation of the esophagus that occurs due to exposure to acidic or alkaline corrosive substances. Clinical symptoms is not always correlated with the degree of esophagus injury. The degree based on esophagoscopy findings is important in determining management and prognosis as an accurate predictor of complications to death. Objective: To know the diagnosis and management of corrosive esophagitis. Objective: To know the diagnosis and management of corrosive esophagitis. Literature Review: Corrosive esophagitis is most common in children caused by accidental ingestion, and in adults caused by suicide. Exposure to corrosive substances can be acids (sulfuric acid, hydrochloric acid), bases (potassium hydroxide, sodium hydroxide) and other substances. Esophagoscopy is an important examination to assess the degree of esophageal injury suspected of ingesting corrosive substances. Initial management according to the degree of esophageal injury can be in the form of observation, medical and surgical. Conclusion: Corrosive esophagitis occurs due to ingestion of corrosive substances that cause burns in the esophagus. Esophagoscopy is one of the useful diagnostics for assessing the degree of injury to the esophagus with the best time being carried out in the first 12-48 hours after ingestion of corrosive substances. The initial management of ingested corrosive substances is supportive care, observation and administration of medication or surgery according to the degree of injury to the esophagus.&#x0D;

Inadvertent caustic ingestion in children in a tertiary health facility in Enugu: critical review of three cases and current literature

Inadvertent ingestion of corrosive substances occurs frequently in children, especially in the younger age group. This could be attributed to their immaturity and the developmental stage of motor and sensory skills. The most common corrosive agent in our environment is caustic soda, which is used in soap making. This substance is usually stored in unlabelled containers without childproof safety caps. Adequate health education and effective legislation on the production, handling, and storage of corrosive substances will help mitigate the dangers of accidental ingestion in children. We present a report of three cases of unintentional caustic ingestion among children seen in Enugu and discuss the relevant literature.

Outcomes of pneumatic dilation in pediatric caustic esophageal strictures: a descriptive and analytic study from a developing country.

Corrosive substance ingestion in children represents a significant public health issue due to its long-term health sequelae. Esophageal stricture, main complication of this dangerous condition, is treated by pneumatic dilation and eventually by esophageal replacement. We aimed, through this study, to report the outcomes of esophageal pneumatic dilation complicating corrosive substance ingestion in children in a developing country. This cross-sectional study was performed on the population of pediatric patients with caustic esophageal stenosis between January 2005 and December 2020. All patients underwent pneumatic balloon dilation. A logistic regression model was built to predict the probability of the occurrence of the event (success/failure) of the dilation. The ROC curve is used to evaluate the performance of the logistic regression model to discriminate between positive and negative values of the dependent variable. The success rate of pneumatic balloon dilation was 80.4%. The median duration of overall management was 11months. The severity of caustic stricture observed during endoscopy was significantly linked to worse outcomes (p = 0.001). Multivariate analysis indicated that the severity of stenosis and the number of dilation sessions were independent risk factors for failure of dilation. ROC curve analysis showed that the area under the curve was 71.7%. A Cut-Off point value of 7 provided the best sensitivity and specificity. Pneumatic balloon dilation has been proven to be efficacious in infants with caustic esophageal stricture. Pediatric surgeons should take into account factors to promptly switch to replacement surgery and avoid unnecessary and time-consuming serial dilations.

Pyloric resection with Billroth 1 gastroduodenostomy versus bypass loop gastrojejunostomy for the management of post corrosive long segment pyloric stricture: a retrospective study

Background Accidental or suicidal ingestion of corrosive substances remains a major public health problem. Worldwide, the causative materials for corrosive injury are not the same. Surgery remains the mainstay of treatment with available different surgical options. The selected surgical technique should offer symptomatic treatment with less postoperative morbidity. Patients and methods Retrospective evaluation of 62 patients with long segment pyloric stricture postacid ingestion presenting with gastric outlet obstruction in the period between May 2017 and June 2022. They were divided into two groups, (group A (n=24), managed by Billroth 1 gastroduodenostomy; group B (n=38), managed by bypass loop gastrojejunostomy). Results In group A, the age ranged 3–59 years with a mean age of 25.7±22.62 years, while in group B, the age ranged 2.5–63 years with a mean age of 19.72±15.71 years. The type of ingested corrosive was hydrochloric acid in 60 patients (96.77%), while in two (3.23%) patients the exact acid was unknown. The interval between initial acid ingestion and symptoms of gastric outlet obstruction was 3 weeks to 18 months. In group A, the mean operative time was 64.125±7.023 min, while in group B, it was 61.763±7.837 min. Postoperative vomiting occurred in three (12.5%) patients in group A and in six (15.78%) patients in group B. In group A, the mean hospital stay was 5.5±0.932 days, while in group B, it was 4.921±1.806 days. Conclusion Billroth 1 gastroduodenostomy has the superiority of prophylaxis against long-term low risk of future malignancy. Bypass loop gastrojejunostomy is a safer alternative to Billroth 1 gastroduodenostomy, especially in the presence of severe perigastric adhesions and malnutrition. Future studies should include a large sample of patients with long periods of follow-up.

Poleptání jícnu a žaludku – nejnovější pohled na diagnostiku a léčbu

Summary Introduction: Ingestion of a corrosive substance is an infrequent but serious condition with a possible threat to life. Symptoms and diagnosis: Clinical symptoms of esophageal burns are non-specific and are determined by the degree and extent of injury Subjective symptoms do not lead to a diagnosis without information of corrosive substance ingestion. It is necessary to define the substance and find out information of its local and systemic toxicity. The next step should be an ENT examination to descibe local extent of corrosive injury in the oral cavity, pharynx and larynx and exclude severe injury and oedema of larynx and urgency of tracheostomy or intubation. A flexible endoscopy of the upper digestive tract is essential for further treatment. The aim of the endoscopic examination is to evaluate the extent of changes in the oesophagus and stomach. If GIT perforation is suspected, CT scan of the thorax and abdomen must precede the endoscopy. Treatment: In the presence of obstructive respiratory symptoms, laryngeal edema or severe burns of the airways is necessary to secure the airways as the first step. Wide-spread antibiotics should be used in the case of perforation of the oesophagus, in the third stage corrosions and in lung involvement. Corticoids are not indicated as a prevention of strictures, the only indication is to reduce oedema of the airways. Patient’s nutrition depends on degree and extent of the injury. Patients with I and II.A degree burns are nourished orally, a liquid diet for 48 hours is recommended. In patients with II.B and III. degree oral intake is excluded and nasoenteral tube is inserted for tube feeding. In case of GIT perforation, an acute surgical procedure is indicated. Stenosis of the oesophagus are frequent and severe long-term consequences of severe corrosions and long-term care and repeated interventions to restore of possibility of oral feeding could be indicated. Conclusion: Oesophageal and stomach burns are less frequent injuries. However, due to its severity, it can endanger patient’s life or its quality for long years. Multidisciplinary approach is essential in corrosive injuries management. Key words corrosion – endoscopy – corticoids – nutrition – stricture

Retrospective analysis of endoscopic dilatation for pediatric patients with esophageal stricture: Bangladesh perspective

Background and objectives: Esophageal stricture in children is an intrinsic narrowing of the esophagus due to different etiologies, including congenital anomalies, corrosive substance or foreign body ingestion, and post-esophageal surgeries. The purpose of this study is to retrospectively evaluate the results and procedures of endoscopic dilatation (ED) performed on children with esophageal strictures in a specialized center in Bangladesh. Methods: Between September 2018 and October 2022, 21 children aged 0.2 to 15 years at the time of the first procedure who underwent 48 ED sessions were included at Bangladesh Specialized Hospital (Dhaka, Bangladesh). We documented the basic characteristics of patients, indications for ED, therapeutic procedures, and outcomes. Outcome parameters were the frequency of dilatations, complications (if any), and clinical success rates. Clinical success was defined as no necessity of ED for a minimum of one year or increasing intervals among repeated dilatations. Results: Among the studied patients, the most common causes of stricture were congenital esophageal atresia and ingestion of corrosive substances. More than half of the studied patients required multiple ED sessions, with one patient requiring eight sessions who had congenital esophageal atresia with a postsurgical stricture. Dilatation was achieved mostly using Savary-Gilliard or controlled radial expansion balloons varying in sizes between 8.0 mm to 30 mm. More than 76% of the studied patients had clinical success, while the rest had clinical failures or unfinished treatment. Conclusion: ED attained good clinical success if performed by skilled gastroenterologists. However, repeated dilatation is frequent, especially in patients with a corrosive-caused stricture.

An autopsy based study of corrosive acid poisoning and its medico-legal aspects – A case report

The study is of ingestion of corrosive substances and its medico-legal aspects. Corrosive refers to any chemicals (strong acids and alkalis) that dissolve and destroy the structure of an object. Corrosives corrode and damage the tissue on contact. In dilute form it acts as an irritant. Strong acid reacts violently with water and generates heat and fire. In our study, corrosive acid ingestion and its deteriorating &amp; devastating effects ranging from signs, symptoms and internal damage leading to death have been analyzed. Here we discuss a case of an adolescent girl who ingested a corrosive substance at home, was rushed to hospital in a gasping stage where resuscitated treated and finally succumbed to death. Correlating the autopsy findings, medical treatment records and the scene of incidence was crucial to determine medico-legal aspects.

Evaluation of Corrosive Substance Ingestion in the Pediatric Emergency Department

Evaluation of Corrosive Substance Ingestion in the Pediatric Emergency Department

Emphysematous gastritis in a patient with neutropenic sepsis: A case report and literature review with comment on management.

Emphysematous gastritis is a severe form of gastritis caused by gas-forming infectious organisms and is most frequently encountered in critically unwell patients. Diagnosis rests on the radiographic appearances of air within the gastric wall, which may extend into the portal venous system. Not previously described in the context of neutropenic sepsis, our case involves a 77-year-old patient with emphysematous gastritis who was admitted to the intensive care unit with a neutrophil count of 0.1 × 109/L and managed successfully with conservative treatment. Presenting complaints usually include abdominal pain, nausea, vomiting and occasionally haematemesis, in the context of systemic upset. Predisposing factors may include diabetes and immunosuppression, ingestion of corrosive substances, alcohol abuse, and abdominal surgery. The historical approach to management which previously involved urgent exploratory laparotomy with gastrectomy, has largely been replaced with conservative therapy, including broad-spectrum antimicrobials, gut rest and parenteral nutrition, with improved outcomes. Previously considered a commonly terminal diagnosis with mortality rates as high as 60%, this recent shift in approach to management has contributed to mortality rates being halved. The role of oesophago-gastro-duodenoscopy has not been established and is unlikely to be indicated in every case. Longterm complications may be of concern and include fibrosis and gastric contractures.

Ingestion of corrosive substances and the endoscopic role in assessing the severity of caustic injury.

The ingestion of caustic substances into the upper gastrointestinal tract is an unusual but potentially life-threatening problem. To evaluate the most commonly ingested corrosive substances, and the endoscopic findings, complications, and final outcomes of caustic intake. This cross-sectional study included 220 inpatient participants with corrosive poisonings during a 3-year period (2017-2019). Data from the national patient electronic system "My term" and from the "Poisoning information centre" at the University Clinic for Toxicology, Skopje were used. Demographic characteristics, type of corrosive substance, endoscopic findings by Kikendall classification, emerging complications, fatal outcome, and hospitalization were analysed. Data obtained were analysed with the SPSS software package, version 22.0 for Windows. During the period 2017-2019, out of 220 hospitalized cases with corrosive substance intake, 132 (60%) were with ingestion of acids, 19 (8.6%) with bases, 32 (14.6%) with bleaches, and 37 (16.8%) with other household products (p = 0.3469). The mean age of patients was 49.89 ±19.86 years. The most severe endoscopy findings (high-grade injury) were significantly more often associated with acid and base ingestion (p = 0.00001). Out of all strictures, 25 (64.1%) were on one location (either oesophagus or stomach), and 12 (30.8%) were on 2 locations. Upper gastrointestinal endoscopy is very important procedure for rapid assessment of severity of caustic injury, early appropriate therapy, as well as the potential development of strictures. The obtained data are very important for the development of a national program for the prevention of corrosive poisoning in our country.

Esophageal dilation through bouginage or balloon catheters in children, as the treatment of benign esophageal strictures: results, considering the etiology, and the methods.

Corrosive substance ingestion, history of esophageal surgery, and reflux esophagitis are the main causes of benign esophageal strictures in children. Esophageal dilation is the first treatment option. Bougies and balloons are the most frequently used dilation tools. The literature record on esophageal dilation methods and their results is mostly composed of data gathered from adults, who differ from children in many terms, including etiology, indications, and results. This study aims to evaluate esophagial dilation in children; comparing the two mentioned modalities; and considering the impact of different diseases on dilation success. The benign esophageal stricture cases who had undergone esophageal dilation between 2001 and 2009, at two tertiary health-care centers of a university were evaluated retrospectively with regard to stricture etiology, treatment methods, and their results. In addition, balloon and bougie dilations were compared. Fifty-four cases were dilated in 447 sessions. The strictures were due to corrosive ingestion or anastomoses in 72.2% of the cases. Of the dilation sessions, 52.6% were performed with Savary-Gilliard bougies, and the rest with balloon dilators. No guidewire was needed in 53.2% of the bougie sessions. Fluoroscopy was used during balloon dilation sessions as a routine part of the method, while it was needed only to check the guide location when needed during the bougie dilation sessions. The complication rates of balloon and bougie dilation sessions were 2.4% and 2.1%, respectively. The mean session length was 26.2±11.8 and 42.6±13.7 min, for bougie and balloon, respectively. Success rate was 93.7% for the balloon, while 98.2% of the bougie sessions. Balloon catheters used were disposable. Savary-Gilliard bougies have advantages over balloon catheters with less need of fluoroscopy, shorter duration of sessions, and lower cost. Both methods are equivalently safe with close complication rates.

Korozif Madde Alan Çocukların Hastane Süreci: Türkiye'de Tek Merkezli Retrospektif Çalışma

Objective: This study retrospectively was aimed to determine how the treatment and care processes of children ingestion corrosive substances are maintained. Material and Methods: The population of the study is children with ingested corrosive substances, and the sample consisted of pediatric patients who ingestion corrosive substances from the pediatric surgery department of a university hospital in western Türkiye. Medical and nursing files of children with corrosive substance ingestion from the university's electronic patient file were examined. The sample of the study consisted of 70 pediatric patients who came between the years 2018-2021. The analysis of data was calculated using SPSS 24.0 program, frequency, percentage, median, interquartile range, comparison analysis and logistic regression. Results: The median age at first admission of pediatric patients was 4.0 years and 57.1% were girls. 35.7% of the pediatric patients due to oil consumption, 30.0% of them applied to the pediatric surgery department in the summer season, and the hospital was not the first application center for 61.4%. According to the Rush Medicus Patient Classification System, 40% of the children were defined as low-level dependent patients. The first arrival age of children affects the level of nursing dependency. It was determined that the rate of dilatation in pediatric patients varied according to the hospital first application center. Conclusion: As a result, although the dependency level of the children taking corrosive substances to the nurse is low, it was determined that the child's first admission age and dilatation status affect the level of addiction.

ACUTE POISONINGS WITH CORROSIVE SUBSTANCES – NEW FINDINGS AND REVIEW OF OUR FIVE-YEAR MATERIAL

Ingestion of corrosive chemical substances remains a serious problem in modern clinical toxicology due to its high mortality rate in the acute phase and the risk of serious, long-term complications during the chronic phase. Findings in this study are based on a five-year material (2017-2021), retrospectively collected from patients’ records at the University Clinic for Toxicology and Urgent Internal Medicine in Skopje, Macedonia. It is a review of our clinical experience, discussion on the results of articles found in the Pub Med database and data citied in various articles related to management of acute corrosive poisonings. This type of poisonings happens after an accidental or aware contact with corrosive substances, usually in suicide attempts. Mainly they happen after ingestion of corrosive chemicals, but often we witness injuries of respiratory organs as a result of inhalation of corrosive fumes, or dermal burns, after direct contact with the skin. There are various types of corrosive chemicals, but the majority of cases report contact with acids. In the diagnosis of this type of intoxications, we use upper endoscopy as a gold standard for quick and proper diagnosis. Nowadays, early computerized tomography is also a recommended procedure for an early evaluation and intervention. Treatment is based on the clinical condition of patients and it mainly consists of intravenous fluids, antacids, antibiotics, sedatives and protocols for artificial nutrition

COVID-19 pandemic and lockdown: what has changed in common home accidents such as foreign bodies and corrosive injuries?

BackgroundCOVID-19 pandemic greatly affected our lives in all areas. Due to the social isolation policies implemented during this period, the majority of parents and all school-age children spent their lives at home. This study aims to investigate the effects of pandemic and isolation on home accidents treated in our center.MethodsForeign body ingestion (gastric foreign bodies: G.FB), foreign body aspiration (respiratory foreign bodies: R.FB), and corrosive substance (CS) ingestion cases admitted to our hospital between March 11, 2019, and March 10, 2021, were retrospectively analyzed. Demographic data, type and cause of home accidents, the time of the accident and the admission to the hospital, the location of the foreign body, and the follow-up data were recorded. The patients were divided into two groups: the pre-pandemic period (11 March 2019–10 March 2020) and the COVID pandemic period (11 March 2020–10 March 2021), and the data were evaluated between two groups as < 6 years old and 6–18 years old.ResultsDuring the 2 years, a total of 982 patients were admitted to our hospital for G.FB, R.FB, or CS. Four hundred and eighty-three of them (49.2%) were in the pre-pandemic period and 499 (50.8%) were in the pandemic period (p = 0.206). The mean age of the patients was 3.63 ± 3.32 years; 82.4% of the patients in the pre-pandemic group and 85.4% of the patients in the pandemic group were children < 6 years old. While the F/M ratio was 1/1.5 during the pre-pandemic period, it was 1/1.1 during the pandemic period. Of the cases, 73.3% were G.FB, 4.6% were R.FB, and 22.1% were CS. Almost half of the accidents occurred between the hours of 16 and 24. During the pandemic period, the accidents increased to occur between 0 and 8 am in children < 6 years old, and between 8 am and 4 pm in children 6–18 years old (p = 0.003). All of the home accidents in the 6–18 age group between 0 and 8 o'clock were girls (p < 0.0001). During the pandemic period, the frequency of button batteries and food products increased in G.FB. Also, the frequency of R.FB increased significantly (p = 0.006) and the most common R.FB was the food products. The frequency of CS increased in girls during the pandemic period, and CSs were brought to the hospital in a shorter time after the accident during the pandemic period (p = 0.007).ConclusionsIt can be thought that the main reason why home accidents are common in the 0–6 age group is due to the developmental characteristics of the child rather than the longer time spent at home. The pandemic and isolation increase the frequency of foreign body aspirations and home accidents in girls.

Case report: Airway management in post corrosive poisoning

Corrosive substance ingestion in the acute phase may result in laryngeal injury, endotracheal or bronchial necrosis with mediastinitis, esophagus perforation. Most common late complications are fibrosis and strictures. Pharyngeal web is a rare anamoly which can be seen congenitally or after corrosive ingestion characterized by mucosal bands extending from the posterior pharyngeal wall anteriorly to the glottis. Challenges in anaesthetic management includes securing difficult airway due to distorted upper airway anatomy. Here, we report a case of pharyngeal web where we safely secured airway without injury to the webs with the use of video laryngoscope.

A suicidal heavy metal poisoning mimicking corrosive acid poisoning: A rare case report

Ingestion of corrosive substances may cause severe to serious injuries of the upper aero-digestive tractand the poisoning can even result in death. Acute corrosive intoxications pose a major problem in clinical toxicology since the most commonly affected population are the young with psychic disorders, suicidal intent and alcohol addiction. In our case report, a 19-year-old male, 2year engineering student committed suicide by consuming a heavy metal salt available in his chemistry lab after leaving a suicidal note. He got treated in a private hospital for 2 days and later he succumbed due to poisoning. Though the findings of this heavy metal poisoning mimicks corrosive acid poisoning, it has to be viewed through the eye of forensic toxicology for a clear view in clinching the diagnosis in the earlier phase of treatment.

The effects of hesperidin on stricture formation in corrosive esophageal burns: an experimental study

Esophageal strictures in children that develop as a result of accidental ingestion of corrosive substances remain an important health problem. The purpose of this study is to determine the effects of Hesperidin, an effective bioflavonoid in the proliferative and exudative phase of inflammation, on the stricture formation in corrosive esophageal burns. Experimental esophageal burns in rats were created using a modified Gehanno and Guedon model with 20% NaOH. Rats were divided into 5 groups. In the Sham group, the distal esophagus was prepared and cannulated according to the model, but no NaOH was administrated. The esophageal burn was created with NaOH in the other groups. The burned groups were divided into two groups as untreated (T14, T21) and treated with 100mg/kg/day Hesperidin (H14, H21) intraperitoneally, and these groups were divided into two according to their sacrification periods (14 and 21days). Inflammation, fibrosis, and necrosis were graded by histopathological evaluation in all groups. The efficacy of treatment was evaluated using the weight of rats, stenosis index, and histopathological parameters. Histopathologic damage scores such as inflammation, necrosis, and fibrosis were lower in the H14 and H21 groups and higher in the T14 and T21 groups. And also stenosis index was found higher in T14 and T21 groups (p < 0.05), while it was similar to the Sham group in H14 and H21 groups. No statistically significant difference was found between the H14 and H21 groups in terms of stenosis index. When weights of the rats at the beginning and end of the experiment were compared, weights of the H14 and H21 groups and the Sham group were similar. There was a significant decrease in the weight of the rats in the T14 and T21 groups (p < 0.001). This study is the first to use Hesperidin in preventing esophageal damage in an esophageal caustic burn model. It was shown that Hesperidin was effective in reducing macroscopic and microscopic histopathologic damage in the corrosive esophageal burn model, preventing the stricture formation, and has positive effects on nutrition in rats with an esophageal burn.