Esophageal injuries in children caused by chemical reagents, their complications and curative options

Introduction. Chemical burns occupy the first place among all esophageal diseases in children. Currently, to choose a tactics for treating this pathology and its complications is on the front burner in pediatrics.

Material and methods. In 2001–2022, 2670 (100%) children with suspected chemical burns of the esophagus (CBE) from St. Petersburg and Leningrad Region were admitted to Filatov Children’s Municipal Clinical Hospital No. 5 in St. Petersburg. Of these, after primary fibroesophagogastroscopy (FEGS) burn lesions in the esophagus were revealed only in 1108 (41.5%) children. In 2001–2003, complications in the form of cicatricial stricture of the esophagus were registered in 22 (10.5%) children with CBE out of 209 (100%) patients. In the second group of patients, admitted in 2004–2022, the curative regimen was changed; as a result, out of 899 (100%) children esophageal stricture was detected only in 26 (2.9%). In this group of patients , the researchers applied a technique, developed by them, with optimal duration of diagnostics and volume of medical care. Of all patients with burns in the esophagus, perforation of the esophagus was registered in 7 cases. The tactics of their treatment and its effectiveness are described in the article.

Results. A comprehensive curative approach allowed to reduce the number of complications after CBE, as well as the duration of treatment in children with cicatricial strictures. The authors also demonstrate satisfactory outcomes in children having burn lesions complicated with esophageal perforation, as well as the tactics of their treatment.

Conclusion. Diagnostics and management of children with esophageal burns and their complications should be carried out in specialized hospitals having round-the-clock endoscopic service and trained pediatric surgeons, intensive care specialists experienced in managing such patients.