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548 Linear Growth and Body Mass Index in Infants and Children after Caustic Ingestion
  1. A Soliman1,
  2. W Saleem2,
  3. A Elawwa1,
  4. M Wagdy1,
  5. H Abdelrahman1
  1. 1Pediatrics
  2. 2Pediatric Emergency, Hamad Medical Center, Doha, Qatar

Abstract

Caustic injuries continue to be a significant morbidity in the pediatric patient group. Management of caustic ingestion in children remains a difficult challenge, with the outcome ranging from an asymptomatic state to esophageal strictures and variable effects on linear growth and weight gain.

We recorded and analyzed the growth data of 10 children ranging in age from 1 to 4 years with caustic ingestion presented from 2005 to 2007 and treated at Hamad Medical Center. Initial management consisted of prompt endoscopy and early institution of steroids and antibiotics. The decision on esophagoscopy was made on the basis of drooling and dysphagia. Significant esophageal burns were confirmed in all of them and subsequently five of them were managed successfully by repeated dilation due to multiple strictures.

None of the patients had underweight and/or stunting for 2 years after treatment. However, the BMI decreased from 16.77 +/– 3.5 kg/m2 to 16.26 +/– 2.9 kg/m2 and the height standard deviation score (HtSDS) decreased significantly from (-) 0.09 +/– 0.99 to (-) 0.58 +/– 1. Children with multiple strictures that required repeated dilatation had significantly decreased HtSDS after 2 years of ingestion versus those with no significant strictures and vs controls.

In conclusion, proper management of strictures and nutritional support appears to decrease subsequent growth problems, those with multiple strictures had slower linear growth.

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