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Hyperplastic polyps after surgical management of Hirschsprung's disease in children treated with argon plasma
Rahaf Ibrahim1, Jaber Mahmoud2, Fayez Sandouk3
1Pediatric Department, Damascus University Pediatric Hospital, Damascus, Syria.
Insights
Argon plasma coagulation effectively treated hyperplastic polyps in a pediatric patient with a history of Hirschsprung's disease. This minimally invasive technique offers a safe endoscopic management option for gastrointestinal conditions.
Area of Science:
- Gastroenterology
- Pediatric Surgery
- Endoscopic Procedures
Background:
- Hyperplastic polyps are common non-neoplastic colonic polyps.
- Argon plasma coagulation (APC) is a noncontact thermal tissue coagulation technique.
- Management of polyps in pediatric patients requires careful consideration.
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.
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