Usefulness of early endoscopy for predicting the development of stricture after corrosive esophagitis in children.
10.3345/kjp.2009.52.4.446
- Author:
Ji Yong PARK
1
;
Jee Youn SHIN
;
Hye Ran YANG
;
Jae Sung KO
;
Woo Sun KIM
;
Jeong Kee SEO
Author Information
1. Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea. jkseo@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Burns;
Chemical;
Caustics;
Esophagitis;
Esophagoscopy;
Esophageal stenosis;
Child
- MeSH:
Burns;
Caustics;
Child;
Constriction, Pathologic;
Deglutition Disorders;
Eating;
Endoscopy;
Endoscopy, Digestive System;
Esophageal Stenosis;
Esophagitis;
Esophagoscopy;
Esophagus;
Hemorrhage;
Humans;
Pyloric Stenosis;
Retrospective Studies;
Sialorrhea;
Stomach;
Vomiting
- From:Korean Journal of Pediatrics
2009;52(4):446-452
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: This study was performed to demonstrate the usefulness of early endoscopy for predicting the development of stricture following corrosive ingestion in children. METHODS: We conducted a retrospective study on 34 children who were brought to Seoul National University Childrens Hospital and Seoul National University Bundang Hospital for corrosive ingestion from 1989 to 2007. RESULTS: The corrosive burns were classified as grade 0 in 8 patients, grade 1 in 2, grade 2a in 7, grade 2b in 13, and grade 3 in 4. There was no significant correlation between the presence of esophageal injury and symptoms including vomiting, dysphagia, and drooling. There was a statistically significant relation between the presence of oropharyngeal injury and esophageal injury (P=0.014). There were no complications including hemorrhage and perforation related to endoscopy. Strictures of the esophagus or the stomach developed in 12 patients (36.4%). Esophageal stricture was observed in 11 patients and pyloric stenosis in 1 patient. The endoscopic grade of mucosal injury was significantly related to the frequency of development of esophageal stricture (P=0.002). Two of eleven patients with esophageal stricture responded to repeated dilation. The remaining seven patients underwent surgery. CONCLUSION: Early esophagogastroduodenoscopy is not only a safe and useful diagnostic tool for children with accidental caustic ingestion but also a necessity for determining the degree and the extent of caustic burns and for predicting the development of late complications.