Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Caustic injury to the esophagus remains a serious health problem in children. Upper endoscopy remains the mainstay diagnostic modality for the evaluation of patients with caustic ingestion. Treatment of caustic esophageal strictures is challenging, time consuming, and in many cases unsatisfactory. Topical application of mitomycin-C could augment the effect of endoscopic dilatation treatment to achieve less dilatation number and significant improvement of dysphagia in patients suffering benign esophageal stricture, and would not increase the risk of complications. This work aimed at evaluating the effect of topical Mitomycin-C application in cases of post corrosive esophageal injury with long segment esophageal strictures. The study was carried out on 60 Patients with established caustic esophageal stricture divided into 2 groups Group I: 30 patients with caustic esophageal stricture received mitomycin-C after esophagoscopy and dilatations Group II: 30 patients with caustic esophageal stricture received periodic endoscopic esophageal dilatations without mMitomycin-C use. Degree of dysphagia was evaluated according to a dysphagia scoring system. Barium swallow to show the presence of stricture, its site and extent. Upper endoscopy to confirm the diagnosis, assess site, extent of esophageal stricture and to get trials for esophageal dilatation up to 12.8 mm (38 F). The mean of age was 3.33±1.48 years among participating patients, A significant statistical difference was encountered between both groups regarding weight gain with better weight gain in group I (p-value = 0.001). Alkaline corrosive material was ingested by 55 (91.7%) of patients while 5(8.3%) were subjected to acidic corrosive material

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