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"Emergency medicine" 4 (67) 2015

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Argon plasma coagulation of bleeding ulcers of the stomach and duodenum in children

Authors: Sokolnyk S.O. - BukovinianState Medical University, Chernivtsi, Ukraine

Categories: Medicine of emergency

Sections: Specialist manual

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According tomost authors, gastric ulcer and duodenal ulcerin childrenisone of the mostcommon diseasesof the digestive systemin Ukraineand abroad, which has a tendency toheavy flow, development of life-threateningcomplications,the frequency of whichin recentyears hasincreased.

Inchildhoodpeptic ulcer has itsfeatures:displaysasymptomaticfor a long time, followed by rapid progression ofthe disease with theaddition ofvarious complicationsthat requiresurgical treatment.

According tomost authorsthe mostfrequent complicationof peptic ulceramongchildrenandadults,isgastrointestinal bleeding.

Inpediatric surgery, despite numerous studies,information onthe likelyincidenceof gastrointestinal bleedingulcersthere,aslongasthe problemchildrenwasnotsoserious.

It should be noted that the treatment of gastrointestinal bleeding in recent years is undergoing radical change. Planned surgery on this disease a thing of the past thanks to a historic achievement in the art of pharmacotherapy and methods of implementation of flexible endoscopy and mini-invasive surgery.

In recent years, endoscopic methods of stopping acute gastroduodenal bleeding widespread in clinical practice. Effective use of endoscopic hemostasis greatly reduce the percentage of surgery, performed at an altitude of bleeding, and in some cases totally avoid surgery.

Depending on the sourceof bleedingand itsintensity,endoscopicequipmentcabinet,electedendoscopistexperienceone way or anotherlocalstop bleeding.

At the presentstage ofscientific progresswidely adoptedendoscopic hemostasistechniques suchasapplication,injection, thermal andmechanical.

The most effective and promising method for endoscopic bleeding stop both in adults and in children is the use of argon plasma coagulation. Properties argon as inert gas have long been known to scholars engineering industries. Successful clinical trials argon plasma coagulator strongly suggest that this new way of coagulation combines the advantages of the known methods of high-frequency surgery that has their flaws. Its originality lies in the fact that high-frequency energy is transferred without contact ionized argon to the fabric that allows for effective coagulation at a controlled depth penetration.

Recently began to appear on studies on the use of argon plasma coagulation in order to stop bleeding ulcer.

Despite the undeniable advantages of the method over other methods, some vigilance towards it persists to this day. A number of experts believe that argon plasma coagulation is not able to provide enough deep coagulation effect on tissue and reliably stop bleeding from blood vessels in the depths of woven wood, especially in ulcer bleeding. However, argon plasma coagulation less than bipolar diathermocoagulation results in rebleeding in the course of primary hemostasis.

In recent years, more and more literature there are reports of the use of argon plasma coagulation in treatment of peptic ulcer complicated by bleeding in adult patients and there are few data on the effectiveness of the use in children.

Conclusion. Treatment of gastrointestinal bleeding ulcers in children should always be comprehensive and personalized. The alternative between conservative and surgical treatment is determined individually and takes into account the severity of bleeding and bleeding activity. Analysis of the literature showed that when choosing the optimal treatment strategy ulcer bleeding should be considered argon plasma coagulation because this method in treatment is the most gentle, has the fewest side effects and achieves stable hemostasis.


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