Caustic ingestion in children: A 6-year retrospective study

  • Cristina Lovera Division of Pediatrics, A.O. Santa Croce e Carle, Cuneo, Italy.
  • Emanuele Castagno | ecastagno@cittadellasalute.to.it A.O.U. Città della Salute e della Scienza di Torino - Regina Margherita Children’s Hospital, Department of Pediatric Emergency, Turin, Italy. http://orcid.org/0000-0001-7756-5075
  • Claudia Bondone A.O.U. Città della Salute e della Scienza di Torino - Regina Margherita Children’s Hospital, Department of Pediatric Emergency, Turin, Italy.
  • Fulvio Ricceri Department of Clinical and Biological Sciences, University of Turin, Turin; Unit of Epidemiology, Regional Health Service, ASL TO3, Grugliasco (TO), Italy.
  • Antonio F. Urbino A.O.U. Città della Salute e della Scienza di Torino - Regina Margherita Children’s Hospital, Department of Pediatric Emergency, Turin, Italy.

Abstract

Some aspects of the management of caustic ingestion in children are still debated. We aimed to determine the predictive value of epidemiological and clinical features of caustic ingestion, and to define guidelines adherence. This is a retrospective study on children ≤18 years referred to our Emergency Department over 6 years because of caustic ingestion. Statistical significance at p<0.05. Overall, 107 caustic ingestions were identified, mainly accidental <5 years (87.85%). Bleach was the most common caustic (46.73%). Forty-six patients underwent endoscopy; 57.38% children who should have endoscopy on guidelines, actually did not (p<0.0001), but no complications were reported. No or minimal lesions were reported in asymptomatic children; ≥2 symptoms correlated with the severity of lesions (p<0.0002). Therapy of severe cases was correct; overtreatment was observed for minor injuries (p<0.0001). Asymptomatic children after caustic ingestion have a very low-probability of moderate-severe endoscopic lesions, and the risk of severe damage increases proportionally with ≥2 symptoms. Prospective studies are needed to evaluate the efficacy of intensive clinical observation versus EGD on low-risk children to identify those with clinically relevant esophageal lesions.

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Published
2020-08-26
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Original Articles
Keywords:
caustics, endoscopy, children
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How to Cite
Lovera, C., Castagno, E., Bondone, C., Ricceri, F., & Urbino, A. (2020). Caustic ingestion in children: A 6-year retrospective study. Emergency Care Journal, 16(2). https://doi.org/10.4081/ecj.2020.9044