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[4岁男孩消化性瘢痕性幽门狭窄的内镜治疗]

[Endoscopic treatment of cicatricial pyloric stenosis of peptic origin in a 4-year-old boy].

作者信息

López Fagalde Guillermo R, Manzotti Leandro N, Keller Eliana, Hidalgo Pilar, Spomer Celso, Jury Gastón

机构信息

Centro de Estudios Digestivos, Mar del Plata, Argentina.

出版信息

Arch Argent Pediatr. 2021 Oct;119(5):354-357. doi: 10.5546/aap.2021.354.

Abstract

Gastric outlet obstruction is an uncommon condition in children. Traditionally, surgery has been the standard mode of treatment, but it is associated with higher morbidity and mortality. Endoscopic treatment has emerged as an alternative to conventional treatment. We present the case of a 4-year-old patient with refractory prepyloric stenosis secondary to peptic ulcer disease. The picture begins with vomiting and abdominal pain of 2 months of evolution. Pre-pyloric stenosis was confirmed. Faced with the lack of response to medical treatment and balloon dilation, radiated incisions were made with electrocautery and steroid injections. When medical treatment is not sufficient, endoscopic balloon therapy should be the first therapeutic gesture in this type of stenosis; given its refractoriness, we believe it is important to highlight the usefulness of endoscopic treatment, which could prevent surgery and associated morbidity and mortality.

摘要

胃出口梗阻在儿童中是一种罕见病症。传统上,手术一直是标准治疗方式,但它伴随着更高的发病率和死亡率。内镜治疗已成为传统治疗的替代方法。我们报告一例4岁患有消化性溃疡疾病继发难治性幽门狭窄的患者。症状始于持续2个月的呕吐和腹痛。幽门狭窄得到确诊。面对药物治疗和球囊扩张无效的情况,采用电灼和类固醇注射进行放射状切口。当药物治疗不足时,内镜球囊治疗应是这类狭窄的首选治疗手段;鉴于其难治性,我们认为强调内镜治疗的有效性很重要,它可以避免手术及相关的发病率和死亡率。

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