Conservative approach to mediastinitis in childhood secondary to esophageal perforation Çocukluk çaǧinda özofagus delinmelerine baǧli mediastinitlere konservatif yaklaşim
Cocuk Cerrahisi Dergisi, cilt.20, sa.1, ss.16-20, 2006 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 20 Sayı: 1
- Basım Tarihi: 2006
- Dergi Adı: Cocuk Cerrahisi Dergisi
- Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.16-20
- Anahtar Kelimeler: Caustic esophagitis, Child, Esophageal perforation, Mediastinitis
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Aim: Esophageal perforation (EP) is one of the most serious injuries of the alimentary tract that requires prompt diagnosis and treatment. The incidence of EP in children is increasing because of widespread use of endoscopy as a diagnostic and therapeutic tool. The aim of this study is to evaluate the safety and efficacy of non-operative treatment of esophageal perforation in children. Material and Methods: Between 1999 and 2004. a total of 13 EP of 12 patients were evaluated. This study was performed in children with EP who were admitted to Departments of Pediatric Surgery GATA and SSI Ankara Childrens Hospital. The treatment program consisted of broadspectrum antibiotics, nasopharyngeal aspiration, parenteral or/and enteral nutrition by gastrostomy, and pleural or mediastinal drainage when required. Results: A total of 13 episodes of EP in 12 patients were treated during this period. Mean age of the patients was 3.75 years (range 3-7 years). Two patients (16.6 %) were girls and ten patients (84.4 %) were boys. Mean hospitali stay was 20,7 days (range 16-27 days). Chest pain was found in 76.9 % of EP (10 of 13 perforations), followed by dyspnea in 69.2 % (9 of 13), vomiting in 46.1 % (6 of 13), fever in 46.1 % (6 of 13) and, epigastric pain in 7.6 % (1 of 13). Only medical therapy was applied in all patients successfully. No patient was deceased. Conclusion: in our country, caustic ingestion and severe esophageal stenoses is still an important problem. Although security measures are imposed on dangerous products, the incidence of EP increases, because of the constantly expanding cleaning-material industry with their attractive appearance for children and, parents' carelessness in saving caustic agents. EP occurs in children with severe esophageal stenoses secondary to caustic ingestion during dilatation. In children, contrary to adults, EP can be treated safely by non-operative methods.