All issues > Volume 52(4); 2009

Original Article

Korean J Pediatr. 2009;52(4):446-452. Published online April 15, 2009.

Usefulness of early endoscopy for predicting the development of stricture after corrosive esophagitis in children

Ji Yong JY Park¹, Jee Youn JY Shin¹, Hye Ran HR Yang¹, Jae Sung JS Ko¹, Woo Sun WS Kim², Jeong Kee JK Seo¹

¹Departments of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
²Departments of Radiology, Seoul National University College of Medicine, Seoul, Korea

Correspondence Jeong Kee JK Seo ,Email: jkseo@snu.ac.kr

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.

Keywords :Burns, Chemical, Caustics, Esophagitis, Esophagoscopy, Esophageal stenosis, Child