ABSTRACT
OBJECTIVE: This study examined a cohort of pediatric patients treated for suspected corrosive injury of the oesophagus in the ENT department between 1994 and 2003. METHODS: During the study period we examined 337 patients. All patients were treated according to an individual diagnostico-therapeutic protocol that included: foremost, early rigid oesophagoscopy; intensive medical therapy; nasogastric tube placement; and/or surgical intervention. RESULTS: Our proposed system of grading on a scale from 0 to 4 was used to classify the findings upon oesophagoscopy. One hundred eighty eight patients (55.7%) had a negative exam; 1st degree corrosive injury was present in 58 patients (17.4%); 2nd and 3rd degree injury in 81 patients (24%); and 4th degree was found in 10 patients (3%). CONCLUSIONS: Because the endoscopic findings were positive in 44% of patients with suspected corrosive injury, early rigid oesophagoscopy is indicated in all patients suspected of having corrosive injury even in the absence of clinical symptoms.
Subject(s)
Burns, Chemical/etiology , Caustics/toxicity , Esophagus/injuries , Anti-Bacterial Agents/therapeutic use , Burns, Chemical/classification , Burns, Chemical/therapy , Catheterization , Child, Preschool , Cohort Studies , Critical Care , Enzyme Inhibitors/therapeutic use , Esophageal Stenosis/chemically induced , Esophageal Stenosis/surgery , Esophagoscopy , Glucocorticoids/therapeutic use , Hospitalization , Humans , Infant , Injury Severity Score , Intubation, Gastrointestinal , Proton Pump Inhibitors , Retrospective StudiesABSTRACT
Over the past few years, the ENT clinic in Motol has noticed an alarming increase in the number of cases of severe upper GIT injury in children, in the majority of cases caused by accidental ingestion of corrosives. Suicidal and homicidal cases in the paediatric population are rare. The following case study describes an interesting episode involving ingestion of granules of the lye NaOH in 13 children of school age. We furthermore stress the importance of early endoscopic investigation in every patient with possible corrosive injury of the oesophagus. We include a brief description of the diagnostico-therapeutic algorithm applied to each such patient that was developed through interdepartmental research in Motol Faculty Hospital.
Subject(s)
Burns, Chemical/diagnosis , Caustics/adverse effects , Esophagoscopy/methods , Esophagus/injuries , Sodium Hydroxide/adverse effects , Burns, Chemical/etiology , Child , Esophagitis/chemically induced , Female , Follow-Up Studies , Humans , Male , Mouth/injuries , Treatment OutcomeABSTRACT
Over the past few years, the ENT clinic in Motol has noticed an alarming increase in the number of cases of severe upper GIT injury in children, in the majority of cases caused by accidental ingestion of corrosives. Suicidal and homicidal cases in the paediatric population are rare. The following case study describes an interesting episode involving ingestion of granules of the lye NaOH in 13 children of school age. We furthermore stress the importance of early endoscopic investigation in every patient with possible corrosive injury of the oesophagus. We include a brief description of the diagnostico-therapeutic algorithm applied to each such patient that was developed through interdepartmental research in Motol Faculty Hospital.
