Trabelsi M, Loukhil M, Boukthir S, Hammami A, Bennaceur B
Service de pédiatrie, hôpital d'Enfants, place Bab-Saadoun, Tunisie.
Pediatrie. 1990;45(11):801-5.
The authors reviewed 125 cases of accidental ingestion of caustic substances admitted to a general pediatrics department over the last four years. L'eau de Javel (bleaching agent with sodium hypochloride) was the most frequently encountered caustic substance (89%). Esophagogastric fibroscopy was performed in 100 cases and esophageal lesions were classified according to tree grades of severity. In 46 cases, fibroscopy was normal, while severe esophagogastric lesions (grades 2 and 3) were found in 26 cases. On follow-up, six patients developed esophageal stricture, three of them after concentrated, eau de Javel ingestion. Stricture was severe in four cases, and required colonoplasty of the esophagus; it was limited in two cases and required endoscopic dilatation only. The authors emphasize the frequency and the severity of lesions caused by chloride bleach (eau de Javel) and recommend that fibroscopy be carried out in all children following ingestion of any caustic substance, even in the absence of oropharyngeal burns.
作者回顾了过去四年间收入普通儿科病房的125例腐蚀性物质意外摄入病例。次氯酸钠漂白剂(“雅韦尔水”)是最常遇到的腐蚀性物质(89%)。100例患者接受了食管胃纤维内镜检查,并根据严重程度的三个等级对食管病变进行分类。46例患者纤维内镜检查正常,26例发现严重食管胃病变(2级和3级)。随访中,6例患者出现食管狭窄,其中3例是在摄入浓缩“雅韦尔水”后出现的。4例狭窄严重,需要进行食管结肠成形术;2例狭窄较轻,仅需内镜扩张。作者强调了含氯漂白剂(“雅韦尔水”)所致病变的发生率和严重性,并建议所有摄入任何腐蚀性物质的儿童,即使没有口咽烧伤,也应进行纤维内镜检查。