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氩等离子体凝固治疗儿童先天性巨结肠术后增生性息肉:病例报告

Hyperplastic polyps after surgical management of Hirschsprung's disease in children treated with argon plasma coagulation: Case report.

作者信息

Ibrahim Rahaf, Mahmoud Jaber, Sandouk Fayez

机构信息

Pediatric Department, Damascus University Pediatric Hospital, Damascus, Syria.

Gastroenterology & Interventional Endoscopy Pediatric Department, Damascus University Pediatric Hospital and Syrian Specialty Hospital, Damascus, Syria.

出版信息

Ann Med Surg (Lond). 2022 Jun 28;79:104098. doi: 10.1016/j.amsu.2022.104098. eCollection 2022 Jul.

Abstract

INTRODUCTION AND IMPORTANCE

The argon plasma coagulation is a technique used for noncontact thermal coagulation of tissue. Hyperplastic polyps are the most common non-neoplastic polyps in the colon.

CASE PRESENTATION

We presented a 3-year-old girl with a chief complaint of bloody stool and rectal tenesmus that began 5 days ago. She was previously being treated because of a history of chronic constipation. She underwent a one stage surgery for Hirschsprung's disease, after a full-thickness rectal wall biopsy was obtained and it consistent with Hirschsprung's disease. Three months after the surgery, the girl presented to our clinic with rectal blood loss and rectal tenesmus. Endoscopic examination of her colon demonstrated sessile and pedunculated polyps. The pedunculated polyps were removed endoscopically. Biopsies were taken from the sessile polyps. Histopathologic examination of the polypectomy specimen and the biopsies of the sessile polyps showed hyperplastic polyps. The endoscopy was repeated for the purpose of argon plasma coagulation ablation of the sessile polyps. Argon plasma coagulation caused an adequate ablation and the entire polyps were burned.

CLINICAL DISCUSSION

Argon plasma coagulation is an effective and safe technique in the endoscopic management of gastrointestinal conditions.

CONCLUSION

Further clinical trials including a comparison of argon plasma coagulation to other treatment modalities, as well as long-term follow-up after argon plasma coagulation treatment are required.

摘要

引言与重要性

氩等离子体凝固术是一种用于组织非接触式热凝固的技术。增生性息肉是结肠中最常见的非肿瘤性息肉。

病例介绍

我们报告了一名3岁女童,主要症状为便血和直肠坠胀感,始于5天前。她曾因慢性便秘病史接受治疗。在获得全层直肠壁活检且结果符合先天性巨结肠后,她接受了一期先天性巨结肠手术。术后三个月,该女童因直肠出血和直肠坠胀感前来我院就诊。对其结肠进行内镜检查发现有广基息肉和带蒂息肉。带蒂息肉通过内镜切除。对广基息肉进行活检。息肉切除标本和广基息肉活检的组织病理学检查显示为增生性息肉。为了对广基息肉进行氩等离子体凝固消融,再次进行了内镜检查。氩等离子体凝固实现了充分消融,整个息肉被烧灼。

临床讨论

氩等离子体凝固术在内镜治疗胃肠道疾病方面是一种有效且安全的技术。

结论

需要进一步开展临床试验,包括将氩等离子体凝固术与其他治疗方式进行比较,以及在氩等离子体凝固治疗后进行长期随访。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8479/9289502/b0d723ee968a/gr1.jpg

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