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Is early esophagoscopy necessary in the pediatric ingested caustic Substances? A retrospective clinical study

Author: 
Nazile ERTURK, Senay KURTURLUS, Alev SUZEN and Munevver HOSGOR
Subject Area: 
Health Sciences
Abstract: 

Ingestion of the corrosive substances can cause serious, even fatal, injuries in the children. There are several approaches in the treatment of the patients with esophageal injuries, including early esophagoscopy. The aim of this study was to evaluate the endoscopic findings retrospectively and correlate them with clinical progress in children ingested caustic substances, as well as to investigate whether the early esophagoscopy is necessary. In thise retrospective cohort study the patients were divided into two groups: G1-patients underwent esophagoscopy and G2- patients did not undergo esophagoscopy. We obtained 103 patients (68 male (66 %) and 35 female (34 %)) with a median age 41 months (range: 4-144 months; Mean age: 41.07 ± 31.24 months). Sixty-six children (64%; Age: 42.7 ± 29.3 months) indicated as G1 underwent early esophagoscopy (within 12-24 h postingestion), whereas 37 patients indicated as G2 did not undergo esophagoscopy (36 %; Age: 38.1 7 ± 34.1 months). In G1, two patients (3.03 %) the endoscopic findings were identified as grade IIa and IIb. On the other hand, in G2 one patient (2.70 %) was observed with stricture requiring repeated dilatation. In both groups, stricture prevalence was found similar. Among the patients, 73 of them (70.9 %) were inspected with oral burns, whereas 30 patients (29.1 %) were not showed any oral burns. No relation between the esophagoscopy findings and stricture development was observed (Pearson Chi-Square test, 2(1) = 0.01, p=0.924). No relation was determined between the stricture development and the presence of oral burns (Pearson Chi-Square test, 2(1) = 0.03, p=0.871). In our study, the prevalence of the stricture development was identified similar in both groups. As the incidence of the stricture development is regardless of esophagoscopy findings. Therefore, our results suggest that early esophagoscopy is not necessary for the caustic ingested pediatrics.

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