부산대학교 도서관

Summary:138 children were taken in care, after ingestion of caustic substances, by the E.N.T. paediatrics department of Bretonneau Hospital between January 1975 and September 1982.A first group of 111 children were followed up from the beginning. 107 endoscopies were carried out within the 24th hour after ingestion which were, in 97,8 % of cases, accidental. 66 children suffered from burns of the upper aerodigestive tract (U.A.D. T.) 37 children suffered from esophagal burns of which 6 without associated burns of U.A.D. T. Gastric burns were associated to esophagal burns in 8 cases (22 %).14 cases developed into esophagal stenosis even though in 13 cases supple calibrage was used. These 13 cases included 12 deep burns and one intermediate burn. The conservative therapy associating calibrage and dilatation cured 8 children. 3 children were handed over to surgery for esophagoplasty because of failure of conservative therapy. 2 children are still under treatment and one child has been lost track of.A second group of 27 children were seen when stenosis has developed some time after ingestion. 15 of them had received no treatment at all. 14 children were cured within 11 months using conservative therapy. 7 children were handed over immediately to surgery in light of time lapse since ingestion and gravity of esophagal stenosis. 3 children are still under conservative therapy and 3 children have been lost track of.This study concludes that early systematic endoscopic examination is necessary with the preference being given to fibroscopic examination. It concludes also in the absence of prevention of stenosis by calibrage and the frequent success of conservative therapy. It proposes the use of surgery where conservative treatment has failed after a delay of 18 months, or earlier in certain circumstances.