Öz
Amaç: Çocuklarda korozif madde içimine bağlı özofagus yanıkları sık görülmektedir. Çocuk cerrahisi pratiğinde sık karşılaşılan, kaza ile korozif madde alımı yaşamı tehdit eden sorunlara yol açabilmektedir. Kliniğimize korozif madde içimi nedeni ile başvurarak özofagoskopi yapılan olguların tedavi sonuçları irdelenerek geriye dönük olarak değerlendirildi. Korozif maddelerin kazayla içilmesi önemli bir sağlık sorunudur. Bu çalışmada korozif made içmiş olan 319 çocuğun retrospektif olarak incelenmesi amaçlandı.Metod: Korozif madde içimi sonrası ilk 48 saat içerisinde özofagoskopi yapılan 319 olgu değerlendirildi. 118’i kız (%37), 201’i (%63) erkek olup yaşları 1ay ile 13 yaş arasında değişiyordu. Olgularımıza ilk endoskopik değerlendirme sonucuna göre bir tedavi protokolü uygulandı. Darlık gelişerek altı aydan uzun süre ile dilatasyon işlemi gerektiren olgularda ayrıca gastroözofageal reflü (GER) araştırması yapıldı.Bulgular: Toplam 148 olguda (%46) değişik derecelerde özofagus yanığı belirlenirken bu olguların 55’inde (%37) gelişen özofagus darlığına dilatasyonlar uygulandı. Endoskopik olarak yanık derecesi Grade 2b ve 3a olan olgularımızın tümü 6 aydan uzun süren dilatasyon programına gereksinim duydular. Bu olgularda 24 saat pHmetre monitorizasyon değerlendirmesi ile GER araştırıldı. Bu olguların %41’inde patolojik düzeyde GER saptanırken, tamamında özofagusta asit temizlenme zamanının uzamış olduğu görüldü.Sonuç: Korozif madde içen çocukların %17’inde özofagus darlığı gelişmektedir. Ciddi darlık ve dilatasyona daha geç yanıt veren olgularda ek olarak GER saptanması daha sıktır. Korozif özofagus yanıklarına bağlı olarak özofagus motilite bozuklukları ve GER sıklıkla görülen durumlardır ve tedavi stratejisini belirlerken mutlaka göz önüne alınmalıdır.
Anahtar Kelimeler
Kaynakça
- de Jong AL, Macdonald R, Ein S, Forte V, Turner A. Corrosive esophagitis in children: a 30-year review. Int J Pediatr Otorhino- laryngol. 2001; 57:203-211.
- Mutaf O, Genç A, Herek O, Demircan M, Ozcan C, Arikan A. Gastroesophageal reflux: a determinant in the outcome of caustic esophageal burns. J Pediatr Surg. 1996; 31:1494- 1495.
- Doğan Y, Erkan T, Cokuğraş FC, Kutlu T. Caustic gastroesopha- geal lesions in Childhood: an analyses of 473 cases. Clin Pediatr (Phila). 2006; 45:435-438.
- Tiryaki T ,Livanelioğlu Z, Atayurt H. Early bougienage for relief of stricture formation following caustic esophageal burns. Pedi- atr Surg Int. 2005 ;21: 78-80.
- Hamza AF, Abdelhay S, Sherif H, Hasan T, Soliman H, Kabesh A, Bassiouny I, Bahnassy AF. Caustic esophageal strictures in child- ren: 30 years’ experience. J Pediatr Surg. 2003; 38:828-833.
- Wijburg FA, Heymens HS, Urbanus NA. Caustic esophageal lesions in children:prevention of stricture formation. J Pediatr Surg.1989; 24:171-173.
- Atabek C, Surer I, Demirbag S, Calıskan B, Ozturk H, Cetinkur- sun S. Increasing tendency in caustic esophageal burns and long term polytetrafluorethylene stenting in severe cases: 10 years ex- perince. J Pediatr Surg. 2007;42:636-640.
- Huang YC, Ni YH, Lai HS, Chang MH. Corrosive esophagitis in children. Pediatr Surg Int. 2004 ;20: 207-210.
- Capella M, Goldberg P, Quaresma E, Araujo E, Pereime M. Per- sistance of corrosive esophageal stricture due to gastroesophageal reflux in children. Pediatr Surg Int. 1992; 7:180-182.
- Bautista A, Varela R, Villanueva A , Estevez E, Tojo R, Cadranel S. Motor function of the esophagus after caustic burn. Eur J Pediatr Surg. 1996; 6:204-207.
- Genç A, Mutaf O. Esophageal motility changes in acute and late periods of caustic esophageal burns and their relation to progno- sis in children. J Pediatr Surg.2002; 37:1526-1528.
- Broto J, Asensio M, Jorro CS, Marhuenda C, Vernet JM, Acosta D, Ochoa JB.Conservative treatment of caustic esophageal inju- ries in children: 20 years of experience. Pediatr Surg Int.1999;15: 325.
- Hillemeier AC, Grill BB, McCallum R, Grybuski J. Esophageal and gastric motor abnormalities in gastroesophageal reflux du- ring infancy. Gastroenterology. 1983;84: 741-746.
- Maddern GJ, Jamieson GG. Oesophageal emptying in patients with gastro-oesophageal reflux. Br J Surg. 1986; 73: 615-617.
Öz
Aim: Esophageal burns as a result of accidental swallowing of caustic material are seen frequently in children. Accidental ingestion of corrosive substances remains a major health hazard in children. The aim of this study was to evaluate the management of our 319 padiatric cases of corrosive substance ingestion retrospectively.Material and methods: We retrospectively analyzed the management of 319 padiatric cases of corrosive substance ingestion in whom initial management consisted of prompt endoscopy. There were 201 male and 118 female patients, age ranges between 1 month to 13 years. Treatment protocols were chosen according to the initial endoscopic evaluation. Gastroesophageal reflux (GER) was investigated in patients who needed esophageal dilatation programme for more than 6 months.Results: 148 patients (%46) were found to have esophageal burns and 55 (37%) of them underwent treatment for stricture formation. Patients with grade 2b and 3a injuries in endoscopic evaluation needed prolonged dilatations. Severe GER and abnormal pH monitorization results were noted in 41% of these patients. Delayed acid clearence was noted in all patients who needed prolonged dilatations..Conclusion: Esophageal stricture was noted in 17% of the patients after corrosive substance ingestion. Gastroesophageal reflux was frequently encountered after the development of severe stricture and prolonged esophageal dilatations. These results indicated that disturbances of motility and GER are frequent sequelae of caustic burns of the esophagus. Treatment modality should include the treatment of the gastroesophageal reflux, and esophageal motility disorders
Anahtar Kelimeler
Kaynakça
- de Jong AL, Macdonald R, Ein S, Forte V, Turner A. Corrosive esophagitis in children: a 30-year review. Int J Pediatr Otorhino- laryngol. 2001; 57:203-211.
- Mutaf O, Genç A, Herek O, Demircan M, Ozcan C, Arikan A. Gastroesophageal reflux: a determinant in the outcome of caustic esophageal burns. J Pediatr Surg. 1996; 31:1494- 1495.
- Doğan Y, Erkan T, Cokuğraş FC, Kutlu T. Caustic gastroesopha- geal lesions in Childhood: an analyses of 473 cases. Clin Pediatr (Phila). 2006; 45:435-438.
- Tiryaki T ,Livanelioğlu Z, Atayurt H. Early bougienage for relief of stricture formation following caustic esophageal burns. Pedi- atr Surg Int. 2005 ;21: 78-80.
- Hamza AF, Abdelhay S, Sherif H, Hasan T, Soliman H, Kabesh A, Bassiouny I, Bahnassy AF. Caustic esophageal strictures in child- ren: 30 years’ experience. J Pediatr Surg. 2003; 38:828-833.
- Wijburg FA, Heymens HS, Urbanus NA. Caustic esophageal lesions in children:prevention of stricture formation. J Pediatr Surg.1989; 24:171-173.
- Atabek C, Surer I, Demirbag S, Calıskan B, Ozturk H, Cetinkur- sun S. Increasing tendency in caustic esophageal burns and long term polytetrafluorethylene stenting in severe cases: 10 years ex- perince. J Pediatr Surg. 2007;42:636-640.
- Huang YC, Ni YH, Lai HS, Chang MH. Corrosive esophagitis in children. Pediatr Surg Int. 2004 ;20: 207-210.
- Capella M, Goldberg P, Quaresma E, Araujo E, Pereime M. Per- sistance of corrosive esophageal stricture due to gastroesophageal reflux in children. Pediatr Surg Int. 1992; 7:180-182.
- Bautista A, Varela R, Villanueva A , Estevez E, Tojo R, Cadranel S. Motor function of the esophagus after caustic burn. Eur J Pediatr Surg. 1996; 6:204-207.
- Genç A, Mutaf O. Esophageal motility changes in acute and late periods of caustic esophageal burns and their relation to progno- sis in children. J Pediatr Surg.2002; 37:1526-1528.
- Broto J, Asensio M, Jorro CS, Marhuenda C, Vernet JM, Acosta D, Ochoa JB.Conservative treatment of caustic esophageal inju- ries in children: 20 years of experience. Pediatr Surg Int.1999;15: 325.
- Hillemeier AC, Grill BB, McCallum R, Grybuski J. Esophageal and gastric motor abnormalities in gastroesophageal reflux du- ring infancy. Gastroenterology. 1983;84: 741-746.
- Maddern GJ, Jamieson GG. Oesophageal emptying in patients with gastro-oesophageal reflux. Br J Surg. 1986; 73: 615-617.
Ayrıntılar
| Diğer ID | JA37SG69HF |
|---|---|
| Bölüm | Research Article |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Ağustos 2009 |
| Gönderilme Tarihi | 1 Ağustos 2009 |
| Yayımlandığı Sayı | Yıl 2009 Cilt: 3 Sayı: 2 |
The publication language of Turkish Journal of Pediatric Disease is English.
Manuscripts submitted to the Turkish Journal of Pediatric Disease will go through a double-blind peer-review process. Each submission will be reviewed by at least two external, independent peer reviewers who are experts in the field, in order to ensure an unbiased evaluation process. The editorial board will invite an external and independent editor to manage the evaluation processes of manuscripts submitted by editors or by the editorial board members of the journal. The Editor in Chief is the final authority in the decision-making process for all submissions. Articles accepted for publication in the Turkish Journal of Pediatrics are put in the order of publication, with at least 10 original articles in each issue, taking into account the acceptance dates. If the articles sent to the reviewers for evaluation are assessed as a senior for publication by the reviewers, the section editor and the editor considering all aspects (originality, high scientific quality and citation potential), it receives publication priority in addition to the articles assigned for the next issue.
The aim of the Turkish Journal of Pediatrics is to publish high-quality original research articles that will contribute to the international literature in the field of general pediatric health and diseases and its sub-branches. It also publishes editorial opinions, letters to the editor, reviews, case reports, book reviews, comments on previously published articles, meeting and conference proceedings, announcements, and biography. In addition to the field of child health and diseases, the journal also includes articles prepared in fields such as surgery, dentistry, public health, nutrition and dietetics, social services, human genetics, basic sciences, psychology, psychiatry, educational sciences, sociology and nursing, provided that they are related to this field. can be published.