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Journal of Indian Association of Pediatric Surgeons
     Journal of Indian Association of Pediatric Surgeons
Official journal of the Indian Association of Pediatric Surgeons         
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Year : 2003  |  Volume : 8  |  Issue : 2  |  Page : 80-85

Epidemiological survey on corrosive esophageal strictures in children


Department of Pediatric Surgery, All n Institute of Medical Sciences, New Delhi, India

Correspondence Address:
DK Gupta
Department of Pediatric Surgery, All n Institute of Medical Sciences, New Delhi
India
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Source of Support: None, Conflict of Interest: None


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ABSTRACT: Aim of the study: A prospective study to evaluate the incidence, mode of injury, socio economic status, educational background, initial phase management and the treatment of strictures if any, in children presenting with corrosive esophageal injuries. Materials and methods: During the period of 1999-2001, 13 children with history of corrosive esophageal injuries presenting in the age group of 1.5-10 years (mean age 4 years) at the outpatients Department of Pediatric Surgery at All India Institute of Medical Sciences, New Delhi, Were assessed for various epidemiological parameters. There were 10 boys and 3 girls. Eight patients had ingested acid while 5 had injuries with strong alkalis. During this period, no child presented to us with acute injury. Children were evaluated clinically for the degree of difficulty in swallowing with other symptoms, if any. A barium swallow was done in all for the status of esophagus, stomach and the pylorus. The initial treatment for the esophageal stricture included repeated dilatations (antegrade-5, retrograde-4, combined -4). Colonic interposition surgery was performed in children who failed to respond to repeated dilatations with six months-one year and had multiple esophageal strictures or very tight stricture resulting in loss of esophageal lumen. Results: Eight children responded to dilatations. Dilatation failed in 5 children requiring resection and end to end anastomosis (with continuation of postoperative dilatation program for next 3 and 4 months) in 2 and colonic interposition in other 3. Complications following colonic interposition included : dilatation proximal to distal anastomosis-1, food impaction-1 and stricture at the upper end of the anastomosis (within one year of surgery) requiring revision-1. Conclusion: Corrosive esophageal injuries, though uncommon in North India, have serious socio economic, educational and professional implications. Initial treatment is usually provided at home using traditional methods. The development of esophageal stricture required visits to the hospital for dilatations, surgery or to manage complications adding further stress especially to the poor and working class of parents with nuclear families. As most injuries are avoidable, a general awakening, needs to be created with the help of the media, and social and Governmental organizations






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  2005 - Journal of Indian Association of Pediatric Surgeons | Published by Wolters Kluwer - Medknow 

Online since 1st May '05