%0 Journal Article
%T Morbidity and Mortality of Caustic Ingestion in Rural Children: Experience in a New Cardiothoracic Surgery Unit in Nigeria
%A E. E. Ekpe
%A V. Ette
%J ISRN Pediatrics
%D 2012
%R 10.5402/2012/210632
%X Background. Inspite of the fact that accidental caustic ingestion is an entirely easily preventable problem, it has however persisted in rural Nigerian communities because the commonly implicated agent which is caustic soda (sodium hydroxide, NaOH) is sold in open markets without restrictive legislations. This study aims to identify the perpetuating factors of paediatric caustic ingestion and recommend preventive measures. Method. Retrospective analysis of clinical records of our paediatric patients who presented following caustic ingestion between November 2006 and November 2010 was made for demography, socioeconomic status of parent(s), caustic substance ingested with amount (where known), circumstance of ingestion, means of oesophageal evaluation, treatment and outcome. Results. There were 16 paediatric cases of caustic ingestion during the study period with age ranging from 1 to 18 years with mode in the 1¨C3 years group and male£¿:£¿female ratio 4.3£¿:£¿1. In 100% of the cases, the caustic ingestion was accidental, while caustic soda was the agent in 93.7%, and 87.5% of the parents were into local soap and detergent production. In all patients, the oesophagus was evaluated with late barium swallow/meal and oesophagoscopy before treatment. Conclusion. Caustic ingestion among rural children in Nigeria can be prevented. 1. Introduction The ingestion of caustic substances induces a wide range of injuries to the gastrointestinal tract, which can be mild or fatal, or leads to chronic disease and is a worldwide problem [1, 2]. Caustic ingestion in children is usually accidental ingestion, while ingestion in adults is often due to suicidal intent, and injuries tend to be more severe [1]. Approximately 17,000 ingestions involving caustic agents were reported to US poison centres in 1988, which when extrapolated to the US population yields an estimate of approximately 26,000 ingestions of corrosive agents yearly [3]. Caustic agents with a pH level <2 or >12 rapidly penetrate layers of the esophagus resulting in necrosis-induced eschar formation in the mucosa that limits deep tissue penetration. The extent of tissue destruction depends on the physical form, type, and concentration of corrosive agent, premorbid state of the tissue, contact duration, and amount of substance ingested. Esophageal mucosa is thought to be more resistant to acidic than alkaline substances, as alkaline liquids are often highly viscous and thus persist for a longer duration in the esophageal mucosa causing liquefactive necrosis, and serious esophageal injury becomes inevitable once
%U http://www.hindawi.com/journals/isrn.pediatrics/2012/210632/