Nasojejunal Tube Feeding And Clinical Pharmacy Intervention In The Management of Caustic Esophageal Injury: A Case Report

Background: Accidental ingestion of corrosive substances, such as sulfuric acid, is a rare but serious medical emergency, particularly in children. Such incidents can result in significant morbidity, including damage to the gastrointestinal tract, and require prompt and comprehensive management. This case is unique as it demonstrates the successful treatment of a 7-year-old boy who ingested sulfuric acid, providing valuable insights into effective clinical interventions. By documenting this case, we aim to expand the knowledge base for managing complex pediatric corrosive ingestion cases, offering a framework for similar scenarios in future clinical practice. Case Presentation: A 7-year-old boy accidentally ingested a mixture of sulfuric acid and water, presenting with severe vomiting and gastrointestinal bleeding. Upon arrival at the hospital, he was hemodynamically stable but exhibited signs of upper gastrointestinal distress. Initial evaluation included physical examination and imaging to assess the extent of damage. A multidisciplinary approach was adopted, starting with nasojejunal tube feeding to bypass the injured esophagus and ensure adequate nutrition. Medications, including proton pump inhibitors to reduce acid secretion and antibiotics to prevent secondary infections, were administered. The patient's vital signs were closely monitored, and a strict dietary plan was implemented, avoiding irritants and promoting gastrointestinal healing. Endoscopy was deferred to avoid further trauma to the already compromised tissue. Over several weeks, the patient showed significant improvement, with resolution of symptoms and no evidence of complications such as stricture formation or perforation. Follow-up care focused on nutritional recovery, psychological support, and education to prevent similar incidents. Conclusion: This case illustrates the critical importance of early recognition and immediate, targeted interventions in managing pediatric acid ingestion. The combination of nasojejunal feeding, vigilant monitoring, and tailored pharmacological and dietary management contributed to a positive outcome. The successful resolution of this complex case without long-term complications highlights effective strategies that can guide clinicians facing similar challenges. By sharing this case, we aim to contribute to the growing body of evidence on pediatric corrosive ingestion management, ultimately enhancing future clinical practices.