European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) report in their guidelines that every child who has ingested a corrosive substance should have a thorough follow-up, with endoscopy dictated by symptoms and dependent on the symptoms and signs, and that the timing should be within 24 hours. ESGE/ESPGHAN also suggest that in the case of suspected corrosive ingestion, esophagoscopy is withheld if the child is asymptomatic (no drooling of saliva/other symptoms and no mouth lesions) and that adequate follow-up is assured.64
An unexpected result was that polytherapy had no effect on pneumonia incidence, despite the fact that it is considered one of the most significant exposure factors.12,13 This could be related to the very high level of total polytherapy in the study population, which affected more than half of the analyzed cohort, while Brazilian studies displayed a prevalence of polypharmacy at 27.5%,14 a Swiss university in primary care settings at 37.0%,15 and a Qatar-based study displayed its prevalence at 75%.16 On the other hand, in the analyzed population, most of the procedures were planned. Preoperative treatment, mainly cardiovascular, was therefore most likely optimized so that the patients could qualify for the surgery, increasing the likelihood of polytherapy that did not have a negative impact on complications. Treatment of musculoskeletal diseases prior to the surgery in our population was a protective factor against the risk of pneumonia. There are reports that treatment of osteoporosis reduces the risk of death.17 Moreover, vitamin D supplementation significantly reduced the incidence of recurrent episodes of pneumonia in a study by Yang et al.18
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