NESMOS Department, School of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea University Hospital, Rome.
Pediatric Surgery Unit, Ospedale Papa Giovanni XXIII, Bergamo.
J Pediatr Gastroenterol Nutr. 2020 Jul;71(1):19-22. doi: 10.1097/MPG.0000000000002685.
Despite the efforts to reduce the exposure to corrosive household products, caustic ingestion in children is currently a significant medical problem. The aims of the present study were to evaluate the clinical consequences of caustic ingestion and to identify prognostic factors that could concur in driving both diagnostic and therapeutic management.
All consecutive children referred for ingestion of a caustic substance from June 2017 to June 2018 were enrolled. Medical records, laboratory and endoscopic findings were reviewed and analyzed.
We enrolled 44 children with caustic ingestion. Alkaline agents were ingested by 26 of 44 (59.1%) patients, whereas acid agents were ingested by 18 of 44 patients (40.9%). Alkaline rather than acid agents were associated with a worse endoscopic score (r: 0.45) and a higher probability of early esophageal stricture occurrence (r: 0.38). The specific risk of the presence of severe esophageal lesions rose progressively with increasing number of symptoms whereas no esophageal injury was found in asymptomatic patients.
Our data suggest that endoscopic evaluation is mandatory in symptomatic patients to direct therapeutic management, but it could be avoided in asymptomatic patients after accidental ingestion, particularly if the ingestion is only suspected and patients have no oropharyngeal burns.
尽管人们努力减少接触腐蚀性家用产品，但儿童腐蚀性摄入目前仍是一个严重的医学问题。本研究旨在评估腐蚀性摄入的临床后果，并确定可能影响诊断和治疗管理的预后因素。
回顾性分析 2017 年 6 月至 2018 年 6 月间因摄入腐蚀性物质而就诊的所有连续儿童患者的病历、实验室和内镜检查结果。
共纳入 44 例腐蚀性摄入患儿。26 例（59.1%）患儿摄入碱性物质，18 例（40.9%）患儿摄入酸性物质。碱性物质与更差的内镜评分（r：0.45）和更高的早期食管狭窄发生率（r：0.38）相关。症状越多，发生严重食管损伤的特定风险就越高，而无症状患儿则未发现食管损伤。
我们的数据表明，对于有症状的患者，内镜评估是必需的，以指导治疗管理，但对于疑似意外摄入且无口咽烧伤的无症状患者，可以避免内镜检查。
