title: Caustic oesophagitis in children: prevalence, the corrosive agents involved, and management from primary care through to surgery.
abstract: OBJECTIVE
  Caustic substance ingestion (CSI) remains a major health issue, particularly in developing countries, where laws are not effectively enforced. This review offers a thorough analysis of the current epidemiology, clinical features, management, treatment, and long-term complications of CSI in children.
  
  
  RESULTS
  Strong alkalis sold in liquid and granular forms, particularly crystalline grease cleaners (concentrated sodium hydroxide), are the principal causes of severe oesophageal damage. Currently, early endoscopy to assess the gastro-oesophageal mucosa is not considered necessary for all CSI cases. Oesophageal stricture is a major complication developing after CSI, and should be diagnosed and treated earlier, 10-14 days after CSI via commencement of a dilation program. Fluoroscopically guided oesophageal balloon dilatation seems to be safe, with a low frequency of complications and a high success rate. However, it should commence earlier than is currently the case, and should be performed gently, using balloons of gradually increasing diameter. If dilation fails after a few months, oesophageal replacement surgery should be performed.
  
  
  CONCLUSIONS
  Unfortunately, neither dilatation treatment nor oesophageal bypass surgery can prevent the development of oesophageal carcinoma, the incidence of which is high after CSI. The continuing unacceptably high incidence of CSI accidents would be reduced if corrosive materials were sold in their original childproof containers, highlighting the need for preventive and adult education programmes.
authors.affiliation: Department of Paediatric Surgery, Medical Faculty of Dicle University, Sur, Diyarbakir, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Uygun
mesh_terms: D000061:Accidents, Home; D002057:Burns, Chemical / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D002424:Caustics / Q000633:toxicity*; D002648:Child; D002921:Cicatrix / Q000209:etiology; D004106:Dilatation; D004938:Esophageal Neoplasms / Q000209:etiology; D004940:Esophageal Stenosis / Q000209:etiology / Q000628:therapy; D004941:Esophagitis / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D009092:Mucous Membrane / Q000473:pathology; D009336:Necrosis; D015995:Prevalence; D011320:Primary Health Care; D000267:Tissue Adhesions / Q000209:etiology
chemical_list: D002424:Caustics