Introduction:

Caustic ingestion in children is a significant public health concern, often leading to severe gastrointestinal complications. Most cases occur accidentally in children aged 1 to 5 years, with alkali agents causing the most damage.

Objective:

This study aims to describe the clinical, epidemiological, and endoscopic features of caustic injuries in pediatric patients.

Materials and methods:

This was a retrospective, observational and descriptive study with an analytical component, performed in 16 patients who were treated between 2013 and 2023. Variables included sociodemographic data, clinical symptoms, the type of caustic agent ingested, and endoscopic findings categorized by Zargar’s classification. Endoscopy timing was analyzed as ≤24 hours, >24 hours, or not performed. Associations between endoscopy timing, injury severity, and complications were evaluated using Fisher's exact test, with p<0.05 considered significant.

Results:

A total of 16 patients were included, 10 (62.5%) were male, with a median age of 2 years (IQR 1.6-3). The most frequent symptoms were vomiting (62.5%) and dysphagia (25%). Alkalis accounted for 15 (93.7%) of cases, primarily caustic soda (62.5%). The average time to consultation was <12 hours. Endoscopic findings included grade 0 (31.3%) and IIa (25%) injuries. A significant association was observed between the timing of endoscopy and injury severity (p=0.03). Complications, mainly esophageal strictures, occurred in 25% of patients and were significantly linked to injury severity (p=0.03).

Conclusions:

Most injuries were mild to moderate, but a quarter of patients experienced complications. Early endoscopy and the severity of the injuries were significantly associated with outcomes, highlighting the importance of prompt endoscopic evaluation in these cases.

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