Upper gastrointestinal burns by peroxyacetic acid in children: a review of seven cases

Zhibin Niu; Keren Zhang; Weilin Wang

摘要：Objective: To study the clinical features of upper gastrointestinal burns by peroxyacetic acid (PA) in children and improve its treatment and outcome. Methods: The clinical materials of 7 cases with upper gastrointestinal burns by PA including clinical presentation, treatment and outcomes were reviewed. Results: There were six boys and one girl. The concentration of the swallowed PA was from 10% to 20% and the amount was 3-10 ml. The mainly burns were located in esophagus in one case, stomach in three cases, both esophagus and stomach in three cases. The gastrostomy and operation of dilating esophagus were performed in the cases with esophageal stricture. The pyloroplasty or gastroduodenostomy was performed in the cases with pyloric obstruction. All the cases were followed up for 12-18 months, dysfunction of esophagus or(and) cardia as well as stiffness and hypodynamia of the stomach was showed in most of the patients. Conclusion: The degree of upper gastrointestinal burns by PA varied according to different concentrations of PA which was swallowed. Correct emergent measures in the acute stage of the bums was very important, gastric tube should be inserted and go through esophagus and pylorus and must be retained for 5-8 weeks to prevent the stricture of esophagus and pylorus, otherwise the tube could act as a passage of nutriment. Prophylaxis of upper gastrointestinal burns by PA is very important because the treatment of the burns is difficulty and the outcomes are not always satisfactory.