Year 2017 Vol. 25 No 4




SE "Republican Scientific and Practical Center of Pediatric Surgery"1
EE "Belarusian State Medical University"2
The Republic of Belarus

The clinical observation of a gastric phlegmon in a 10-year-old child is presented in this paper. Difficulties of diagnosis and choice of treatment of this pathology in children are shown; the efficiency of surgical treatment (atypical hardware stomach resection) of the disease is demonstrated in an extremely debilitated patient.
This disease is described in patients of different age groups starting from 3-month old babies and ending by elderly patients. Overall mortality of this pathology is quite high and according to some data reaches 92%; the postoperative mortality is about 18%. The development of this disease is due to penetration of pathogenic and opportunistic pathogens n the stomach wall. This inflammatory process is localized mainly in the submucosal layer. The clinical picture of a gastric phlegmon cannot be called specific. In general, it be may singled out three main syndromes: pain syndrome, dyspeptic syndrome and intoxication syndrome. Radiological and endoscopic methods of examination, ultrasound examination of the abdominal cavity and laparoscopic surgery can help in diagnosing this pathology. At present treatment tactics generally accepted for patients with a gastric phlegmon has not been worked out. In choose a treatment method the localization of the process, its prevalence, the stage of the disease, presence of complications should be taken into account. In the choice of treatment tactics is equally important to take into consideration the patients age and presence of accompanying diseases.
A gastric phlegmon in children is an extremely rare disease and in most cases is described as casuistry. Efficacy of treatment, including surgery, depends on early diagnosis and subsequent intervention tactics. Gentle methods of surgical treatment (atypical hardware stomach resection) can be used in extremely debilitated patients.

Keywords: gastric phlegmon, clinical observation, atypical hardware stomach resection, children, debilitated patients, abdominal cavity, laparoscopic surgery
p. 431-436 of the original issue
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Address for correspondence:
220013, Republic of Belarus, Minsk,
64 Nezavisimost ave.,
Republican Scientific and
Practical Center for Children's Surgery,
Tel. +375 29 633 23 76,
Larisa V. Valek
Information about the authors:
Averin V.I. MD, Professor, Head of department of the pediatric surgery, EE "Belarusian State Medical University".
Valiok L.V. Surgeon of department of surgery N4, SE "Republican Scientific and Practical Center of Pediatric Surgery".
Svirsky A.A. PhD, Ass. Professor, Head of the pediatric surgery department, SE "Republican Scientific and Practical Center of Pediatric Surgery".
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