Esofagitis cáustica: Estenosis esofágica y su tratamiento con dilataciones

Laura Delgado; Alex Acosta; Claudio Iglesias; María Noel Tanzi; Violeta Sereno; Daniela Armas; Virginia Méndez; Alicia Montano

Authors

Laura Delgado Universidad de la República, Facultad de Medicina, Clínica Pediátrica "A" en Gastroenterología Pediátrica ", Docente colaborador. Ex Asistente
Alex Acosta Universidad de la República, Facultad de Medicina, Clínica Quirúrgica Pediátrica, Ex Prof. Adjunto
Claudio Iglesias Pediatra. Gastroenterólogo. Médico de Gastroenterología Pediátrica "A"
María Noel Tanzi Universidad de la República, Facultad de Medicina, Clínica Pediátrica "C", Prof. Adjunto. Médico de Gastroenterología Pediátrica "B"
Violeta Sereno Médico de Gastroenterología Pediátrica "A". Pediatra
Daniela Armas Médico de Gastroenterología Pediátrica "B". Pediatra. Gastroenteróloga
Virginia Méndez Universidad de la República, Facultad de Medicina, Clínica Pediátrica "A", Prof. Agdo. Gastroenterología Pediátrica "A", Jefa. Gastroenteróloga
Alicia Montano Universidad de la República, Facultad de Medicina, Clínica Pediátrica "B", Prof.

Keywords:

CAUSTIC STENOSIS, BALL DILATION

Abstract

Accidental ingestion of caustic substances during childhood is frequent. Esophageal stenosis (EE) secondary to caustic esophageal injuries (EC) is a severe complication.
Endoscopic dilation with balloon was the selected treatment for EE. Most of the patients showed good responses but required reiterative dilations. Surgical treatment is needed when there is a fail of endoscopic dilation.
The study analyzes retrospectively the development of children with EC and the treatment of those who presented esophageal stenosis.
All children with EC admitted into the Endoscopic Service (Hospital Pereira Rossell) from January 1997 to December 2002. Ninety two patients were diagnosed with esophageal injuries.
The mean age was 2.8 years; 61 males.
The ingested substance most frequently was alkaline.
Types of EC were as follow: type I, 35 (38%); type IIa, 23 (25%); type IIb, 16 (17%); type IIIa, 10 (10.8%) and type IIIb, 8 (8.7%). Nine developed to stenosis (two with esophagitis type IIb, two with type IIIa and five with type IIIb injury). Overall dilations were 168 (mean 18.6): five children did not need dilations, two are still under treatment and two children were assigned to surgery (mean follow up: 10.5 months).
Although the study population was small, we concluded that moderate and severe EC (type II and III respectively) developed more frequently to stenosis, balloon treatment was suitable and the number of complications was low.
Prevention measures are highlighted.

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