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Journal Article

Citation

Radhakrishna V, Kumar N, Gadgade BD, Vasudev RB, Alladi A. J. Indian Assoc. Pediatr. Surg. 2022; 27(4): 435-440.

Copyright

(Copyright © 2022, Indian Association of Pediatric Surgeons, Publisher MedKnow Publications)

DOI

10.4103/jiaps.jiaps_133_21

PMID

36238332

PMCID

PMC9552654

Abstract

AIM: This study aims to determine the sequelae of corrosive ingestion in children.

METHODS: A retrospective study was conducted in the Department of Pediatric Surgery at a Tertiary Center. The children presenting between January 2015 and December 2020 with a history of ingestion of caustic agents were included in the study.

RESULTS: A total of 26 children were included in the study. The children with suicidal attempts were significantly older than those who ingested the corrosive agents accidentally (14.2 ± 1.9 years vs. 6 ± 3.3 years; P < 0.01; Student's t-test). Sixteen (62%) children had esophageal strictures, 8 (31%) had pyloric strictures, and a child (4%) had both esophageal and gastric strictures. Eight (31%) children required an initial feeding jejunostomy and 6 (23%) required a feeding gastrostomy as they had significant weight loss on presentation. Eleven (65%) esophageal strictures responded to the dilatation regimen and are symptom-free on follow-up. Three (18%) children with esophageal stricture underwent esophageal replacement. Eight (31%) children had a pyloric stricture and all of them were treated with a modified Billroth I gastro-duodenostomy. The children who presented after 2 months were found to have a significantly increased need for esophageal replacement (3/9 vs. 0/17; P = 0.03; Fischer's exact test).

CONCLUSION: The corrosive ingestion in children is associated with higher morbidity. The sequelae include esophageal and antro-pyloric strictures. A feeding gastrostomy or jejunostomy was required in more than half of the patients. The children presenting after 2 months of ingestion were associated with an increased need for esophageal replacement.


Language: en

Keywords

Acid; alkali; corrosive ingestion; esophageal dilatation; esophageal stricture; gastric outlet obstruction

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