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Correlation of 99mTc sucralfate scan and endoscopic grading in caustic oesophageal injury

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Abstract

Purpose

To determine a correlation between the 99mTc sucralfate scan and the endoscopy findings in children with caustic oesophageal injury.

Methods

This is an observational analytic study of children who had both 99mTc sucralfate scan and endoscopy after caustic substance ingestion at our institution in a period between January 2009 and September 2016. The oesophageal injury was classified into low grade and high grade according to the degree of adhesion on 99mTc sucralfate scan and modification of Zargar endoscopic grading.

Results

Out of a total of 197 children, 40 children were identified who had both investigations done on average 26 h post-injury. Low-grade adhesion on 99mTc sucralfate scan was found in 27 children (68%), and all had low-grade Zargar’s oesophageal injuries. None of these subsequently developed residual pathology. Thirteen had high-grade adhesion and five of these had high-grade injury on endoscopy. Three (23%) developed oesophageal strictures. Correlation of 99mTc sucralfate and endoscopic findings reached statistical significance with a p value of 0.0014. No morbidity was associated with either the scan or endoscopy.

Conclusions

We concluded that low-grade sucralfate scan finding has the potential to successfully eliminate the need for invasive endoscopy under general anaesthesia and thereby reducing procedure-related morbidity, hospitalization and associated costs. However, mandatory endoscopy is required in children with high-grade adhesion seen on 99mTc sucralfate scan. This requires confirmation using a larger prospective study.

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Authors and Affiliations

  1. Division of Paediatric Surgery, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa

    Babalwa B. Nondela, Sharon G. Cox, Anita Brink, Alastair J. W. Millar & Alp Numanoglu

  2. Division of Nuclear Medicine, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa

    Anita Brink & Alastair J. W. Millar

Authors
  1. Babalwa B. Nondela
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  2. Sharon G. Cox
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  3. Anita Brink
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  4. Alastair J. W. Millar
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  5. Alp Numanoglu
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Correspondence to Babalwa B. Nondela.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Nondela, B.B., Cox, S.G., Brink, A. et al. Correlation of 99mTc sucralfate scan and endoscopic grading in caustic oesophageal injury. Pediatr Surg Int 34, 781–788 (2018). https://doi.org/10.1007/s00383-018-4276-7

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  • DOI: https://doi.org/10.1007/s00383-018-4276-7

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