• children
• endoscopy
• pediatric gastroenterology

• Humans
• Caustics/toxicity
• Burns, Chemical/therapy
• Burns, Chemical/etiology
• Child
• Child, Preschool

• None

• Acid
• Alkali
• Corrosive injury
• Dilatation
• Dysphagia
• Endoscopy
• Gastric outlet obstruction
• Stricture

• caustic
• caustic injury
• esophageal
• esophageal strictures
• strictures

• Humans
• Esophageal Stenosis/chemically induced
• Caustics/toxicity
• Burns, Chemical/complications
• Male
• Female
• Retrospective Studies
• Adult
• Risk Factors
• Middle Aged
• Esophagus/injuries
• Esophagus/pathology
• Young Adult
• Aged
• Adolescent
• Risk Assessment

• button battery
• esophogastroduodenoscopy
• stricture

• Caustics
• Dilatation
• Dysphagia
• Esophageal stenosis
• Esophagus
• Gastric outlet obstruction
• Gastrointestinal endoscopy
• Mitomycin C
• Nasogastric intubation
• Triamcinolone

To investigate the efficacy of cordycepin, an adenosine analogue, on prevention of esophageal damage and stricture formation due to esophageal caustic burns in rat model comparing with prednisolone.

Caustic esophageal burn was introduced by 37.5% of NaOH to distal esophagus. Thirty-two Wistar albino rats were divided in four groups: sham rats undergone laparotomy, treated with 0.9% NaCl; control rats injured with NaOH without cordycepin treatment; cordycepin group injured with NaOH, treated with 20 mg/kg cordycepin; prednisolone group injured with NaOH, treated with 1 mg/kg prednisolone for 28 days. Efficacy was assessed by histopathological and immunohistochemical analysis of esophageal tissues.

Cordycepin treatment significantly decreased inflammation, granulation tissue and fibrous tissue formation and prevented formation of esophageal strictures shown by histopathological damage score and stenosis indexes compared to control group (p < 0.01). These effects are relatively more substantial than prednisolone, probably based on attenuation of elevation of proinflammatory cytokines hypoxia-inducible factor 1-alpha (HIF-1?), tumor necrosis factor alpha (TNF-?), proliferative and fibrotic factor fibroblast growth factor 2 (FGF2) and angiogenic factor vascular endothelial growth factor A (VEGFA) (p < 0.05).

The findings suggest that cordycepin has a complex multifactorial healing process in alkali-burned tissue, more successful than prednisolone in preventing the formation of esophageal strictures and may be used as a therapeutic agent in the acute phase of esophageal alkali-burn.

• Caustic injury
• Corrosive esophageal injury
• Esophageal stricture
• Omeprazole

• Corrosive ingestion
• acid ingestion
• base ingestion
• caustic ingestion
• caustic substances
• corrosive substances

• caustic agents
• children
• endoscopy
• gastrointestinal tract injuries

• Caustic injury
• Corrosive esophageal injury
• Esophageal stricture

• Acetic acid
• haemofiltration
• ingestion
• oesophageal burn
• poisoning

Ingestion of caustic substances and its long-term effect on the gastrointestinal system maintain its place as an important public health issue in spite of the multiple efforts to educate the public and contain its growing number. This is due to the ready availability of caustic agents and the loose regulatory control on its production. Substances with extremes of pH are very corrosive and can create severe injury in the upper gastrointestinal tract. The severity of injury depends on several aspects: Concentration of the substance, amount ingested, length of time of tissue contact, and pH of the agent. Solid materials easily adhere to the mouth and pharynx, causing greatest damage to these regions while liquids pass through the mouth and pharynx more quickly consequently producing its maximum damage in the esophagus and stomach. Esophagogastroduodenoscopy is therefore a highly recommended diagnostic tool in the evaluation of caustic injury. It is considered the cornerstone not only in the diagnosis but also in the prognostication and guide to management of caustic ingestions. The degree of esophageal injury at endoscopy is a predictor of systemic complication and death with a 9-fold increase in morbidity and mortality for every increased injury grade. Because of this high rate of complication, prompt evaluation cannot be overemphasized in order to halt development and prevent progression of complications.

• Caustic ingestion
• Esophageal caustic
• Caustic injury
• Corrosive ingestion
• Esophageal injury

• Caustic ingestion
• Computerised tomography
• Corrosive ingestion
• Endoscopy

• Acids
• Alkalies
• Caustic injury

Prevention has a paramount role in reducing the incidence of corrosive ingestion especially in children, yet this goal is far from being reached in developing countries, where such injuries are largely unreported and their true prevalence simply cannot be extrapolated from random articles or personal experience. The specific pathophysiologic mechanisms are becoming better understood and may have a role in the future management and prevention of long-term consequences, such as esophageal strictures. Whereas the mainstay of diagnosis is considered upper gastrointestinal endoscopy, computed tomography and ultrasound are gaining a more significant role, especially in addressing the need for emergency surgery, whose morbidity and mortality remains high even in the best hands. The need to perform emergency surgery has a persistent long-term negative impact both on survival and functional outcome. Medical or endoscopic prevention of stricture is debatable, yet esophageal stents, absorbable or not, show promising data. Dilatation is the first therapeutic option for strictures and bougies should be considered especially for long, multiple and tortuous narrowing. It is crucial to avoid malnutrition, especially in developing countries where management strategies are influenced by malnutrition and poor clinical conditions. Late reconstructive surgery, mainly using colon transposition, offers the best results in referral centers, either in children or adults, but such a difficult surgical procedure is often unavailable in developing countries. Possible late development of esophageal cancer, though probably overemphasized, entails careful and long-term endoscopic screening.

• Caustic ingestion
• Corrosive stricture
• Developing countries
• Surgical management
• Endoscopic management

• Burns, Chemical
• Caustics/adverse effects
• Colon/transplantation
• Endoscopy, Gastrointestinal
• Esophageal Neoplasms/prevention & control
• Esophageal Stenosis/chemically induced
• Esophageal Stenosis/diagnosis
• Esophageal Stenosis/therapy
• Humans
• Prevalence
• Plastic Surgery Procedures
• Upper Gastrointestinal Tract/injuries

Aerodigestive tract burns represent a rare but potentially devastating injury pattern throughout the world. Although the majority of these injuries do not require intervention, these burns have the potential for poor outcomes. Traditionally this disease has been caused by superheated gases found in explosions or fire-related injury. However, as technology advances, it brings novel methods for injury that require physician awareness of potential hazards. We describe a case of laryngeal and esophageal thermal burn caused by a microwave heated food bolus.