Acta Medica Iranica 2016. 54(7):465-470.

Caustic Agent Ingestion by a 1.5-Year-Old Boy
Behdad Gharib, Masoud Mohammadpour, Bahareh Yaghmaie, Meisam Sharifzadeh, Mehrzad Mehdizadeh, Fatemeh Zamani, Rouhollah Edalatkhah, Reihaneh Mohsenipour


We present a case of caustic ingestion by a 1.5-year-old boy. The caustic agent was drain opener which is a strong alkaline substance. Children in Iran and many other countries are still exposed to not “child proof” (child resistant packaging) toxic substance containers. Ingestion of caustic agents may lead to necrosis, perforation, and strictures. Substances that are ingested more frequently are liquid alkali material which causes severe, deep liquefaction necrosis. Common signs and symptoms of caustic agents are vomiting, drooling, refusal to drink, oral burns, stridor, hematemesis, dyspnea, dysphagia and abdominal pain. Even if no oropharyngeal lesion is seen, a significant esophageal injury which can lead to perforation and stricture cannot be ruled out. If abdominal pain or rigidity, substernal, chest or back pain exists, visceral perforation should be considered. The first thing to be checked is airway assessment. A lot of patients should be admitted to intensive care unit, and endoscopic evaluation, surgical intervention, long-term hospitalization, and worsening quality of life or among the complications. Preventive measures especially at the country level and approving proper legislation for obligating the related industries to produce child proof containers for house hold toxic products are the urgent measures to be followed by all of us.


Caustic ingestion; Esophageal burns; Endoscopic evaluation

Full Text:



- Chung-Chieh Huang, MD, Hurng-Sheng Wu, MD, MPH, Yung-Chie Lee, MD, PhD. Extensive Tracheobronchitisand Lung Perforation After Alkaline Caustic Aspiration. The Annals of Thoracic Surgery. Volume 89, Issue 5, May 2010, Pages 1670–1673.

- Sandro Contini a, Alim Swarray-Deen b & Carmelo Scarpignato c, Bulletin of the World Health Organization 2009;87:950-954, Oesophageal corrosive injuries in children: a forgotten social and health challenge in developing countries

- Christopher M. Johnson, Matthew T. Brigger, The Public Health Impact of Pediatric Caustic Ingestion Injuries, Arch Otolaryngol Head Neck Surg. 2012;138(12):1111-1115.

- Murat Çakmak, Gülnur Göllü, Özlem Boybeyi, Gönül Küçük, Mehmet Sertçelik, Yasemin Dere Günal, Mustafa K. Aslan, Tutku Soyercorrespondenceemail, Orhan M. Koçak, Aytül Çakmak, Şirin Çetin, Meltem Bingöl-Koloğlu, Aydın Yağmurlu, Hüseyin Dindar, Birim Günay Kılıç, Cognitive and behavioral characteristics of children with caustic ingestion, Journal of Pediatric Surgery, April 2015Volume 50, Issue 4, Pages 540–542

- Najafi Sani Mehri, Asgar Shirazi M., Farahmand Fatemeh, Khodadad Ahmad, Falahi Gholam Hossein, Accidental Caustic Ingestion in children and its sequel in esophagus; one year follow up, Iranian Journal of Pediatrics October 2007, Volume 17 , Number 2 (SUPPLEMENT); Page(s) 205 To 210.

- Michael G. Sherenian, Mark Clee, Amanda C. Schondelmeyer, Alessandro de Alarcón, MPHc, Jinzhu Li, Amal Assa’ad, and Kimberly Risma, Caustic Ingestions Mimicking Anaphylaxis: Case Studies and Literature Review, PEDIATRICS, Published online January 12, 2015

- Pietro Betalli, Alfredo Rossi, Marta Bini, Giuseppe Bacis, Osvaldo Borrelli, Cesare Cutrone, Luigi Dall’Oglio, Gian Luigi d’Angelis, Diego Falchetti, Maria Luisa Farina, PierGiorgio Gamba, Paolo Gandullia, Giuliano Lombardi, Fillippo Torroni, Claudio Romano,1 and Paola De Angelis, Update on Management of Caustic and Foreign Body Ingestion in Children, Diagnostic and Therapeutic Endoscopy, Volume 2009, Article ID 969868, 8 pages

- Michael Lupa, Jacqueline Magne, J. Lindhe Guarisco, Ronald Amedee, Update on the Diagnosis and Treatment of Caustic Ingestion, The Ochsner Journal 9:54–59, 2009

- Seema Khan, Susan R. Orenstein, Caustic Ingestions. In: Robert M. Kliegman, Bonita F. Stanton, Joseph W. St. Geme III, Nina F. Schor, Richard E. Behrman, et al, editors. Nelson Textbook of Pediatrics, 20th Edition. Philadelphia, United States of America: Saunders; 2016: p. 1794-1796

- Christine Carter-Kent, Caustic ingestion and foreign bodies. In: Robert Wyllie, Jeffrey S. Hyams, Marsha Kay, et al, editors. Pediatric gastrointestinal and Liver disease, 4th edition, Philadelphia, United States of America: Saunders; 2011: p. 197-200

- Joanna S. Brooke , Stenotrophomonas maltophilia: an Emerging Global, Opportunistic Pathogen, Clinical Microbiology Reviews, January 2012 Volume 25 Number 1

- Aref A. Bin Abdulhaka, Valerie Zimmermanb, Bassim T. Al Beiroutic, Larry M. Baddourd, Imad M. Tleyjeha,b,d,⁎ Stenotrophomonas maltophilia infections of intact skin: a systematic review of the literature, Diagnostic Microbiology and Infectious Disease 63 (2009) 330–333


  • There are currently no refbacks.

Creative Commons Attribution-NonCommercial 3.0

This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.