Prevost Allison, Talley Adam, Klepper Emily, McDonough Elizabeth
Pediatric Residency Program, Our Lady of the Lake Children's Hospital, Baton Rouge, LA, USA.
Louisiana State University Health Sciences Center, New Orleans, LA, USA.
Case Rep Pediatr. 2017;2017:1859352. doi: 10.1155/2017/1859352. Epub 2017 Apr 18.
Thermal esophageal and gastric damage from ingestion of hot liquids is poorly studied in pediatrics. Limited case reports exist in the literature. Many cases presented with chest pain, dysphagia, and odynophagia. Variable histologic findings were reported. No definitive management guidelines exist for such injuries. We provide a report of the acute assessment and management of an obvious thermal esophageal injury and contribute to what is known about this presentation. A 16-year-old male presented with odynophagia, dysphagia, and hematemesis following ingestion of "nearly boiling" mushroom water. Ondansetron, pantoprazole, ketorolac, maintenance intravenous fluids, and a clear liquid diet were started. At sixty hours after ingestion, an esophagogastroduodenoscopy (EGD) revealed blistering and edema of the soft palate and epiglottis, circumferential erythema of the entire esophagus with an exudate likely to be desquamated mucosa, and linear erythema of the body and fundus of the stomach. An EGD one month after ingestion showed no residual effects from the injury. The pantoprazole was weaned and restrictions to his diet were lifted. To better standardize care in these rare esophageal injuries, the development of a clinical care algorithm may be beneficial to provide clinicians with a guide for management based on outcomes of previously reported cases.
儿科中关于摄入热液体导致的食管和胃热损伤的研究较少。文献中仅有有限的病例报告。许多病例表现为胸痛、吞咽困难和吞咽痛。报告的组织学结果各异。对于此类损伤尚无明确的管理指南。我们报告了一例明显的热食管损伤的急性评估和处理情况，为了解这种临床表现提供了资料。一名16岁男性在摄入“近乎沸腾”的蘑菇水后出现吞咽痛、吞咽困难和呕血。开始使用昂丹司琼、泮托拉唑、酮咯酸、维持性静脉输液，并给予清流食饮食。摄入后60小时，食管胃十二指肠镜检查（EGD）显示软腭和会厌有水泡和水肿，整个食管周缘红斑伴可能为脱落黏膜的渗出物，胃体和胃底有线性红斑。摄入后一个月的EGD检查显示损伤无残留影响。泮托拉唑逐渐减量，对其饮食的限制解除。为了更好地规范这些罕见食管损伤的治疗，制定临床治疗方案可能有助于根据既往报告病例的结果为临床医生提供管理指南。
