الفهرس 
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Abstract
C
orrosive injuries in children still represent an important social, medical and economic problem especially in developing countries. The effect and complications of corrosive injuries depends on the type of substance ingested, the concentration and amount taken.
The most common delayed complication of corrosive ingestion includes stricture formations. The rates of caustic strictures have been reported in 15% to 80% of caustic ingestions. The management of strictures is important in pediatrics as it may hinder swallowing leading to nutritional compromise, repeated chest infections and delay in developmental milestones.
The mainstay of treatment is esophageal dilatation most commonly with Savary Gillard dilators over a guide wire. The use of adjuvant agents especially local corticosteroid injection and mitomycin C application have been highly promoted by different investigators.
Mitomycin C, isolated from Streptomyces caespitosus, inhibits DNA-dependent RNA synthesis and can suppress cellular proliferation at any phase of the cell cycle. It is known for its antibiotic and antineoplastic properties, however, has gained popularity for its use as an anti-fibrotic agent reducing collagen production and fibroblast proliferation.
Corticosteroids also inhibit stricture formation by interfering with collagen synthesis, fibrosis, and chronic scarring processes and have been described many years ago for the use in esophageal strictures.
The aim of this randomized controlled study was to compare the outcomes of corticosteroid and mitomycin C use in caustic strictures in terms of the total number of dilatations needed, symptom free period in-between dilatations, periodic dilatation index, improvement of dysphagia scores, contrast swallow study findings, percentage of completely cured patients, percentage of markedly improved patients and any encountered complications.
from June 2022 to June 2024, 38 caustic esophageal stricture patients were enrolled in our study.
22 were subjected to topical mitomycin C application and 16 were subjected to local corticosteroid injection, 17 had short strictures and 21 had long strictures.
Through analyzing our results, we found no difference in outcome with short strictures, however, with long strictures, patients subjected to mitomycin C had a significantly lower dilatation frequency than those compared to the steroids group (p<0.05).