[Accidental caustic ingestion in Tunisian child. Study of 330 cases].

We studied retrospectively 330 cases of caustic product ingestion at the child collected in the pediatric department of Sousse (CHU Sahloul and CHU Farhat Hached) during eight years (1993-2000). It is about 194 boys and 136 girls (sex-ratio to 1.42/1) aged of 4 months at 14 years (middle age at 3 years and 5 months). Concerned products are dominated by the water of bleach (55.7%) dilute essentially (49%), caustic soda (27.9%), diluent of painting (8.5%), potash (2.7%) and the acidic products (2.2%). Endoscopy showed oeso-gastric lesions in 89% of cases: oesophagitis stage I (73.5%), stage IIa (11%), stage IIb (4%), stage III (11.2%) and an inflammatory sténose case of straightaway. The associated gastric lesions have been found in 15.1% of the cases. The recovery was the rule for all patient presenting a benign oesophagitis. The 46 cases of severe oesophogitis have been treated according two protocols: --A group (n=1 ), treated by parenteral food with treatment by antibiotics (1993-1994). --B group (n=35), treated by high dose of corticosteroids (Méthyl-prednisolone) aiming to warn esophageal sténosis (1995-2000). Three patients of the A group and five of the B group developed stenosis with statistically meaningful difference (p=0.44). Among these eight patients, six required oesophagoplasty and two had a good evolution after esophageal dilation.