Corrosive Ingestion in Children: Clinical, Laboratory and Endoscopic Findings

Article Sidebar

PDF Download
Published Nov 10, 2023
DOI: https://doi.org/10.18103/mra.v11i10.3494

Downloads

Download data is not yet available.

Submit your own article

Register as an author to reserve your spot in the next issue of the Medical Research Archives.

Author Registration

Join the Society

The European Society of Medicine is more than a professional association. We are a community. Our members work in countries across the globe, yet are united by a common goal: to promote health and health equity, around the world.

Join Europe’s leading medical society and discover the many advantages of membership, including free article publication.

Membership

Main Article Content

Sinem Oral Cebeci, M.D.
Department of Pediatrics, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
Hasret Ayyıldız Civan, M.D.
Department of Gastroenterology, Hepatology and Nutrition; Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey

Abstract

Background and aim: Caustic substance ingestion usually occurs accidental in children or voluntary in suicidal adolescents. The tissue damage depends on type of corrosive chemicals, location of injury, duration, and amount. Endoscopy still remains as a reliable and gold standard procedure to evaluate the tissue injury. Thus, we aimed to compare the clinical, laboratory and gastroscopic findings of children presented with corrosive substance ingestion in relation with the ingested corrosive substance type in our study.


Material and Method: One hundred forty-one children and adolescents (62 female, 79 male) presented with caustic substance ingestion history within 24 hours, were evaluated retrospectively. Patients' demographic characteristics, ingested type and form (acid or base) of corrosive chemicals, gastroscopic findings, laboratory results were recorded and compared.


Results: The mean age was significantly higher in female patients (3,60±3,81) than male patients (2,27±2,89) (p=0,000). Caustic substance ingestion prevalence (69.5%) was peaked in the 0-3 age group. Of the patients 84,4% presented with no symptom. Bleacher was the most common corrosive substance (31.9%), followed by rinse aid (16.3%) and other substances (14.9%). 65,2% of caustic substance ingestions were caused by alkaline substances, and 18,4% by acidic agents. According to the gastroscopy findings underlying pathology was detected in 31,9% (n=45) of the cases. The stage I corrosive esophagitis was the most common pathology with a rate of %51,1. There were no statistically significant differences found according to the ingested form of corrosive agents [acid (34,6%) vs. base (27,2%)] between the patients with negative and positive baseline gastroscopy findings. But the mean value of neutrophile/lymphocyte ratio was statistically higher in the cases with ingested alkaline corrosive agents (0,96±0,80) than patients with ingested acidic corrosive agents (0,85±1,06) (p=0,016).


Conclusions: The findings of the present study suggest that elevated the neutrophil-lymphocyte ratio would improve diagnostic accuracy in cases with caustic substance ingestion. Therefore, widely available, simple, minimally invasive, and cost-effective hematological parameters suggest potential clinical benefits in cases with caustic injury. Furthermore, since ingestion of caustic agents is simply preventable issue in children, appropriate public education programs should provide by governments.


 

Keywords: Corrosive ingestion, Caustic injury, Corrosive agents, Pediatric Gastroscopy, Pediatric emergency

Article Details

How to Cite
CEBECI, Sinem Oral; CIVAN, Hasret Ayyıldız. Corrosive Ingestion in Children: Clinical, Laboratory and Endoscopic Findings. Medical Research Archives, [S.l.], v. 11, n. 10, nov. 2023. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/3494>. Date accessed: 15 may 2024. doi: https://doi.org/10.18103/mra.v11i10.3494.
ABNT APA BibTeX CBE EndNote - EndNote format (Macintosh & Windows) MLA ProCite - RIS format (Macintosh & Windows) RefWorks Reference Manager - RIS format (Windows only) Turabian
Issue
Vol 11 No 10 (2023): October Issue, Vol.11, Issue 10
Section
Research Articles

The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.

 

References

1. Arnold M, Numanoglu A. Caustic ingestion in children-A review. Semin Pediatr Surg. 2017 Apr;26(2):95-104.
2. Rafeey M, Ghojazadeh M, Sheikhi S, Vahedi L. Caustic ingestion in children: a systematic review and meta-analysis. Journal of caring sciences. 2016 Sep;5(3):251.
3. Ananthakrishnan N, Parthasarathy G, Kate V. Acute corrosive injuries of the stomach: A single unit experience of thirty years. ISNR Gastroenterol. 2011;2011:914013.
4. Hall AH, Jacquemin D, Henny D, Mathieu L, Josset P, Meyer B. Corrosive substances ingestion: a review. Critical reviews in toxicology. 2019 Sep 14;49(8):637-69.
5. Lupu VV, Ignat AN, Paduraru GA, Ciubara A, Ioniuc I, Ciubara AB, Gheonea CR, Burlea M. The study of effects regarding ingestion of corrosive substances in children. Rev. Chim.(Bucharest). 2016 Dec 1;67:2501.
6. Nagi B, Kochhar R, Thapa BR, Singh K. Radiological spectrum of late sequelae of corrosive injury to upper gastrointestinal tract. A pictorial review. Acta Radiol. 2004;45:7–12.
7. Abbas A, Brar TS, Zori A, Estores DS. Role of early endoscopic evaluation in decreasing morbidity, mortality, and cost after caustic ingestion: a retrospective nationwide database analysis. Diseases of the esophagus. 2017 Jun 1;30(6).
8. Betalli P, Falchetti D, Giuliani S, Pane A, Dall'Oglio L, de'Angelis GL, Caldore M, Romano C, Gamba P, Baldo V, Caustic Ingestion Italian Study Group. Caustic ingestion in children: is endoscopy always indicated? The results of an Italian multicenter observational study. Gastrointestinal endoscopy. 2008 Sep 1;68(3):434-9.
9. Riffat F, Cheng A. Pediatric caustic ingestion: 50 consecutive cases and a review of the literature. Diseases of the Esophagus. 2009 Feb 1;22(1):89-94.
10. De Jong AL, Macdonald R, Ein S, Forte V, Turner A. Corrosive esophagitis in children: a 30-year review. International journal of pediatric otorhinolaryngology. 2001 Mar 1;57(3):203-11.
11. Karaman I, Koç O, Karaman A, Erdoğan D, Çavuşoğlu YH, Afşarlar ÇE, Yilmaz E, Ertürk A, Balci Ö, Özgüner IF. Evaluation of 968 children with corrosive substance ingestion. Indian journal of critical care medicine: peer-reviewed, official publication of Indian Society of Critical Care Medicine. 2015 Dec;19(12):714.
12. Kayaalp L, Odabaşı G, Doğangün B, Çavuşoğlu P, Bolat N, Bakan M, Bozkurt P (2006). Endoskopik İzlem Gerektiren Korozif Olan Çocuk Ve Ergenlerde Kazanın Meydana Geliş Şekli Ve Aile Özelliklerinin Değerlendirilmesi. Türk Pediatri Arşivi, 41(1), 24 – 30.
13. Boskovic A, Stankovic I. Predictability of gastroesophageal caustic injury from clinical findings: is endoscopy mandatory in children? European journal of gastroenterology & hepatology. 2014 May 1;26(5):499-503.
14. Doğan Y, Erkan T, Cokuğraş FC, Kutlu T. Caustic gastroesophageal lesions in childhood: an analysis of 473 cases. Clin Pediatr (Phila) 2006; 45: 435-438.
15. Kucuk G, Gollu G, Ates U, Cakmak ZA, Kologlu M, Yagmurlu A, Aktug T, Dindar H, Cakmak AM. Evaluation of esophageal injuries secondary to ingestion of unlabeled corrosive substances: pediatric case series. Arch Argent Pediatr. 2017 Apr 1;115(2):e85-e88.
16. Sabzevari A, Maamouri G, Kiani MA, Saeidi M, Kianifar H, Jafari SA, Ahanchian H, Jarahi L, Roudi E, Sharafkhani M. Clinical and endoscopic findings of children hospitalized in Qa’em Hospital of Mashhad due to caustic ingestion (2011–2013). Electronic physician. 2017 Apr;9(4):4248.
17. Dehghani SM, Bahmanyar M, Javaherizadeh H. Caustic ingestion in children in south of Iran: a two-year single center study. Middle East journal of digestive diseases. 2018 Jan;10(1):31.
18. Briggs C. Quality counts: new parameters in blood cell counting. Int J Lab Hematol 2009; 31: 277-97.
19. Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des 2011; 17: 47-58.
20. Oylumlu M, Yuksel M, Dogan A, et al. The usefulness of plateletcrit to predict cardiac syndrome X in patients with normal coronary angiogram. Advances in Interventional Cardiology 2015;11(3):41.
21. Bakir VL, Dundar O, Bodur S, et al. Mean platelet volume as an inexpensive bio-marker of endometriosis. Int J Clin Exp Med 2016;9(6):9431-9436.
22. Sack U, Biereder B, Elouahidi T, et al. Diagnostic value of blood inflammatory markers for detection of acute appendicitis in children. BMC Surg 2006; 6:15.
23. Uyar S, Kök M. Neutrophil to lymphocyte ratio as a predictor of endoscopic damage in caustic injuries. J Clin Toxicol. 2017;7(349):2161-0495.
24. Kaya M, Ozdemir T, Sayan A, Arikan A. The relationship between clinical findings and esophageal injury severity in children with corrosive agent ingestion. Ulus Travma Acil Cerrahi Derg. 2010 Nov 1;16(6):537-40.
25. Rigo GP, Camellini L, Azzolini F, Guazzetti S, Bedogni G, et al. (2002) What is the utility of selected clinical and endoscopic parameters in predicting the risk of death aіer caustic ingestion? Endoscopy 34: 304-310
26. Rezan K, Firdevs T, Umut P, Yeşim AP, Cemil K, Zeynep K, Fatih T. Neutrophil Lymphocyte Ratio in Predicting Severity of Injury, Complications and Mortality In Caustic Ingestion Cases. Acta Medica. 2020;36:3501.
27. Siddique J, Altaf M, Khan S, Siddiqui A. Correlation of Neutrophil To Lymphocyte Ratio Endoscopic Grade Of Injury In Causatic Injuries. PalArch's Journal of Archaeology of Egypt/Egyptology. 2021;18(1):613-21.
28. Kim JH, Park JM, Kim MJ, Kim KH, Park JS, Shin DW, Kim H, Jeon WC, Kim HJ. Hematological parameters predicting complications of caustic ingestion: A Retrospective Study. Journal of the Korean Society of Emergency Medicine. 2015 Dec 30;26(6):591-7.