Featured Research

from universities, journals, and other organizations

Endoscopy May Not Be Necessary In Asymptomatic Children After Caustic Ingestion

Date:
September 30, 2008
Source:
American Society for Gastrointestinal Endoscopy
Summary:
A new study from researchers in Italy reports that endoscopy may not be necessary in children who show no symptoms after a caustic ingestion. The results demonstrated that the incidence of severe abnormalities of the esophagus in children without any early symptoms is very low and an endoscopy could be avoided.

A new study from researchers in Italy reports that endoscopy may not be necessary in children who show no symptoms after a caustic ingestion. The results demonstrated that the incidence of severe abnormalities of the esophagus in children without any early symptoms is very low and an endoscopy could be avoided.

The study appears in the September issue of GIE: Gastrointestinal Endoscopy, the monthly peer-reviewed scientific journal of the American Society for Gastrointestinal Endoscopy (ASGE).

In the pediatric population, the ingestion of caustic substances remains a difficult problem to assess because of the unclear relationship between signs and symptoms, and the extent of esophageal damage. The most efficient method for assessing the upper-gastrointestinal tract lining after a caustic ingestion is an upper endoscopy, or esophogogastroduodenoscopy (EGD). An important characteristic of cases of ingestion in the pediatric age group is that they are generally accidental, whereas in adolescents and adults, the substance was usually deliberately ingested.

"Whether or not an urgent endoscopy should be performed on children after a caustic ingestion is still a matter of debate, particularly in asymptomatic patients," said study lead author Pietro Betalli, MD, University of Padova, Padova, Italy. "Our study looked to determine if the symptoms at presentation can predict the presence of esophageal lesions. We found that the risk of severe damage increased proportionally with the number of signs and symptoms, indicating that an endoscopy should always be performed in symptomatic patients."

Patients and Methods

The multicenter observational study was conducted from January 2005 to January 2007 at hospitals in 10 Italian cities. A total of 162 children, mostly infants and toddlers, who were seen at the emergency center for caustic substance ingestion were enrolled. All cases involved accidental ingestion. An EGD was performed in children younger than 15 years old within 12 to 24 hours from the ingestion. A form was completed for each child in the emergency department by a trained pediatrician who collected information on the patient, the substance involved, and signs and symptoms. Signs and symptoms were graded as minor (oral and/or oropharyngeal lesions, and vomiting) or major (dyspnea, dysphagia, drooling, and hematemesis).

In every EGD, the esophagus, stomach and duodenum were thoroughly examined. Pediatric endoscopes were used and the procedures were performed by experienced endoscopists. Endoscopy reports were reviewed and graded for severity of esophageal injuries by a physician blinded to the initial symptoms using an endoscopic classification system for esophageal burns.

Results

Mild esophageal lesions (e.g., redness) were identified at the time of EGD in 88 percent of children. Severe lesions (third degree such as ulcers or necrosis) were seen in 12 percent of the cases. Furthermore, nine patients had gastric ulcers with all nine also having esophageal abnormalities on the EGD. Children without any signs or symptoms after an ingestion were much less likely to develop significant endoscopic findings than those who had at least three signs or symptoms (odds ratio of 0.13 v. 11.97, respectively). Of those with signs or symptoms, major complaints were more likely than minor complaints to predict esophageal damage. Severe esophageal damage at endoscopy predicted the eventual development of an esophageal stricture (14 out of 19 children).

Researchers concluded that the likelihood of finding severe esophageal damage in patients without any early signs and symptoms was very low, therefore an endoscopy could be avoided. The specific risk of the presence of third-degree lesions rises progressively with increasing numbers of signs and symptoms. The presence of three or more symptoms is an important predictor of esophageal lesions. The study notes that an endoscopy is warranted in all symptomatic children.


Story Source:

The above story is based on materials provided by American Society for Gastrointestinal Endoscopy. Note: Materials may be edited for content and length.


Cite This Page:

American Society for Gastrointestinal Endoscopy. "Endoscopy May Not Be Necessary In Asymptomatic Children After Caustic Ingestion." ScienceDaily. ScienceDaily, 30 September 2008. <www.sciencedaily.com/releases/2008/09/080926120522.htm>.
American Society for Gastrointestinal Endoscopy. (2008, September 30). Endoscopy May Not Be Necessary In Asymptomatic Children After Caustic Ingestion. ScienceDaily. Retrieved July 24, 2014 from www.sciencedaily.com/releases/2008/09/080926120522.htm
American Society for Gastrointestinal Endoscopy. "Endoscopy May Not Be Necessary In Asymptomatic Children After Caustic Ingestion." ScienceDaily. www.sciencedaily.com/releases/2008/09/080926120522.htm (accessed July 24, 2014).

Share This




More Health & Medicine News

Thursday, July 24, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

New Painkiller Designed To Discourage Abuse: Will It Work?

New Painkiller Designed To Discourage Abuse: Will It Work?

Newsy (July 24, 2014) The FDA approved Targiniq ER on Wednesday, a painkiller designed to keep users from abusing it. Like any new medication, however, it has doubters. Video provided by Newsy
Powered by NewsLook.com
Doctor At Forefront Of Fighting Ebola Outbreak Gets Ebola

Doctor At Forefront Of Fighting Ebola Outbreak Gets Ebola

Newsy (July 24, 2014) Sheik Umar Khan has treated many of the people infected in the Ebola outbreak, and now he's become one of them. Video provided by Newsy
Powered by NewsLook.com
Condemned Man's US Execution Takes Nearly Two Hours

Condemned Man's US Execution Takes Nearly Two Hours

AFP (July 24, 2014) America's death penalty debate raged Thursday after it took nearly two hours for Arizona to execute a prisoner who lost a Supreme Court battle challenging the experimental lethal drug cocktail. Duration: 00:55 Video provided by AFP
Powered by NewsLook.com
China's Ageing Millions Look Forward to Bleak Future

China's Ageing Millions Look Forward to Bleak Future

AFP (July 24, 2014) China's elderly population is expanding so quickly that children struggle to look after them, pushing them to do something unexpected in Chinese society- move their parents into a nursing home. Duration: 02:07 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

    Health News

      Environment News

        Technology News



          Save/Print:
          Share:

          Free Subscriptions


          Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

          Get Social & Mobile


          Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

          Have Feedback?


          Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
          Mobile: iPhone Android Web
          Follow: Facebook Twitter Google+
          Subscribe: RSS Feeds Email Newsletters
          Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins