Urška Cvajnar
Zdravstveni dom Domžale, Domžale, Slovenija

Matevž Srpčič
Klinični oddelek za torakalno kirurgijo, Kirurška klinika, Univerzitetni klinični center Ljubljana, Ljubljana, Slovenija

Matjaž Homan
Klinični oddelek za gastroenterologijo, hepatologijo in nutricionistiko Pediatrična klinika Univerzitetni klinični center Ljubljana Katedra za pediatrijo, Medicinska fakulteta, Univerza v Ljubljani Bohoričeva 20, Ljubljana, Slovenija

Abstract

Background: Frequently in the preschool period, children accidentally ingest caustic substances (alkalis more often than acids). While the ingested quantities are usually small, caustic ingestions can cause serious gastrointestinal tract injuries, including esophageal strictures. They can be usual­ly treated with repetitive dilatations. In resistant strictures esophagectomy and reconstruction is necessary. Methods: At the department of gastroenterology, hepato­logy and nutrition, 21 children were treated from 1.1.2012 to 30.6.2018. There were 15 boys (71%) and 6 girls (29%). The majority (67%) was younger than 5 years of age. Results: The ingestion in all children was unintentional and the amount of ingested caustic substances was small. In 81% of cases the agent was alkaline, most commonly (62 %) a household cleaning product. The worst injury occurred to a boy after ingestion of a professional cleaning product. Low grade injury was observed in 79% and high grade injury in 21% of patients. Two patients developed esophageal stric­ture, mechanical dilatation was performed in one of them and an esophagectomy and reconstruction with gastric pull -up was performed on the second patient. Conclusions: Unintentional caustic agent ingestion in preschool children could be minimized or even completely prevented with education of parents and appropriate labe­ling of products on the market.

Key words: caustic ingestion, esophageal injuries, compli­cations, children