**Caustic Ingestion in Children**

**Caustic Ingestion in Children**

Alfredo Larrosa-Haro, Carmen A Sánchez-Ramírez, Johnatan M Mesa-Magaña and Edgar M Vasquez-Garibay Carmen A Sánchez-Ramírez, Johnatan M Mesa-Magaña and Edgar M Vásquez-Garibay

Additional information is available at the end of the chapter Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.68604

#### **Abstract**

Alfredo Larrosa-Haro,

Caustic ingestion (CI) is an unfortunate event that occurs in families with a poor preven‐ tion culture. Its prevalence is unknown in developing countries; it occurs mainly in chil‐ dren < 5 years and is more common in boys. The chemical caustic agents are alkaline (85%) or acid products stored in food or beverage containers without warning labels and safety caps. The immediate symptoms include salivation, oropharyngeal burns, vomiting and oropharyngeal/retrosternal pain. Upper endoscopy is the first‐line tool to identify the type and extension of oesophageal and gastric damage. A barium swallow performed 2–3 weeks after the CI may identify oesophageal stricture. Dysphagia occurs in about one‐third of cases. Regarding the nutritional status, children with dysphagia and/or oesophageal strictures may have lower fat reserves or muscle mass than the cases without these com‐ plications, meaning impaired nutritional status. All patients should be hospitalized for eval‐ uation and treatment. Hemodynamic stabilization and adequacy of the patient's airway are priorities; vomiting induction and gastric lavage are contraindicated. Methylprednisolone in II‐b oesophageal burns for 3 days diminishes the risk of stricture. Selected cases will require oesophageal dilatations, gastrostomy or oesophageal replacement by colon or stom‐ ach. There are other promising agents in the management of caustic oesophageal strictures.

DOI: 10.5772/intechopen.68604

**Keywords:** caustics, oesophageal burns, oesophageal stricture, dysphagia, child malnutrition

#### **1. Introduction**

CI in children and adolescents is an unfortunate event that may lead to significant upper gastrointestinal tract damage manifested in the short term as oesophageal burns and in the long term as oesophageal stricture or acquired motility disorders. A high proportion of

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2017 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

these patients may evolve to permanent disability associated to feeding difficulties as well as growth and nutritional impairment. The aim of the chapter is to discuss the experience with our CI paediatric patients treated in a paediatric referral hospital in the context of the pub‐ lished data from other authors.
