| Caustic Esophagitis and Gastrofiberoscopy in Children |
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Hyeon Jeong Kim, Jeong Kee Seo |
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Department of Pediatrics, Seoul National University, College of Medicine, Seoul, Korea |
| 소아 부식성 식도염의 내시경 소견 및 합병증에 관한 연구 |
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김현전, 서정기 |
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서울대학교 의과대학 소아과학교실 |
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| Abstract |
Purpose
: There have been many accidental ingestions of strong acid or alkali in early childhood.
If the patient survives the acute effects of caustic ingestion, the reparative response can result in
esophageal and gastric stenosis. However there have been few endoscopic studies on caustic
esophagitis in children. The aim of this study was to review the contribution of the endoscopy
to the diagnosis and management of eosphageal stricture and to search for the guidline of the
proper management.
Methods
: We carried out the retrospective study on 15 children who admitted to Seoul
National University Children's Hospital after accidental ingestion of caustic agents from the
March 1990 to July 1995. They all underwent flexible gastrofiberoscopy to predict the
complication of the caustic esophagitis.
Results
: The early gastrofiberoscopy showed that the 2nd degree esophageal injury was most
common and the majority of patients had diffuse, not localized esophagitis. The incidence of the
late occurance of the esophageal stenosis was higher in patients who showed more severe degree
of the esophageal mucosal damage on the early endoscopic examination. After the detection of
esophageal stenosis on follow up esophagographic examination, 7 children were initially managed
with balloon dilatation : Only 2 of them were successfully treated and 5 of them showed poor
response to dilatation and finally treated with surgical correction. One child was successfully
treated with surgical correction without trial of esophageal balloon dilatation. One child with mild
esophageal stenosis improved clinically with supportive care only including antibiotics, steroid
therapy, hyperalimentation etc.
Conclusion
: The early gastrofiberoscopic examination immediately after the accident is
essential for predicting the late occurance of the esophageal stenosis. Esophageal stenosis could
be successfully treated with esophageal balloon dilatation and/or surgical correction with caustic
esophagitis in childtren. |
| Key Words:
Caustic esophagitis, Esophageal stenosis, Gastrofiberoscope |
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