Pediatric corrosive ingestion: A retrospective study of 230 children evaluating the role of routine diagnostic esophagoscopy

OBJECTIVES: Corrosive substance ingestion remains a significant pediatric emergency, particularly in developing countries. This study aims to evaluate the clinical characteristics of pediatric patients hospitalized for corrosive ingestion and assess the necessity of routine esophagoscopy in their diagnostic workup. METHODS: A retrospective review was conducted of 230 patients aged 0-18 years admitted between 2010 and 2020. Demographic data, clinical findings, type and amount of corrosive substance, and management approach (conservative vs. endoscopic) were analyzed. Esophageal burn presence and grade were recorded using Zargar's classification. Outcomes included oral feeding tolerance, hospital stay duration, and development of strictures. RESULTS: Among 230 patients, 73% underwent diagnostic esophagoscopy, and 69.6% of them had mucosal burns, mostly in the upper esophagus. Vomiting was the most frequent symptom (33.6%), while oropharyngeal hyperemia was the most common physical sign (30.8%). Notably, 24% of patients were both asymptomatic and had normal physical exams. Esophageal burns correlated with larger ingestion volumes and prolonged hospitalization and oral feeding initiation (p < 0.05). Seventeen patients (7%) developed esophageal strictures, predominantly among those with Grade 2A or higher burns. Physical examination findings, especially visible oropharyngeal lesions, were more predictive of mucosal injury than isolated symptoms. CONCLUSION: Routine esophagoscopy in asymptomatic pediatric patients without pathological findings may be unnecessary. Clinical decision-making should prioritize symptom severity, ingestion history, and physical examination. These findings support a selective, individualized approach to endoscopy, aiming to reduce unnecessary procedures while ensuring timely identification of high-risk cases.