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. 2024 Mar 14:12:20503121241234301.
doi: 10.1177/20503121241234301. eCollection 2024.

Clinical evaluation and treatment outcomes of caustic ingestion injuries in Syrian pediatric patients: A retrospective study: Short title: High-dose steroids for pediatric caustic ingestions in Syria

Martini Nafiza  1   2 , Almasri Imad-Addin  2   3 , Almouallem Mohamad Moamen  1   2 , Khaled Raghad  1   2 , Hamdar Hussein  1   2 , Nahle Ali Alakbar  1   2 , Mahmod Jaber  1   2 ; Data Collecting Group
Affiliations

Clinical evaluation and treatment outcomes of caustic ingestion injuries in Syrian pediatric patients: A retrospective study: Short title: High-dose steroids for pediatric caustic ingestions in Syria

Martini Nafiza et al. SAGE Open Med. .

Abstract

Introduction: Accidental ingestion of caustic agents poses a significant concern in pediatric emergency departments globally. It is a growing public health concern in low-to-middle income countries, which often lack comprehensive data reporting. This study examines high doses of corticosteroid treatment outcomes of caustic ingestion injuries in Syrian pediatric patients, addressing clinical features, and associated variables.

Methods and materials: A retrospective observational study was conducted at University Pediatric Hospital from January 2016 to January 2019. Medical records were reviewed for patients aged <10 years with esophagoscopy-confirmed grade IIa, IIb, or III burns. Data collected included sociodemographics, esophagoscopy results, treatment details, and outcomes.

Results: Among 114 pediatric patients, 76 (67%) were males and 38 (33%) were females. Age groups included <1 year (11%), 1-3 years (39%), 3-5 years (29%), 5-7 years (11%), and >7 years (11%). Alkaline burns accounted for 54% of injuries, acidic for 32%, and other substances for 13%. Complications included bleeding (19%) and psychomotor disability (7%). The most common burn site was the entire esophagus (62%), with 81% having grade II burns. Healing was achieved in 71% of patients with high doses of corticosteroids treatment, and 29% required dilation, with final 92% healing rate.

Conclusion: The use of corticosteroids for esophageal strictures remains inconclusive, demanding further robust research with larger sample sizes and control groups. While our study revealed that high doses of corticosteroids treatment followed by esophageal dilation had a 92% success rate. However, our study demonstrates promising results, methodological limitations and absence of a control group underscore the need for more definitive evidence. Both alkali and acidic ingestion contribute to stricture development.

Keywords: Caustic ingestion; Chi-square test; corticosteroid treatment; esophageal strictures; pediatric patients; treatment outcomes.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Treatment protocol using high-dose steroids for pediatric caustic ingestions.
Figure 2.
Figure 2.
Illustrating the characteristics of sample patients within the healed and non-healed groups.
Figure 3.
Figure 3.
Illustrating the treatment protocol reaching the healed and non-healed groups.
See this image and copyright information in PMC

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