Pediatric Surgery International

, Volume 34, Issue 7, pp 781–788 | Cite as

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

  • Babalwa B. Nondela
  • Sharon G. Cox
  • Anita Brink
  • Alastair J. W. Millar
  • Alp Numanoglu
Original Article



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


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.


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.


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.


Caustic substance ingestion Caustic oesophageal injury Oesophagitis 99mTc sucralfate scan Paediatric 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

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.

Informed consent

For this type of study formal consent is not required.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Babalwa B. Nondela
    • 1
  • Sharon G. Cox
    • 1
  • Anita Brink
    • 1
    • 2
  • Alastair J. W. Millar
    • 1
    • 2
  • Alp Numanoglu
    • 1
  1. 1.Division of Paediatric Surgery, Red Cross War Memorial Children’s HospitalUniversity of Cape TownCape TownSouth Africa
  2. 2.Division of Nuclear Medicine, Red Cross War Memorial Children’s HospitalUniversity of Cape TownCape TownSouth Africa

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