The Impact of Initial Management for Pediatric Corrosive Ingestion in a Specialized Toxicology Center “Poison Control Center Ain Shams University Hospitals (PCCASUH)” on Long Term Outcome of Corrosive Ingestion Sequels

Document Type : Original Article

Authors

1 Department of Forensic Medicine, Faculty of Medicine Ain shams Universoty

2 Pediatric Surgery,Faculty ofmedicine, ain Shams University

3 Pediatric Surgery, Faculty of Medicine, Ain Shams University

4 Pediatric Surgery Faculty of Medicine, Ain Shams University

5 Pediatric Surgery Faculty of Medicine Ain Shams University

Abstract

Background: Acute management of corrosive ingestion showing great variability among health care facilities, with some centers having experience and others lack it.
Aim of the Work: aimed to investigate the pediatric cases with corrosive ingestion presented to Poison Control Center Ain-Shams University Hospitals from Jan. 2014 to Dec. 2018 and to compare long term outcome of these patients, with those referred from other non-specialized healthcare facilities to Pediatric Surgery department of Ain Shams University
Patient and Methods: Observational retrospective study of two phases; the first included data collected from all pediatric patients’ records received, treated and referred from PCCASUH. The second included all patients’ records at pediatric surgery department with the diagnosis of corrosive ingestion during the same period, either referred from PCCASUH or other health care facilities. Subsequent grouping; group I: patients referred from PCCASUH, Group II patients referred from other healthcare facilities with analysis of their outcome (feeding gastrostomy, endoscopic dilatation alone, colonic interposition, esophageal resection and anastomosis, corrective surgery for gastric outlet obstruction, long term disability, and late mortality).
Results: The PCCASUH received 661pediatric patient during (2014-2018) with Caustic alkali represented (89.5%). Gastrointestinal manifestations were the chief presentation of the more 50% of cases. Pediatric surgery department received 59 from PCCASUH (group I), and 178 not referred from PCCASUH (group II). Although the long term disabilities (permanent tracheostomy, laryngeal injury, and retained gastrostomy) were recorded only in group II, the need for feeding gastrostomy more in (group II), was the only significant difference between both groups.
Conclusion and recommendations: Pediatric patients with acute corrosive ingestion have better long term sequels if they were initially managed in specialized toxicology center like PCCASUH. Standardization of protocols of management, establishment of communication channels with specialized toxicology center, and national registry of acute corrosive ingestion in pediatrics is mandatory.

Keywords

Zagazig Journal of Forensic Medicine and Toxicology
Volume 20, Issue 1
January 2022
Pages 210-222

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