DOZ047.60: Evaluation of gastroesophageal reflux in children born with esophageal atresia using pH and impedance monitoring

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
F W T Vergouwe ◽  
M P van Wijk ◽  
C A ten Kate ◽  
M C W Spaander ◽  
M J Bruno ◽  
...  
Keyword(s):  
Gastroesophageal Reflux ◽  
Esophageal Atresia ◽  
Measurement Data ◽  
Tube Feeding ◽  
Impedance Analysis ◽  
Esophageal Replacement ◽  
Acid Therapy ◽  
School Aged Children ◽  
The Mean

Abstract Aim of the Study The ESPHGAN-NASPGHAN guideline (Krishnan, 2016) recommends routine prescription of proton pump inhibitors in the first year of life after esophageal atresia (EA) repair, and to monitor gastroesophageal reflux (GER) using pH-impedance (pH-MII) monitoring and/or endoscopy at time of discontinuation and during long term follow up of these patients. This study aimed to evaluate acid and non-acid GER in infants and school-aged children with EA using pH-MII monitoring. Methods Children born with EA between 2011–2017, who underwent a 24-hour pH-MII study during infancy (≤18 months) or at 8 years old as part of a standardized longitudinal follow-up program, were included. Exclusion criteria were: isolated tracheoesophageal fistula, esophageal replacement therapy, tube feeding and monitoring < 18 hours. Anti-acid therapy was discontinued before pH-MII measurement. Data was collected on reflux index (RI; exposure to pH < 4 in %, >7% considered abnormal), retrograde bolus movements (RBM) and bolus clearance time (BCT). Automatically detected RBM were manually reviewed and modified/deleted if necessary. Results We included 57 children (51% male, 2% isolated EA, 44% thoracoscopic repair): 24 infants (median age 0.6 years) and 33 school-aged children (median age 8.2 years). In infants, median RI was 2.6% (abnormal in n = 2), median RBM was 61 (62% non-acid, 58% mixed) and median of the mean BCT was 11 seconds. In school-aged children, median RI was 0.3% (abnormal in n = 4), median RBM was 21 (64% non-acid, 75% mixed) and median of the mean BCT was 13 seconds. Of the automatically detected 3,313 RBM, 1,292 were manually deleted from the tracings: 52% of non-acid RBM and 8% of acid RBM (mainly misinterpreted swallows or one event recognized as several events). Conclusions Most children with EA off medication have a normal RI, yet experience a significant number of non-acid RBM. After manual revision of the tracings a high percentage of RBM was deleted. Our data show that automated impedance analysis software needs refinement for use in infants and children with EA, and question the need for standard anti-acid therapy in these patients.

scholarly journals Erudition after neonatal gastric transposition for esophageal atresia at 10 years of follow-up

2021 ◽  
Vol 10 ◽  
pp. 37
Author(s):  
Kanika Sharma ◽  
Shilpa Sharma ◽  
Devendra Kumar Gupta
Keyword(s):  
Esophageal Atresia ◽  
Primary Anastomosis ◽  
Esophageal Replacement ◽  
Contrast Study ◽  
Hepatobiliary Scintigraphy ◽  
Oral Contrast ◽  
Cross Sectional ◽  
Gastric Transposition ◽  
The Mean

Background: Gastric transposition (GT) is a well-established procedure of esophageal re­placement (ER) for children with esophageal atresia. ER in the neonatal period is sparsely reported. We report characteristics of children who have undergone neonatal GT and have completed ten years of follow-up. Methods: The cross-sectional study was conducted which included all children who under­went neonatal GT at the institute and have completed a follow-up of at least 10-years. An­thropometry, oral contrast study, Hepatobiliary Scintigraphy, Gastroesophageal reflux study, Gastric emptying test, spirometry, and blood investigations were done for all the children. Results: Four children (three male and one female) were included in the study. The mean age at ER was 5.3 ±2.2 days with a mean birth-weight of 2.43 ±0.13 kg. Two children had prima­ry GT, while the other two had GT following a leak in primary anastomosis. During the mean follow-up of 180.25 ±43.5 months, none of the children required esophageal dilatation or other surgical intervention or procedures. All children were below 3rd centile for weight-for-age while all except one were below 50th centile for height-for-age. There was no stricture on oral contrast study, however, one child had grade III reflux on GER scan. Persistent duode­nogastric reflux on HIDA scan was seen in one child. Three children had restrictive parame­ters on spirometry. Symptomatically, all reported poor weight gain, one had left vocal cord palsy with hoarseness, and one had chest-wall protuberance.     Conclusions: Neonatal gastric transposition is a feasible alternative to delayed esophageal replacement for neonates with esophageal atresia with limited complications.

scholarly journals Minimal Invasive Surgery for Gastroesophageal Reflux Disease and Hiatus Hernia—Our Experience: A Case Series with Review of Literature

2021 ◽  
Author(s):  
Rafique Umer Harvitkar ◽  
Abhijit Joshi
Keyword(s):  
Retrospective Study ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Operating Time ◽  
Type I ◽  
Type Ii ◽  
The Mean ◽  
Gerd Symptoms

Abstract Introduction Laparoscopic fundoplication (LF) has almost completely replaced the open procedure performed for gastroesophageal reflux disease (GERD) and hiatus hernia (HH). Several studies have suggested that long-term results with surgery for GERD are better than a medical line of management. In this retrospective study, we outline our experience with LF over 10 years. Also, we analyze the factors that would help us in better patient selection, thereby positively affecting the outcomes of surgery. Patients and Methods In this retrospective study, we identified 27 patients (14 females and 13 males) operated upon by a single surgeon from 2010 to 2020 at our institution. Out of these, 25 patients (12 females and 13 males) had GERD with type I HH and 2 (both females) had type II HH without GERD. The age range was 24 to 75 years. All patients had undergone oesophago-gastro-duodenoscopy (OGD scopy). A total of 25 patients had various degrees of esophagitis. Two patients had no esophagitis. These patients were analyzed for age, sex, symptoms, preoperative evaluation, exact procedure performed (Nissen’s vs. Toupet’s vs. cruroplasty + gastropexy), morbidity/mortality, and functional outcomes. They were also reviewed to examine the length of stay, length of procedure, complications, and recurrent symptoms on follow-up. Symptoms were assessed objectively with a score for six classical GERD symptoms preoperatively and on follow-up at 1-, 4- and 6-weeks postsurgery. Further evaluation was performed after 6 months and then annually for 2 years. Results 14 females (53%) and 13 males (48%) with a diagnosis of GERD (with type I HH) and type II HH were operated upon. The mean age was 46 years (24–75 years) and the mean body mass index (BMI) was 27 (18–32). The range of duration of the preoperative symptoms was 6 months to 2 years. The average operating time dropped from 130 minutes for the first 12 cases to 90 minutes for the last 15 cases. The mean hospital stay was 3 days (range: 2–4 days). In the immediate postoperative period, 72% (n = 18) of the patients reported improvement in the GERD symptoms, while 2 (8%) patients described heartburn (grade I, mild, daily) and 1 (4%) patient described bloating (grade I, daily). A total of 5 patients (20%) reported mild dysphagia to solids in the first 2 postoperative weeks. These symptoms settled down after 2 to 5 weeks of postoperative proton-pump inhibitor (PPI) therapy and by adjusting consistency of oral feeds. There was no conversion to open, and we observed no perioperative mortality. There were no patients who underwent redo surgeries in the series. Conclusion LF is a safe and highly effective procedure for a patient with symptoms of GERD, and it gives long-term relief from the symptoms. Stringent selection criteria are necessary to optimize the results of surgery. Experience is associated with a significant reduction of operating time.

Ten Years of Extracorporeal Membrane Oxygenation: Neurodevelopmental Outcome

PEDIATRICS ◽  
1991 ◽  
Vol 87 (4) ◽  
pp. 549-555
Author(s):  
Dena Hofkosh ◽  
Heidi M. Feldman ◽  
Ann E. Thompson ◽  
Robert J. Nozza ◽  
Susan S. Kemp ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
High Frequency ◽  
Neurodevelopmental Outcome ◽  
Cognitive Testing ◽  
Neurologic Examination ◽  
Cognitive Score ◽  
School Aged Children ◽  
Membrane Oxygenation ◽  
The Mean

Of the 87 survivors of extracorporeal membrane oxygenation over a 10-year period, 67 participated in a follow-up study which included neurologic examination (n = 67), cognitive testing (n = 67), and audiologic assessment (n = 33). Matched control subjects for those older than 5 years were also evaluated. Outcome was defined as normal for cognitive scores ≥85 and normal neurologic examination results, suspect for cognitive scores 70 through 84 or nonfocal neurologic findings such as hypertonia/hypotonia, and abnormal for cognitive scores &lt;70 or abnormal neurologic examination results. Of the 10 school-aged children studied, 9 were normal and there were no differences in mean cognitive scores between subjects and controls (IQ subjects = 109 ± 12 [SD], IQ controls = 107 ± 13). For preschoolers aged 2.7 through 4.11 years, the mean cognitive score was 91 ± 11 and 7 (70%) were normal. For infants 6 through 30 months, the mean cognitive score was 101 ± 22 and 27 (57%) were normal. A total of 7 children (21% of those studied) had abnormal audiologic assessments. Three children demonstrated mild high-frequency and 4 moderately severe high-frequency sensorineural hearing loss which was bilateral in 3 and of undetermined laterality in 1. Abnormal neurodevelopmental outcome was significantly associated with cerebral infarction and chronic lung disease. Outcome was not related to demographic or perinatal variables, illness severity prior to extracorporeal membrane oxygenation, or underlying diagnosis. Neurodevelopmental outcome among survivors of extracorporeal membrane oxygenation in this series is consistent with previous reports of morbidity among neonates with severe respiratory failure treated conventionally.

scholarly journals Outcome of Surgery for Pediatric Gastroesophageal Reflux: Clinical and Endoscopic Follow-up after 300 Fundoplications in 279 Consecutive Patients

2017 ◽  
Vol 107 (1) ◽  
pp. 68-75 ◽  
Author(s):  
A. I. Koivusalo ◽  
M. P. Pakarinen
Keyword(s):  
Gastroesophageal Reflux ◽  
Confidence Interval ◽  
Esophageal Atresia ◽  
Risk Ratio ◽  
Ph Monitoring ◽  
Anastomotic Stricture ◽  
Symptom Control ◽  
Neurological Impairment ◽  
Underlying Disorder

Purpose: Clinical and endoscopic assessment of the outcome after fundoplication for pediatric gastroesophageal reflux. Basic procedures: Hospital records of 279 consecutive patients who underwent fundoplication for gastroesophageal reflux from 1991 to 2014 were reviewed. Underlying disorders, clinical and endoscopic findings, imaging studies, pH monitoring, and surgical technique were assessed. Main outcome measures were patency of fundoplication, control of symptoms and esophagitis, complications, redo operations, and predictive factors of failures. Main results: A total of 279 patients underwent 300 fundoplications (277 primaries and 23 redos). Underlying disorders in 217 (72%) patients included neurological impairment (28%) and esophageal atresia (22%). Indications for fundoplication included recalcitrant gastroesophageal reflux symptoms (44%), failure to thrive (22%), respiratory symptoms (15%), esophageal anastomotic stricture (4%), apneic spells (2%), and regurgitation (2%). Preoperative endoscopy was performed in 92% and pH monitoring in 49% of patients. Median age at primary fundoplication was 2.2 ((IQR = 0.5–7.5)) years. Fundoplication was open in 205 (74%; Nissen n = 63, Boix-Ochoa n = 97, Toupet n = 39, and other n = 6), laparoscopic in 72 (24%; Nissen n = 67 and Toupet n = 5), and included hiatoplasty in 73%. Clinical follow-up was a median of 3.9 (IQR = 1.2–9.9) years. Mortality related to surgery was 0.3%. Symptom control was achieved in 87% of patients, and esophagitis rate decreased from 65% to 29% (p < 0.001). Fundoplication failed in 41 (15%) patients. Failure was predicted by esophageal atresia risk ratio = 3.9 (95% confidence interval = 1.3–11, p = 0.01), any underlying disorder risk ratio = 3.1 (95% confidence interval = 1.1–9.1, p = 0.04), and hiatoplasty risk ratio = 2.6 (95% confidence interval = 1.1–6.6, p = 0.03). Of the 23 redo-fundoplications, 32% failed. Conclusion: The majority of patients who underwent fundoplication had an underlying disorder. Primary fundoplication provided control of symptoms in almost 90% of patients and also reduced the rate of esophagitis. Failure of primary fundoplication occurred in 15% of patients, and an underlying disorder, esophageal atresia, and hiatoplasty increased the risk of failure.

DOZ047.34: Oral feeding attainment

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
K Hernandez ◽  
K Davidson ◽  
J Dargie ◽  
R Jennings ◽  
M Manfredi
Keyword(s):  
Esophageal Atresia ◽  
Genetic Diagnosis ◽  
Tube Feeding ◽  
Case Series ◽  
Oral Feeding ◽  
Retrospective Case ◽  
Genetic Syndrome ◽  
Feeding Success ◽  
Therapeutic Services

Abstract Aim A primary goal of esophageal atresia repair is to establish esophageal continuity to allow for swallowing of secretions, liquid, and food boluses. The transition to oral feeding and acquisition of oral sensorimotor skills following repair of long-gap esophageal atresia (LGEA) can be challenging. The timing of attaining full PO status (F-PO), without need for enteral tube feeding support, can vary greatly. A retrospective study was performed to identify predictors of oral feeding success in children with LGEA. Methods A retrospective case series was conducted with chart review of patients with a diagnosis of LGEA who underwent Foker process for staged repair from 2012 to 2017. Children with previous failed attempts at esophageal repair or other significant surgeries were excluded. Comparison was made between patients who achieved full PO status (F-PO) within the study follow-up period (minimum of one year postrepair) and those who did not. Results Twenty-three patients were included: twelve male and eleven female. Eight patients (35%) had an accompanying genetic diagnosis. Thirteen patients (57%) were born prematurely. Six patients (26%) were F-PO at 6 month post-repair; four of which were on an age appropriate diet without restrictions/modifications. Thirteen patients (57%) achieved F-PO by end of the study follow-up period while 43% required supplemental nutrition. Gestational age ≥ 37 weeks (P = 0.03), younger age at first PO trial (P = 0.013), shorter time between Foker 2 and first PO trial (P = 0.011), consistent PO intake at 6 months post-repair (P = 0.02), and fewer total number of airway/esophageal procedures within 1 year post-repair (P = 0.018) were found to be significantly associated with achieving F-PO. Total number of esophageal dilations within 2 years of esophageal repair and presence of a genetic syndrome were not significantly different between groups. Conclusion A majority of patients (57%) who undergo repair of LGEA via Foker process will progress to oral feeding; however, the timing of this progression is variable. Predictors of oral feeding success can be used to guide prognosis and identify patients at greatest need of therapeutic services.

DOZ047.71: Long-gap vs. non-long-gap esophageal atresia: a prospective two-year follow-up study

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
L Valfre ◽  
A Conforti ◽  
M Scuglia ◽  
L Aite ◽  
F Bevilacqua ◽  
...  
Keyword(s):  
Esophageal Atresia ◽  
Measurement Data ◽  
Esophageal Surgery ◽  
Follow Up Study ◽  
Long Gap ◽  
Gap Measurement ◽  
Chi Squared ◽  
Long Gap Esophageal Atresia ◽  
Vertebral Bodies

Abstract Aim of the Study Long-gap esophageal atresia (LGEA) represents the most challenging spectrum of esophageal atresia (EA). This condition is poorly defined, particularly regarding long-term sequelae. The aim of this study was to evaluate mid-term outcomes of patients with LGEA. Methods A longitudinal prospective study was performed of all EA patients treated at our institution from January 2008 to December 2016. Patients were followed up in a dedicated multidisciplinary outpatient clinic. LGEA was defined as a gap wider than 3 vertebral bodies at preoperative gap measurement. Data were collected with specific attention to auxological outcomes, esophageal dilations, antireflux procedures, redo-esophageal surgery, readmission, and dysphagic problems. Chi-squared test and Mann–Whitney test were used as appropriate; P < 0.05 was considered significant. Results During the study period, 183 EA patients were treated, 52 with LGEA. Of those, 151 reached a minimum of 1-year follow-up and were enrolled into this study. Long-gap vs non-long-gap: weight 1st year, gr; 6800 vs 8800 P < 0.0001; weight 2nd year 9500 gr vs 11000 p < 0.0001. BMI 1st year, median 14,75 vs 15,64 p 0.04; BMI 2nd year, median 15,18 vs 15 p 0.9; N° dilations 1st year, median 3 vs 1 P < 0.0001, N° dilations 2nd year, median 1 vs 0 P < 0.0001; Nissen 1st year, n (%) 9 vs 3 p 0.0019; Nissen 2nd year, n (%) 12 vs 4 p 0.0002. Redo-esophageal surgery 1st year, n (%) 7 vs 7 p 0.14. Redo-esophageal surgery 2nd year, n (%) 8 vs 0 < 0.0001. Readmission 1st year, median 4 vs 2 P < 0.0001; readmission 2nd year, median 3 vs 0 P < 0.0001. Oral aversion 1st year, n (%) 27 vs 10 P < 0.0001; oral aversion 2nd year, n (%) 17 vs 6 P < 0.0001. Dysphagia 1st year, n (%) 25 vs 18 P < 0.0001; dysphagia 2nd year, n (%) 14 vs 19 p 0.13. Conclusions LGEA patients underwent a more challenging course at follow-up, experiencing late auxological, more esophageal and GERD-related problems, and increased feeding and swallowing disorders in comparison with non-LGEA patients. A longer follow-up study is warranted to describe late and/or persistent problems.

DOZ047.76: Eosinophilic esophagitis and esophageal atresia. Is there an association?

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
L García ◽  
C Giné ◽  
A Laín ◽  
M Martín ◽  
J A Molino ◽  
...  
Keyword(s):  
Gastroesophageal Reflux ◽  
Diagnostic Criteria ◽  
Esophageal Atresia ◽  
Eosinophilic Esophagitis ◽  
Esophageal Mucosa ◽  
Early Puberty ◽  
High Power Field ◽  
Esophageal Biopsy ◽  
Macroscopic Appearance

Abstract Aim of the Study Eosinophilic esophagitis (EoE) is a recently diagnosed entity and seems to be more prevalent in patients with esophageal atresia (EA). It can mimic dysphagia and gastroesophageal reflux (GER) symptoms frequently observed in EA, but treatment is different. Methods Retrospective review (2002–2019) of patients with EA who underwent esophagogastroduodenoscopy (EGD) and esophageal biopsy was performed. EGD was performed in symptomatic patients and in all patients at 12–15 years. Diagnostic criteria for EoE included >15 eosinophils for a high-power field in the esophageal mucosa. Main Results From a total of 110 patients with EA, 27 lost follow-up. In the remaining 83, 56 patients (67, 5%) underwent EGD because of dysphagia or gastroesophageal reflux (GER) studies. Esophageal biopsies were performed in 35 patients and the diagnostic criteria for EoE were achieved in 5 (14,3%). The mean age at diagnosis of EoE was 10 + 2 years and the indication for EGD was GER symptoms (3) or dysphagia (2). In one case an antireflux surgery was previously performed but symptoms slightly persisted, while in 4 cases contrast studies and pH-metry showed no or minimal GER. EGD demonstrated light distal esophagitis in 2 cases, white exudates in 2, and was completely normal in the remaining one. On follow-up, 4 patients remain asymptomatic with proton pump inhibitor medication, and periodic EGD shows macroscopic improvement with a decreased eosinophilic peak on esophageal biopsies. Conclusions Patients with EA seem to have a higher risk of developing EoE at early puberty. EGD on follow-up should be focused not only on studying GER or Barrett, but also on actively search for EoE with an esophageal biopsy, even when the macroscopic appearance is normal.

Gastroesophageal Reflux and Related Pathology in Adults Who Were Born With Esophageal Atresia: A Long-Term Follow-up Study

2007 ◽  
Vol 5 (6) ◽  
pp. 702-706 ◽  
Author(s):  
Andrew C.F. Taylor ◽  
Kerry J. Breen ◽  
Alex Auldist ◽  
Anthony Catto–Smith ◽  
Tom Clarnette ◽  
...  
Keyword(s):  
Gastroesophageal Reflux ◽  
Esophageal Atresia ◽  
Follow Up Study ◽  
Long Term Follow Up

scholarly journals Association between teeth loss and nasogastric tube feeding dependency in older adults from Taiwan: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chun-Chieh Wang ◽  
Yu-Yen Chen ◽  
Kuo-Chuan Hung ◽  
Shang-Jung Wu ◽  
Yung-Feng Yen ◽  
...  
Keyword(s):  
Older Adults ◽  
National Health ◽  
Nasogastric Tube ◽  
Tube Feeding ◽  
Nasogastric Feeding ◽  
Number Of Teeth ◽  
Increased Risk ◽  
The Mean ◽  
Nasogastric Tube Feeding

Abstract Background To examine the association between teeth loss and nasogastric tube feeding dependency in older people. Methods The National Health Interview Survey (NHIS) 2005, 2009, and 2013 in Taiwan. Participants were selected by a multistage stratified sampling method and baseline characteristics, including socioeconomic status and health habits, were obtained by well-trained interviewers. The NHIS was linked with the National Health Insurance research database 2000–2016 and the National Deaths Dataset, which contains all the medical information of ambulatory and inpatient care. Cox regression was used to examine the association between the number of teeth lost and nasogastric tube feeding dependency. Results There were 6165 adults older than 65 years old enrolled in the analysis, with 2959 male (48%) and the mean (SD) age was 73.95(6.46) years old. The mean follow-up duration was 6.5(3.3) years. Regarding the teeth loss categories, 1660 (26.93%), 2123 (34.44%), and 2382 (38.64%) of participants were categorized as having no teeth loss, loss of 1–9 teeth, and loss of 10–28 teeth, respectively. During 39,962 person-years of follow-up, new-onset nasogastric feeding dependency was recognized in 220(13.25%), 256(12.06%), and 461(19.35%) participants who were categorized as having no teeth loss, loss of 1–9 teeth, and loss of 10–28 teeth, respectively. Kaplan-Meier curves demonstrated significant findings (Log-rank P < 0.01). After potential confounders were adjusted, compared with those without teeth loss, older adults who had lost 10–28 teeth had significantly increased risks of occurrence nasogastric feeding dependency (AHR, 1.31; 95% CI, 1.05–1.62; p-value = 0.02). Furthermore, a significant dose-response relation between the number of teeth lost and increased risk of nasogastric feeding was found (p for trend< 0.01). Conclusions Older adults who had lost 10–28 teeth had a significantly increased risk of nasogastric tube feeding dependency. Early identification of the oral disease is crucial for the prevention of the occurrence of teeth loss and the following nutrition problems, which would reduce risk of nasogastric tube feeding dependency.

scholarly journals Long term evolution of caustic induced esophagitis: A descriptive 20-years cohort.

2020 ◽  
pp. 8-11
Keyword(s):  
Esophageal Injury ◽  
Esophageal Replacement ◽  
Caustic Ingestion ◽  
Social Concern ◽  
Gender Ratio ◽  
Esophageal Strictures ◽  
Secondary Stage ◽  
The Mean

Introduction: Corrosive esophagitis following caustic agent ingestion remains a significant medical and social concern in Tunisia. Secondary stricture is the most challenging complication. The aim of this study is to determine the incidence of caustic esophageal injuries and to highlight the characteristics of the management. Methods: Over a 20 years period, we conducted a retrospective and descriptive study about 164 consecutive patients presented to our department following ingestion of caustic agents. Results: The mean age was 26 years (16-87) with a gender ratio of 0.2. The ingestion was accidental in 58% of cases and as a suicidal attempt in 42%. Bleach largely dominates ingested solutions in 78.3 % of cases. The delay of the consultation was less than 12 hours in 98.4% of cases. We noticed gravity signs in eight patients. Lesions in Esophagoscopy were recorded in 62 patients (37.8%). The esophageal injury assessed as grade I in 36 patients, grade IIa limited lesions in 10 patients, grade IIa extensive in 8 patients, grade IIb in 5 patients and grade III in 3 patients. During the follow-up, 26 patients (41.9%) had a second assessment during the secondary stage, only 4 patients (2.4%) presented esophageal strictures. Three patients underwent coloplasty for esophageal replacement. Conclusion: During a 20-year period, 164 cases of caustic ingestion were reported. Constituted esophagitis injuries were noted in 37.8% and strictures in 6.45% of all cases.

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