{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T02:40:52Z","timestamp":1792377652940,"version":"4.4.0"},"reference-count":32,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T00:00:00Z","timestamp":1792281600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T00:00:00Z","timestamp":1792281600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Endoscopic examination is the main diagnostic test to evaluate the extent and severity of any mucosal lesions after caustic ingestion, in order to target the most appropriate treatment and follow\u2010up. Our main aim was to evaluate clinical, biochemical, and instrumental parameters in order to identify possible key predictors of poor outcome and therefore identify possible subgroups of asymptomatic or paucisymptomatic children who may benefit from the endoscopic examination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All children admitted for caustic ingestion were prospectively enrolled. Poor outcome was defined as the presence of mucosal lesions with severe\/uncertain prognosis: Zargar score 2b to 4 or severe gastric\/duodenal lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Two hundred and eighty\u2010three children were enrolled. No asymptomatic patient showed poor outcome (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Children showing hematemesis, drooling, vomiting, oropharyngeal or labial lesions showed a higher risk of developing severe mucosal lesions (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). The ingestion of caustic substances inappropriately stored in plastic glasses or bottles was found to be a risk factor for unfavorable outcome (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Asymptomatic children should not undergo endoscopic examination since severe mucosal lesions are associated with the development of at least one sign or symptom. However, this recommendation may not apply to children under 18 months of age or those with delayed psychomotor development or neuropsychiatric pathologies, likely because they are unable to reliably report symptoms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jpn3.70623","type":"journal-article","created":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T02:17:47Z","timestamp":1792376267000},"source":"Crossref","is-referenced-by-count":0,"title":["Caustic ingestion in children: A prospective analysis of poor outcome key predictors useful for clinical management optimization"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-1308-1710","authenticated-orcid":false,"given":"Piergiorgio","family":"Gragnaniello","sequence":"first","affiliation":[{"name":"Pediatric Gastroenterology and Hepatology Unit, Santobono\u2010Pausilipon Children's Hospital Naples Italy"},{"name":"University Hospital San Giovanni di Dio e Ruggi d'Aragona Salerno Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Torroni","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy and Surgery Unit, Bambino Ges\u00f9 Children's Hospital (IRCCS) Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Malamisura","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy and Surgery Unit, Bambino Ges\u00f9 Children's Hospital (IRCCS) Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renato","family":"Tambucci","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy and Surgery Unit, Bambino Ges\u00f9 Children's Hospital (IRCCS) Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca Maria","family":"Antoniello","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Unit, Department of Women's and Children's Health University Hospital of Padova Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Chiaro","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology and Digestive Endoscopy Unit, IRCCS Istituto Giannina Gaslini Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Destro","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Buzzi Children's Hospital Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Dipasquale","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood \u201cG. Barresi\u201d University Hospital \u201cG. Martino\u201d Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Felici","sequence":"additional","affiliation":[{"name":"Pediatric and Pediatric Emergency Unit, Children Hospital, AOU SS Antonio e Biagio e C. Arrigo Alessandria Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Macchini","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department Grande Ospedale Metropolitano Niguarda Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Maino","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy, Fondazione IRCCS San Gerardo dei Tintori Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Parma","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Mariani Foundation Center for Fragile Children ASST\u2010Lariana, Sant'Anna Hospital, San Fermo della Battaglia Como Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessio Pini","family":"Prato","sequence":"additional","affiliation":[{"name":"Umberto Bosio Center for Digestive Diseases, The Children Hospital, AOU SS Antonio e Biagio e Cesare Arrigo Alessandria Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Renzo","sequence":"additional","affiliation":[{"name":"Gastroenterology and Nutrition Unit, Meyer Children's Hospital IRCCS Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Dolce","sequence":"additional","affiliation":[{"name":"Department of Public Health University of Naples Federico II Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margherita","family":"Rosa","sequence":"additional","affiliation":[{"name":"Chronic and Multifactorial Diseases Unit, Santobono\u2010Pausilipon Children's Hospital Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossella","family":"Turco","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology and Hepatology Unit, Santobono\u2010Pausilipon Children's Hospital Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Letizia","family":"Zenzeri","sequence":"additional","affiliation":[{"name":"Emergency Pediatric Department Santobono\u2010Pausilipon Children's Hospital Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"di Nardo","sequence":"additional","affiliation":[{"name":"NESMOS Department, Pediatric Unit, Faculty of Medicine &amp; Psychology Sapienza\u2010University of Rome, Sant'Andrea University Hospital Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0734-7472","authenticated-orcid":false,"given":"Paolo","family":"Quitadamo","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology and Hepatology Unit, Santobono\u2010Pausilipon Children's Hospital Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,18]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"crossref","first-page":"2041","DOI":"10.1016\/S0140-6736(16)30313-0","article-title":"Caustic ingestion","volume":"389","author":"Chirica M","year":"2017","journal-title":"Lancet"},{"key":"e_1_2_7_3_1","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/s13017-019-0245-2","article-title":"Esophageal emergencies: WSES guidelines","volume":"14","author":"Chirica M","year":"2019","journal-title":"World J Emerg Surg"},{"issue":"1","key":"e_1_2_7_4_1","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1097\/MPG.0000000000001408","article-title":"Paediatric gastrointestinal endoscopy: European Society for Paediatric Gastroenterology Hepatology and Nutrition and European Society of Gastrointestinal Endoscopy Guidelines","volume":"64","author":"Thomson M","year":"2017","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"3","key":"e_1_2_7_5_1","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1016\/j.gie.2008.02.016","article-title":"Caustic ingestion in children: is endoscopy always indicated? 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