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; Almasri Imad-Addin; Almouallem Mohamad Moamen; Khaled Raghad; Hamdar Hussein; Nahle Ali Alakbar; Mahmod Jaber; Data Collecting Group

doi:10.1177/20503121241234301

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

SAGE Open Med. 2024 Mar 14:12:20503121241234301. doi: 10.1177/20503121241234301. eCollection 2024.

Authors

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

¹ Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic.
² Stemosis for Scientific Research, Damascus, Syrian Arab Republic.
³ Applied Statistics Department, Damascus University, Damascus, Syrian Arab Republic.

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.