Treatment of children with the complication of chemical burns of the esophagus

Objective to improve the results of treatment of children with cicatricial narrowing of the esophagus in various dilative ways. The results of treatment of 95 patients aged from 1 year to 18 years with Cicatricial esophageal stenosis in the period from 2014 to 2019 were analyzed. There were 59 boys (62.1%) and 36 girls (37.9%). The patients were divided into two groups. The control group included 47 (49.5%) patients who had esophageal dilatations performed "blind" in 15 children and "thread" in 32 children, the main group 48 (50.5%) patients who had esophageal augmentation performed using conductor screws. Of the 95 patients, 70 (73.7%) were after burning with acetic essence, 20 (21.05%) after burning with alkali, 2 (2.1%) after consuming potassium permanganate crystals, 2 (2.1%) after swallowing a round battery, and another (1.05%) received a burn from an unknown chemical reagent. Diameters and lengths of narrowed sections were taken into account based on endoscopic and radiological data in order to select the appropriate sizes of branches in both groups. 18 (26%) of 70 children with scar stenosis after acetic essence were admitted to the hospital later than a month, with dilation of which in 4 cases (5.7%) there was a complication in the form of esophageal perforation, where two children had short scar stenosis, and the rest had tubular and elongated. The cases of complications in the control group were in three cases (two during blind bugging and one during bugging "for a thread"), and in the main group in one. 20 (21.05%) children had scar stenosis after an alkaline burn, where extended scar stenosis was observed 6 (30%) patients. In the control group, 4 of patients had boujinga complications, and in the main group 2. In 2 (2.1%) patients with Scar stenosis, which occurred after the potassium permanganate crystals were successfully run "along the thread". In two children, scar stenosis was formed after swallowing batteries, where one was reinforced with a "thread" (there was a perforation of the esophagus), and the other with a conducting string. Two children who received scar stenosis from an unknown reagent were reinforced with a conducting string, where in the first case a favorable result was achieved, and the outcome of treatment of the second child due to expanded stenosis was not successful. They were offered gastrostomy surgery to perform "thread" listening, but this offer was not accepted. Conclusions. The obtained results reflect an advantage for bougienage on the conductor string in the treatment of children with cicatricial stenosis of the esophagus compared with other dilatation methods.