Conservative treatment of caustic esophageal strictures in children

The most common cause of esophageal stricture in children is the accidental ingestion of strong corrosive agents. During a 13-year period between 1976 and 1989, 202 patients were diagnosed as having caustic esophageal strictures at the Hacettepe University Children's Hospital Department of Pediatric Surgery. A retrospective clinical study was performed to find out the place and predictors of a successful outcome for conservative treatment in children who have caustic esophageal strictures. Two hundred two children, of whom 145 were male (71.7%) and 57 female (28.3%) with 168 (83.2%) being younger than 6 years of age, were evaluated retrospectively. Whereas only 49.3% of patients could be treated within a 12-month period, 50.7% needed more than 1 year, 32.9% needed more than 2 years, 26.7% needed more than 3 years, and 15.4% needed more than 4 years of periodic dilations in order to become swallowers through native esophaguses. The success of conservative treatment has been higher in patients younger than 8 years of age, and in strictures due to caustics other than lye involving upper third portion and less than five cm of an esophageal segment. Most caustic esophageal strictures could have been treated by conservative measures in children.