Pediatric caustic ingestion in Minas Gerais--Brazil: an observational study at the university hospital of Uberlandia/Ingestao caustica pediatrica em Minas Gerais--Brasil: um estudo observacional do hospital universitario de Uberlandia

• Published in: Revista de medicina (São Paulo, Brazil) Vol. 101; no. 5
• Main Authors: dos Santos, Ana Flavia Ferreira, Pereira, Monique Arantes, Kock, Tatyana Borges Cunha, de Oliveira, Ana Luisa Guedes, de Morais, Ana Paula Pereira, Santos, Camila Amaro Guedes, Moises, Fernanda Miranda, do Carmo, Guilhane Maria Magalhaes Assuncao, Valente, Hileia Carolina de Oliveira, Castro, Isadora Barbosa, Goncalves, Joao Pedro Rodrigues, Faria, Larissa Fernanda de Deus, Terence, Leonardo Tsuchida, Rodrigues, Marina de Lima, Rocha, Mayra Bernardes, Lima, Nathaniel Lucas Soares, de Oliveira, Suzenkelly Lucia, de Souza, Talissa Gomes Silva, Baccega, Thais de Melo, da Silva, William Nicoleti Turazza, Rezende, Erica Rodrigues Mariano de Almeida, Barros, Cristina Palmer
• Format: Journal Article
• Language: Portuguese
• Published: Universidade de Sao Paulo. Departamento Cientifico da Faculdade de Medicina 01-09-2022
• Subjects: Brasil
• ISSN: 0034-8554
• DOI: 10.11606/issn.1679-9836.v101i5e-176782

Introduction: Children under five years old are the principal victims of accidents caused by the ingestion of caustics, so considering Brazilian epidemiology and the risks of exposure to these agents the importance of this study is emphasized. This study aims to carry out a descriptive analysis of cases of caustic accidents in pediatric patients treated in a university hospital in Minas Gerais. Methods: This is a descriptive cross-sectional study, with a quantitative character, based on data obtained from medical records of pediatric patients (0-13 years old) treated for ingestion of caustic agents at the Hospital of the Federal University of Uberlandia (Minas Gerais, Brazil). Results: We collected 132 medical records of children treated for ingestion of caustic substances from January 2011 to April 2018. The accidents affected children aged between 8 months and 12 years, with 82.60% of the cases occurring in the home environment. Among the main substances ingested are cleaning products, as for their chemical composition, caustic soda, sodium hypochlorite, and ammonia predominated. Upper digestive endoscopy (EGD) was performed in 104 patients. Almost 13% of the children had esophageal strictures and required esophageal dilation. During the study period, 296 dilatation procedures were performed, with an average of 17.4 procedures per patient. Discussion: Considering that caustic accidents are prevalent in children under five years of age and the home environment, the main substances ingested are those of an alkaline nature, which cause injury to the respiratory and gastrointestinal tract, the main consequence being esophageal stenosis. Furthermore, there are no well-defined protocols for the management of patients who have ingested these substances. The main limitations of the study were the incomplete filling of the medical records analyzed and the bureaucratic procedures for accessing them. Conclusion: Caustic accidents predominated in children under two years old in the home environment, which implies the need for educational and preventive actions. Keywords: Caustic; Child health; Esophageal stenosis. Introducao: Criancas menores de cinco anos sao as principais vitimas de acidentes por ingestao de causticos, assim considerando a epidemiologia brasileira e dos riscos a exposicao desses agentes ressalta-se a importancia deste estudo que objetiva realizar uma analise descritiva dos casos de acidentes causticos em pacientes pediatricos atendidos em um hospital universitario de Minas Gerais. Metodo: Este e um estudo transversal descritivo, de carater quantitativo, a partir dos dados obtidos de prontuarios de pacientes pediatricos (0-13 anos) atendidos por ingestao de substancias causticas, no Hospital de Clinicas da Universidade Federal de Uberlandia (Minas Gerais, Brasil). Resultados: Foram levantados 132 prontuarios de criancas atendidas por ingestao de substancias causticas de janeiro de 2011 a abril de 2018. Os acidentes acometeram criancas na faixa etaria de 08 meses a 12 anos, sendo que 82,60% dos casos ocorreram em ambiente domiciliar. Entre as principais substancias ingeridas estao os produtos de limpeza, quanto a sua composicao quimica predominaram soda caustica, hipoclorito de sodio e amoniaco. A endoscopia digestiva alta (EDA) foi realizada em 104 pacientes. Quase 13% das criancas apresentaram estenose esofagica e necessitaram de dilatacao esofagica. No periodo estudado, foram realizados 296 procedimentos de dilatacoes, com media de 17,4 procedimentos por paciente. Discussao: Considerando que os acidentes causticos sao prevalentes em criancas menores de cinco anos e em ambiente domiciliar, as principais substancias ingeridas sao aquelas de carater alcalino, que causam lesao no trato respiratorio e gastrointestinal, sendo a principal consequencia a estenose esofagica. Ademais, nao ha protocolos bem definidos para o manejo e a conducao de pacientes que fizeram a ingestao dessas substancias. As principais limitacoes do estudo foram o preenchimento incompleto dos prontuarios analisados e os tramites burocraticos para o acesso aos mesmos. Conclusao: Predominaram os acidentes causticos domiciliares e em criancas menores de 2 anos, o que implica a necessidade de acoes educativas e preventivas. Palavras-chaves: Causticos; Saude da crianca; Estenose esofagica.