Strictures In Children Research Articles

Efficacy and safety of laparoscopic urethral anastomosis in the repair of congenital urethral stricture in children: a systematic review

Introduction: Congenital urethral strictures are rare but significant defects in pediatric urology, causing urinary system abnormalities. These defects are difficult to manage in children due to differences in anatomy and physiology. Laparoscopic urethral anastomosis, a minimally invasive surgery, has become a popular option in pediatric urology.Objective: The research paper was aimed to assess the outcomes of laparoscopic urethral anastomosis in the pediatric patients with congenital urethral strictureMethods: This review article focuses on the effectiveness and safety of laparoscopic urethral anastomosis in pediatric patients. It includes studies focusing on pediatric patients, surgical outcomes, and published in peer-reviewed journals. Exclusions include adult populations, non-academic studies, non-academic methods, lack of adequate outcome data, and non-academic studies. Data integration and statistical evaluation are performed using a systematic review approach.Result: The studies were selected for the analysis, and the results showed that laparoscopic urethral repair is a secure method with positive postoperative results. The subcuticular uninterrupted suturing method exhibited a reduced complication rate compared to full-thickness interrupted stitches in distal hypospadias treatment. Various suturing methods such as close and open reported various complications. Interrupted suturing in the urological surgical procedure showed a tendency for reduced incidence of urethrocutaneous fistula development. The review indicated that urethral surgical intervention showed significant positive consequences.Conclusion: It was concluded that both interrupted and continuous suturing techniques were effective in treating pediatric patients with congenital urethral strictures. However interrupted suturing showed a potential benefit. The study highlighted the need for more large-scale, randomized controlled trials to validate these findings and improve surgical methodologies and postoperative outcomes

Replacement of extended ureteral strictures in children: a multicenter experience with appendicoplasty

Introduction. The first description of ureteral appendicoplasty was provided by the Italian surgeon Giannettasio in 1901, followed by two German surgeons, Franke and Rydygier. Their work was later included in a review by Melnikoff in 1912. However, it is Melnikoff who is often erroneously credited with performing the first appendicoplasty in the literature. The first ureteral appendicoplasty operation on a 1.5-year-old child in Russia was performed by Soloviev in 1976.Objective. To report the results of performing operations on replacement of ureteral defects by ureteral appendicoplasty in children.Materials & Methods. Between 2009 and 2023, a total of 11 surgeries were conducted to replace extended ureteral defects using the appendix technique in four clinics in Russia and the Republic of Belarus. The follow-up included six boys and five girls with an average age of 79 months (ranging from 18 months to 16 years). Six operations were performed by laparoscopic access (mean operative time 356 minutes). Five operations were performed by open access (mean operative time 257 minutes).Results. Long-term results were assessed between 18 and 192 months in all patients. Urinary tract patency was evaluated based on the results of micturition cystography (in one case, vesicoureteral reflux was recorded) and intravenous urography (one case of stenosis of the distal anastomosis, which was corrected by endoscopic dissection of the stricture site using a fiberoureteroscope). In patients who underwent renoscintigraphy, no progression of renal function decline was observed. In all patients, long-term follow-up showed satisfactory urine passage.Conclusion. The results of the surgical interventions performed by us are assessed as good. In all 11 cases, the replacement of the extended ureteral stricture using an appendix allowed for the restoration of urinary flow. Furthermore, any complications that arose did not necessitate repeated reconstruction of the urinary tract. Nevertheless, it is important to note that, in our opinion, this technique cannot be considered the method of choice. Rather, it represents a last resort for patients who have undergone multiple previous operations due to severe trauma or oncological diseases. In cases involving ureteral strictures, priority should always be given to an operation involving anastomosis with sufficient ureteral length and minimal tissue tension. We firmly believe that this approach offers the best chance for a successful outcome.

Endoscopic Balloon Dilation of Esophageal Strictures in Children with Esophageal Atresia: 19 Years’ Experience

Endoscopic Balloon Dilation of Esophageal Strictures in Children with Esophageal Atresia: 19 Years’ Experience

Recurrent Esophageal Stricture in a Child Post Steven-Johnson Syndrome: A Case Report

Background: Esophageal stricture is an abnormal narrowing of the esophageal lumen, resulting in dysphagia. Despite its rarity, this condition could be caused by various etiologies, including Steven-Johnson Syndrome (SJS). In some cases, stricture could recur, which complicates the management. This case report presented a rare case of refractory esophageal stricture in children with Steven-Johnson Syndrome. Case: A 5-years-old boy with a prior history of SJS presented with dysphagia for one month. The patient experienced choking, blood vomiting, stomatitis, swelling on the lips, and difficulty in swallowing solid food. Barium meal and EGD test confirmed the diagnosis of esophageal strictures. The patient then underwent dilation using bougie dilator. However, he continued to experience dysphagia, resulting in a total of 15 serial dilation sessions. Discussion: Esophageal dysphagia is observed in patients who experience difficulty swallowing solid food. SJS can contribute to the development of esophageal dysphagia by causing inflammation of the esophageal mucosa, resulting in lesions and strictures. In patients with esophageal strictures, two types of dilation methods are available: bougie dilator with wire guidance (Savary-Gilliard) and balloon dilator, with the current consensus for dilation procedures supporting the rule of three. For patients with refractory strictures, other modalities such as mitomycin-C injection and stent placement are also available. Esophageal replacement surgery is considered as the last resort for refractory stricture patients who have not responded to previous treatments. Conclusion: Steven-Johnson Syndrome is a rare cause of esophageal strictures. The management of refractory esophageal stricture requires a comprehensive subspecialty care and long-term monitoring.

P614 Endoscopic Electroincision Therapy for Children

Abstract Background Anastomotic strictures can be successfully treated by endoscopic balloon dilation (EBD); however, the emerging modality of stricturotomy with electroincision therapy (EIT) and strictureplasty(stricturotomy followed by endoscopic clipping) may achieve superior outcomes. Endoscopic stricturotomy has been shown to have greater efficacy than EBD in adult patients with IBD. While the rate of perforation is lower in EIT as compared to EBD in IBD, stricturotomy has a 4-10% rate of delayed bleeding, with a smaller proportion requiring blood transfusion. EIT can delay the need for surgical intervention and in many circumstances obviate the need indefinitely. This study is to describe the use of EIT for luminal strictures in children. Methods Retrospective cohort study of 10 pediatric patients (including 18 procedures) with anastomotic and primary luminal stricture who underwent endoscopic EIT with stricturotomy or strictureplasty. Outcomes and complications were documented. Results Among 18 performed, 14 stricturotomy and 4 strictureplasty, 2 patients did not require further intervention and had no stricture recurrence at time of follow-up. 3 patients required repeat stricture therapy but the time duration between interventions, previously EBD, extended. There were 2 procedural complications, tension pneumoperitoneum managed by needle decompression and microperforation, neither of which required surgical repair or resection. There were no episodes of GI bleeding. Conclusion EIT for luminal stricture in children may offer an alternative to EBD or surgical resection and re-anastomosis. The relative risk in children remains to be delineated.

Clinical analysis of endoscopic esophageal dilation for the treatment of corrosive esophageal strictures in children

To investigate the clinical application of endoscopic esophageal dilation in the treatment of corrosive esophageal strictures in children. A retrospective analysis was performed on the clinical data of 15 children with corrosive esophageal strictures who underwent endoscopic esophageal dilation in Children's Hospital, Zhejiang University School of Medicine. The clinical features, treatment modality of endoscopic esophageal dilation, number of dilations, complications, and prognosis were reviewed. A total of 96 esophageal dilations were performed in the 15 children with corrosive esophageal strictures, with a median of 6 dilations per child. Among them, 9 children (60%) underwent 6 or more dilations. The children with a stricture length of >3 cm had a significantly higher number of dilations than those with a stricture length of ≤3 cm (P<0.05). The children with strictures in a single segment had a significantly better treatment outcome than those with strictures in multiple segments (P=0.005). No complication was observed during all sessions of dilation. The overall effective rate (including significant improvement and improvement) of endoscopic esophageal dilation treatment was 87%, with 2 cases of failure. Endoscopic esophageal dilation is an effective and relatively safe treatment method for corrosive esophageal strictures in children, and children with strictures in a single segment tend to have a better treatment outcome than those with strictures in multiple segments.

Efficacy of bougie versus balloon dilatation in children with benign esophageal stricture: a propensity score–matched retrospective cohort study

Background and AimsEndoscopic dilatation is the primary management of esophageal strictures in children. However, pediatric data on which of the two endoscopic techniques, bougie or balloon, is better, and the effect of endoscopic dilatation on the growth of children is lacking. We aimed to evaluate (i) whether bougie or balloon dilatation is superior in efficacy and safety for short esophageal strictures in children and (ii) the impact of endoscopic dilatation on their growth. MethodsWe performed endoscopic dilatation every 2 to 3 weekly using either a bougie or balloon and considered it adequate if we could dilate the esophageal lumen to 15 mm (11mm in < 2 years, 12mm in 2-5years of age) with complete relief of symptoms for >2 months. ResultsTwo-fifty-nine children were enrolled, with 2580 dilatations performed during the study. We performed a comparative analysis on 77 children where an exclusive bougie versus balloon dilatation was carried out for short strictures (defined as stricture length <5cm). Both bougie and balloon showed similar efficacy [sessions for adequate dilatation: 5 (2.5-7.5) vs. 4 (2-6), p=0.40] and safety [perforation rate; 0.54% vs. 0.35%, p=0.591] for short strictures. On follow-up (median of 17 months), there was a significant improvement in both weight and height z-scores in children with successful dilatation. ConclusionsEndoscopic bougie and balloon dilatations were safe and effective, with no significant difference for short strictures. Successful dilatation resulted in significant improvement in growth on follow-up.

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.

Effectiveness of sucralfate in preventing esophageal stricture in children after ingestion of caustic agents.

Ingestion of caustic agents by children is a serious health issue that can affect the patient for the rest of his life. The role of sucralfate in preventing stricture caused by caustic agents is controversial, and limited studies have been conducted in this field. We aimed to investigate the effect of sucralfate on preventing esophageal stricture in children. Sixty children with mean age of 36.69 ± 20.50months and grade II B esophageal burns due to ingestion of caustic agents were enrolled in the study. In the intervention group, in addition to the usual treatment, sucralfate was administered orally at a dose of 80mg/kg every 2h for 3days. For the control group, only the usual treatment was prescribed. Stricture development was compared between groups based on endoscopic and radiologic findings. Of the 60 patients enrolled in the study, 53 were examined. The incidence of esophageal stricture in the intervention group was significantly lower than in the control group (37% versus 67%, P-value = 0.042). In addition, the odds of esophageal stricture after sucralfate intervention was significantly reduced after adjustment for potential confounders (OR = 0.198, P-value = 0.031). Conclusions: The results of this study showed that sucralfate may reduce the development of esophageal stricture in children when used to manage IIB esophageal burns due to ingestion of caustic agents. What is Known: •Ingestion of caustic agents by children is a serious health issue that can affect the patient for the rest of his life. •The role of sucralfate in preventing stricture caused by caustic agents is controversial and limited studies have been conducted in this field. What is New: • It seems that sucralfate significantly reduces the incidence of esophageal stricture following the ingestion of caustic agents in children compared to the control group. •We believe that the prognosis may be improved and the risk of stricture formation may be reduced with high doses of sucralfate therapy in grade IIB esophageal injury.

Risk-Factor Analysis and Prediction-Model Construction of Urethral Stricture after Hypospadias Surgery in Children: A Single-Centre Retrospective Study.

This study aimed to explore the incidence of postoperative urethral stricture in children after hypospadias surgery, analyse its risk factors, and construct a prediction model. We retrospectively analysed the clinical data of 402 children with hypospadias surgery in Hunan Children's Hospital from January 2022 to January 2023. To explore the risk factors of urethral stricture after hypospadias surgery in children, the incidence of postoperative urethral stricture in children was statistically analysed, and univariate and multivariate logistic regression analyses were adopted. A prediction model was established, and the prediction efficiency of the model was examined using a receiver operating characteristic curve. The incidence of postoperative urethral stricture in children after hypospadias surgery was 9.20% (37/402). On this basis, the children were divided into stricture group (SG, n = 37) and normal group (NG, n = 365). Both groups had overt differences in disease classification, urinary tract infection, indwelling-catheter time, and surgical methods (p < 0.05). Logistic regression analysis showed that urinary tract infection, surgical methods, and long indwelling-catheter time were the risk factors (p < 0.001). The prediction model constructed based on the above results had certain prediction efficiency. More attention should be paid to children with urinary tract infection, high-risk surgery, and long indwelling-catheter time after hypospadias surgery. Our prediction model can serve as an effective reference for evaluating the occurrence of postoperative urethral stricture.

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.

Histological evaluation of esophageal stricture in children with caustic burn

Histological evaluation of esophageal stricture in children with caustic burn

The Utility of Contrast Enhanced Ultrasound and Elastography in the Early Detection of Fibro-Stenotic Ileal Strictures in Children with Crohn's Disease.

Crohn's disease (CD) is a chronic, idiopathic bowel disorder that can progress to partial or complete bowel obstruction. At present, there are no reliable diagnostic tests that can readily distinguish between acute inflammatory, purely fibrotic and mixed inflammatory and fibrotic. Our aim is to study the utility of contrast enhanced ultrasound (CEUS) in combination with shear wave elastography (SWE) to differentiate fibrotic from inflammatory strictures in children with obstructive CD of the terminal ileum. Twenty-five (19 male) children between 2016-2021 with CD of the terminal ileum were recruited into the study. Among these patients, 22 had CEUS kinetic measurements of tissue perfusion, including wash-in slope (dB/sec), peak intensity (dB), time to peak intensity (sec), area under the curve (AUC) (dB sec), and SWE. In total, 11 patients required surgery due to bowel obstruction. Histopathologic analysis was performed by a pathologist who was blinded to the CEUS and SWE test results. Patients that underwent surgical resection had significantly higher mean area under the curve on CEUS compared to patients responsive to medical therapy (p=0.03). The AUC also correlated with the degree of hypertrophy and the percent fibrosis of the muscularis propria, as determined by histopathologic grading (p<0.01). There was no difference in the mean elastography measurements between these two patient groups. CEUS is a useful radiological technique that can help identify pediatric patients with medically refractory obstructive fibrotic strictures of the terminal ileum that should be considered for early surgical resection.

Evaluation of the efficacy and safety of percutaneous nephrolithotomy in children

Background: Children represent 2-4.3% of the total population of stone formers. Currently, the majority of stones in children can be managed either with shock-wave lithotripsy (SWL), percutaneous nephrolithotomy (PCNL), ureterorenoscopy (URS), or a combination of these modalities. Open surgery is currently necessary in a few selected cases only. In our study, we wanted to evaluate the overall results of pediatric percutaneous nephrolithotomy (PCNL).Methods: This study was based on patients of age &lt;14 years who underwent PCNL at Nizam’s Institute of Medical Sciences, Hyderabad, India from January 2019 to December 2020. This was a retrospective study. Children with &gt;1 cm calculi were included and the exclusion criteria were stones of &lt;1 cm, deranged renal functions, and bleeding disorders.Results: We performed 73 PCNL procedures on 65 children, achieved complete stone clearance in 93% and residual calculi (&lt;10 mm) was seen following five cases; three patients underwent redo-PCNL. The complication rate in the present study was (16.4%) however, 100% of the total complications were minor i.e. Clavien score I and II, which were managed conservatively.Conclusions: Thus, PCNL is a suitable treatment option for children with nephrolithiasis as avoiding open surgery in children. Higher rates of failure and numerous sessions under anesthesia with short wave lithotripsy (SWL) makes it a non-viable option in children. RIRS is not widely available, non-affordable by many and long-term outcomes not clearly known with respect to ureteral strictures in children.

Endoscopic versus fluoroscopic esophageal dilatations in children with esophageal strictures: 10-year experience.

Esophageal strictures in children may cause dysphagia, choking during feeds, and failure to thrive. They can be treated by balloon dilatations, either under endoscopic or fluoroscopic guidance; there is no literature comparing the methods. Retrospective review of the medical records of children (0-18years) who were treated with balloon dilatations between 2010 and 2020. The primary outcome was the number of dilatation sessions required until clinical success after 3months. Secondary outcomes were long-term success at 12months, and complications of bleeding and perforation. Forty-six patients underwent 174 dilatation sessions. Success rates in the endoscopy and fluoroscopy groups were similar: 62% versus 67% (p = 0.454) at 3months and 57% versus 67% (p = 0.721) at 12months. Complication rate was lower in the endoscopy group (0% vs. 15%, p < 0.001). Both endoscopic and radiologic-guided balloon dilatations were shown to be equally effective, but endoscopic guidance had fewer complications.

Routine contrast enema prior to stoma reversal seems only required following treatment for necrotizing enterocolitis: An evaluation of the diagnostic accuracy of the contrast enema

IntroductionContrast enemas are often made prior to stoma reversal in order to detect distal intestinal strictures distal of the stoma. If untreated these strictures can cause obstruction which might necessitate redo-surgery. However, the value of contrast enemas is unclear. Therefore, we aim to evaluate the contrast enema's diagnostic accuracy in detecting strictures in children with a stoma. MethodsYoung children (≤3 years) treated with a stoma between 1998 and 2018 were retrospectively included. The STARD criteria were followed. Patients treated for anorectal malformations and those that died before stoma reversal were excluded. Surgical identification of strictures during reversal or redo-surgery within three months was used as gold standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under the curve (AUC) reflected diagnostic accuracy. ResultsIn 224 included children, strictures were found during reversal in 10% of which 95% in patients treated for necrotizing enterocolitis. Contrast enema was performed in 68% of all patients and detected 92% of the strictures. In the overall cohort, the sensitivity was 100%, specificity 98%, PPV 88% and NPV 100% whilst the AUC was 0.98. In patients treated for NEC, the sensitivity was 100%, specificity 97%, PPV 88% and NPV 100% whilst the AUC was 0.98. ConclusionStrictures prior to stoma reversal seem to be mainly identified in patients treated for NEC and not in other diseases necessitating a stoma. Moreover, the contrast enema shows excellent diagnostic accuracy in detecting these strictures. For this reason we advise to only perform contrast enemas in patients treated for NEC. Level of EvidenceII

Fluoroscopy-guided balloon dilatation of benign esophageal strictures in children: 11-year experience.

The esophageal stricture is an important clinical problem in children, and the treatment is difficult. To evaluate the results of fluoroscopy-guided balloon dilatation of benign pediatric esophageal strictures and to suggest a safety range for balloon diameters. We retrospectively reviewed the medical records of children who underwent fluoroscopy-guided esophageal balloon dilatation for treatment of benign esophageal stricture from February 2008 to July 2019. We recorded the demographic data of the children, technical details of each procedure, balloon diameter, number of repeated procedures, clinical and technical success rates, complications and follow-up period. Technical success was defined as the disappearance of the waist formation on the balloon catheter, and clinical success was defined as no need for re-dilation or other treatment methods during the 1-year follow-up after the procedure. These children were divided into groups and evaluated according to esophageal stricture etiology. Technically successful procedures included 375 balloon dilatations in 116 patients (67 boys; age range: 1month to 18years; mean age: 4.3 ± 4.8 standard deviation [SD] years at the initial dilatation). The follow-up period was 1-138months (median: 41months; mean: 44months) since the last dilatation. In this study, the clinical success rate was 34% per procedure (120 of 353 procedures) and 85% per patients (91 of 107 patients). The total complication rate per procedure was 0.5%, and the perforation rate was 0.25% per session. Fluoroscopy-guided esophageal balloon dilatation is an effective and reliable method for treating benign esophageal strictures in children.

Risk factors for esophageal strictures in children and adolescents with eosinophilic esophagitis

Studies in children with eosinophilic esophagitis (EoE) have reported esophageal strictures but none have examined risk factors associated with strictures. Aim: To assess risk factors associated with strictures in children with EoE. Methods: In this retrospective study, children with EoE seen over 20 years were separated into two groups; with and without strictures. Physical features, CBC, endoscopic findings, and biopsy of the distal and mid-esophagus were captured. Statistical significance with p - value and multivariate logistic regression was done. Results: Total patients 222 and 20 (9.1%) had strictures. Mean age of stricture patients 12.7 years (range 7-18) and non-stricture 9.3 years (range 1-17) (p = 0.006). Among stricture patients following were prevalent and significant; dysphagia (stricture 100% vs. non-stricture 41.6%, p = 0.0005) and food impaction (70.04% vs. 4%, p = 0.0005); EGD: rings and exudates were strongly associated with stricture, 45.0% vs. 4.5%, p = 0.0005 and 60% vs. 30.7%, p = 0.008, respectively. Abdominal pain was lower in the stricture group (5% vs. 31.2%, p = 0.017). Eosinophil counts were numerically more in the stricture group but not significant. Multivariate logistic regression confirmed that strictures are likely to occur among patients with dysphagia (p = 0.02, OR = 11.7, 95% LCL 2.0) and food impaction (p = 0.0001, OR = 80.9, 95% LCL 15.4), respectively, adjusted for age and gender. Conclusion: EoE children with dysphagia or food impaction have a higher chance of having an esophageal stricture. These EoE children 12 years or over with exudates or rings on endoscopy, should be treated and carefully monitored, to reduce the risk of stricture formation.

Caustic Esophageal Strictures in Children: Diagnosis, Treatment and Evolution in the City of Douala

Caustic Esophageal Strictures in Children: Diagnosis, Treatment and Evolution in the City of Douala

Corrosive upper gastrointestinal strictures in children: Difficulties and dilemmas.

Children constitute 80% of all corrosive ingestion cases. The majority of this burden is contributed by developing countries. Accidental ingestion is common in younger children (< 5 years) while suicidal ingestion is more common in adolescents. The severity of injury depends on nature of corrosive (alkali or acid), pH, amount of ingestion and site of exposure. There are multiple doubts and dilemmas which exist in management of both acute ingestion and chronic complications. Acute ingestion leads to skin, respiratory tract or upper gastrointestinal damage which may range from trivial to life threatening complications. Esophagogastroduodenoscopy is an important early investigation to decide for further course of management. The use of steroids for prevention of stricture is a debatable issue. Upper gastrointestinal stricture is a common long-term sequelae of severe corrosive injury which usually develops after three weeks of ingestion. The cornerstone of management of esophageal strictures is endoscopic bougie or balloon dilatations. In case of resistant strictures, newer adjunctive therapies like intralesional steroids, mitomycin and stents can be utilized along with endoscopic dilatation. Surgery is the final resort for strictures resistant to endoscopic dilatations and adjunctive therapies. There is no consensus on best esophageal replacement conduit. Pyloric strictures require balloon dilatation , failure of which requires surgery. Patients with post-corrosive strictures should be kept in long term follow-up due to significantly increased risk of carcinoma. Despite all the endoscopic and surgical options available, management of corrosive stricture in children is a daunting task due to high chances of recurrence, perforation and complications related to poor nutrition and surgery.