Keywords
Caustic esophageal stenosis; Esophageal dilation; Esophagocoloplasty; Surgery; Children
Abstract
Background: In developing countries, most of esophageal burns are seen at the step of caustic stenosis which is frequent, and their treatment is grafted with difficulties associated with lack of therapeutic means. We aim to take stock of accidental circumstances, therapeutic and evolutionary aspects of cases we treated during six years’ experience.
Materials and Methods: It was a retrospective study over 6 years in the Pediatric Surgery Department of Lomé, involved children treated for esophageal caustic stenosis. Savary-Gilliard dilators were used for dilations by laryngoscopy. Endoscopy was not available on-site. Therapeutic results were assessed on the quality of the oral feeding recovery and were considered successful in case of normal oral total swallowing; average in case of semi-solid food swallowing and bad in case of important dysphagia sequelae or death.
Results: During 6 years, 18 cases of caustic stenosis of esophagus were treated in 10 boys and 08 girls with average age of 5.03 years. Ingestion was accidental in 17 cases and intentional in 1 case. Caustic agents were a base in 17 cases and a hydrochloric acid in 1 case. UGI was implemented in 17 children. Stenosis were in the middle third in 10 children, the upper third in 5 children, the lower third in 1 child, the esophageal mouth in one child and a triple stenosis layered in 1 child. Fifteen children were treated by esophageal dilations, one had esophagocoloplasty, one is waiting for esophagocoloplasty and one was transferred to Switzerland for a pharyngo-oesophagoplasty. Results were good in 16 cases and bad in 1 case. In the latest case, the result will be appreciated after the oesophagoplasty.
Citation
Boume MA, Adabra K, Amavi AKA, Kante TB, Mihluedo-Agbolan KA, Sanni SY, et al. Management of the Caustic Stenosis of the Esophagus in Children: Six Years’ Experience in a Developing Country (Togo). SM J Pediatr Surg. 2017; 3(1): 1038.