Publication:
Ingesta de cáusticos en niños, experiencia de 3 años

Loading...
Thumbnail Image

Date

2015-05

Authors

Losada M, María
Rubio M, María
Blanca G, Jose Antonio
Pérez A, Cristina

Advisors

Journal Title

Journal ISSN

Volume Title

Publisher

Sociedad Chilena de Pediatría
Metrics
Google Scholar
Export

Research Projects

Organizational Units

Journal Issue

Abstract

Introdución: La ingesta accidental de cáusticos en pediatría no dispone de un consenso claro de actuación. El objetivo de este estudio fue caracterizar la población pediátrica atendida por ingesta de cáusticos en un centro asistencial. Pacientes y método: Estudio descriptivo de los pacientes atendidos en nuestro hospital por la ingesta de cáusticos durante el período 2008-2011. Resultados: Se atendieron 12 pacientes, edad media de 3,8 años (1-13 años). Predominio de varones (58,8%). Un 58,3% ingirió producto alcalino y un 41,6% ácido. El 58,3% no refería sintomatología, el resto refirió vómitos (33,3%), odinofagia (16,6%), hematemesis (8,3%), sialorrea (8,3%) y dificultad respiratoria (8,3%). El 75% presentaron lesiones en la cavidad oral. Todos, salvo un caso, fueron accidentales. Se realizó endoscopia al 100% entre las 12 y 24 h postingesta con hallazgos patológicos en un 41,6%. En el grupo ingesta de álcalis 2 pacientes presentaron lesiones (16,6%): una esofagitis grado 2B y una grado 3. En el grupo ingesta de ácidos 4 pacientes (33,3%) presentaron lesiones: una esofagitis aguda grado 1-2A, 2 gastritis agudas no erosivas y una gastritis aguda hemorrágica. Se realizó endoscopia de control según los hallazgos endoscópicos previos. Solo 2 presentaron complicaciones posteriores. Conclusiones: Destacamos la valoración endoscópica en las primeras 24 h en todas las ingestas sintomáticas y deliberadas, así como la reevaluación estrecha en las ingestas ácidas, por asociar lesiones diferidas.
There is no clear consensus on the management of accidental ingestion of caustic substances in paediatrics. The aim of this study was to determine the profile of the paediatric population treated due to caustic ingestion in a Healthcare Centre. Patients and method: A descriptive study was conducted on patients treated for the ingestion of caustic substances in our hospital during the period 2008-2011. Results: A total of 12 patients were treated, with a mean age of 3.8 years (1-13 years), with the majority males (58.8%). An alkaline product was ingested by 58.3%, and an acid by 41.6%. The majority (58.3%) did not refer to symptoms and the remainder referred to vomiting (33.3%), odynophagia (16.6%), haematemesis (8.3%), hyper-salivation (8.3%) and shortness of breath (8.3%). Oral cavity lesions were observed in 75% of cases. All, except one, were accidental. An endoscopy was performed on all of them (100%) between 12 and 24 hours post-ingestion, with pathological findings in 41.6%. In the group that ingested an alkali, 2 (16.6%) patients had lesions, one a grade 2B and one a grade 3 oesophagitis. In the acid ingestion group, 4 (33.3%) patients had lesions; one grade 1-2A oesophagitis, two acute non-erosive gastritis, and one acute haemorrhagic gastritis. A follow-up endoscopy was performed depending on the previous endoscopic findings. Only two patients presented with complications. Conclusions: Emphasis is placed on the endoscopic evaluation in the first 24 hours of deliberate asymptomatic ingestions, as well as a strict follow-up in those that ingested acids, due to delayed associated lesions.

Description

MeSH Terms

Medical Subject Headings::Chemicals and Drugs::Inorganic Chemicals::Alkalies
Medical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Specialty Uses of Chemicals::Caustics
Medical Subject Headings::Named Groups::Persons::Age Groups::Child
Medical Subject Headings::Psychiatry and Psychology::Behavior and Behavior Mechanisms::Psychology, Social::Group Processes::Consensus
Medical Subject Headings::Diseases::Respiratory Tract Diseases::Respiration Disorders::Dyspnea
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Techniques, Surgical::Endoscopy
Medical Subject Headings::Diseases::Digestive System Diseases::Gastrointestinal Diseases::Esophageal Diseases::Esophagitis
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Follow-Up Studies
Medical Subject Headings::Diseases::Digestive System Diseases::Gastrointestinal Diseases::Gastroenteritis::Gastritis
Medical Subject Headings::Diseases::Digestive System Diseases::Gastrointestinal Diseases::Gastrointestinal Hemorrhage
Medical Subject Headings::Diseases::Digestive System Diseases::Gastrointestinal Diseases::Gastrointestinal Hemorrhage::Hematemesis
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Check Tags::Male
Medical Subject Headings::Anatomy::Body Regions::Head::Face::Mouth
Medical Subject Headings::Disciplines and Occupations::Health Occupations::Medicine::Pediatrics
Medical Subject Headings::Phenomena and Processes::Physiological Phenomena::Nutritional Physiological Phenomena::Nutrition Processes::Digestion::Salivation
Medical Subject Headings::Diseases::Pathological Conditions, Signs and Symptoms::Signs and Symptoms::Signs and Symptoms, Digestive::Vomiting

DeCS Terms

CIE Terms

Keywords

Ingesta cáustica, Ácido, Álcalis, Estenosis esofágica y gástrica, Endoscopía, Estudios de seguimiento, Gastritis, Hemorragia gastrointestinal

Citation

Losada M. M, Rubio M. M, Blanca G. JA,Pérez A. C. Ingesta de cáusticos en niños, experiencia de 3 años. Rev. chil. pediatr. 2015; 86 (3) 189