An experienced pediatric surgeon, Professor Talant Omurbekov, is concerned: more and more children with esophageal burns are admitted to the 3rd Children’s Hospital each year. He asks the parents to be more careful and not to leave dangerous substances in the children’s access area for a second. Pension Cactus.media talked to the surgeon about the problem.
– Talent Oroskulovich, you are talking about the growing number of young patients with this terrible injury. State the numbers.
– There are many patients. My second student is working on a dissertation on chemical burns of the esophagus. One has already defended. What am I talking about? What is the problem. In terms of numbers, if we take chemical burns of the oral mucosa and esophagus, then in 2017 186 children were admitted, in 2019 – already 228, in 2021 – 242 children. For five months of this year, 77 patients were admitted. It turns out that almost a day later a patient comes. Is very.
And the patients are very sick. First-degree burns are treated conservatively, but second- and third-degree burns require long-term treatment in several stages, the first of which is surgery. We impose a gastrostomy (artificial opening that connects the anterior abdominal wall to the stomach), because food no longer enters the esophagus, then we pass a thread to suffocate – to stretch the scar that develops in the esophagus. The whole treatment process takes a year and a half or two.
Mostly children under the age of five come with esophageal burns. This is 100% the fault of adults: parents, older siblings, grandparents. The children themselves will not buy chemicals. The adults used and left, the child walked, saw and swallowed …
What are the most common causes of burns in children? In the first place is the concentrated acetic acid. It is now bottled in bottles that are not much different from bottles of other substances. In Soviet times, a special container made of dark frosted glass was made, it was irregular, triangular in shape. It was impossible to confuse her with anything. And now the vinegar can be in any container. And adults, using in cooking, cooking, leave such a bottle in an accessible place. The kids open up – a sip, and that’s it.
This is a terrible pain, salivation, the child can not swallow … The oral cavity is burned, the tongue is burned. In the esophagus, as I said, a scar develops.
In second place is potassium permanganate, or potassium permanganate, in crystals. The container was not closed properly, the child takes these crystals in his mouth. And they are wet with saliva and burned by the mucous membranes, they enter the esophagus and burn everything.
Caustic soda follows. This is scary because caustic soda is alkaline. If the same vinegar denatures the protein, forms a scab, but does not penetrate deep, then the alkali simply penetrates deep into the walls of the esophagus and forms very rough scars, the esophagus narrows, food does not pass. The child swallows and swallows, but the food sticks and then comes out with vomit.
It’s just a problem – she’s a cleaner named Aurora. Mothers say that it is convenient for them to clean boilers. But again, after use, it is necessary to remove this tool higher so that the child does not get it.
Then the white spirit is on the list. He, of course, does not cause very serious burns, but the first and second degree – yes. They did not remove it, they badly screwed the cork – and now the child is in the hospital.
Of all the incoming, 6-7% of parents do not believe in doctors that it is necessary to impose an ostomy, to perform bougienage. With a second-degree burn, the pain disappears after ten days and the child begins to swallow, because the scar is just beginning to form. And take the children home. And then they return, because the food no longer passes into the stomach.
Do many children then need an esophageal transplant?
– Not. Fortunately, we treat 97-98% of children with bougienage. But, I repeat, it takes one and a half to two years. The child all this time eats through gastrostomy, otherwise he will die of hunger. About 2% of children need a transplant, depending on how much alkali they received. We form the esophagus from the intestine of the patient himself.
We now have six children with esophageal burns in our ward. I made a detour, I asked how it was done. In all cases the parents are to blame. Someone was preparing food and took a bite for a while, also half-open, and a three-year-old child quickly grabbed it and swallowed it. Children are like that. They immediately took what was standing nearby and tried it.
We had a case where a newborn was inserted with a burn in the esophagus because a little brother or sister decided to feed it, took an open bottle and treated it.
We also treated a child who was burned with acid spilled on a car battery because it was spilled on a bottle of a sweet soda. Then we barely took out this patient, not only the esophagus, but also the stomach burned there.
Talent Omurbekov urged parents to be careful and remove strong substances that are dangerous for children. Vinegar, household chemicals should be hidden somewhere upstairs, in a locked closet. The bottles must be screwed on tightly so that the child cannot unscrew the cap. If you throw something in a regular bottle, then mark it so as not to confuse it yourself.