[Caustic ingestion in children: a review of 589 cases]

ABSTRACT

Accidental ingestion of caustic substances remains frequent in children. Esophageal stricture is a severe complication of caustic esophageal burns. To study the epidemiologic features of caustic ingestion in children and to assess the management of a caustic esophageal burns. Records for 589 children hospitalized for ingestion of a caustic agent, between l990-2000, were reviewed. Hospital prevalence was 2.25%. Children with ages ranging between one and three years were observed in 53.3% of cases. Domestic products were the most common corrosive substance ingested, especially bleach which was ingested in 80.5% of cases. Upper gastro-intestinal endoscopy was performed only in 435 children. 112 patients have corrosive burns on the upper gastro-intestinal tract [25.7%] including esophagitis in 71 cases, gastric burn in nine cases and both in 32 cases. Among the 20 children having a severe oesophageal burn, nine developed strictures. Four of these received high doses of steroids at acute phase. Four cases of stricture underwent esophagoplasty. An improvement of the management t of corrosive esophageal burns is required to decrease the risk of esophageal stricture