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KMID : 1130320090520040446
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Korean Journal of Pediatrics
2009 Volume.52 No. 4 p.446 ~ p.452
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Usefulness of early endoscopy for predicting the development of stricture after corrosive esophagitis in children
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Park Ji-Yong
Seo Jeong-Kee
Shin Jee-Youn
Yang Hye-Ran
Ko Jae-Sung
Kim Woo-Sun
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Abstract
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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.
Conclusions: 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.
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KEYWORD
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Burns, Chemical, Caustics, Esophagitis, Esophagoscopy, Esophageal stenosis, Child
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