1 The essence of

technology The esophagus buzzing is a medical procedure to expand the internal esophageal canal by introducing a special probe - bougie. Previously, significant stenosis( narrowing) of the esophagus was surgically eliminated, which naturally caused considerable damage to the tissues. Buzhirovanie refers to non-surgical methods of treatment, although the procedure is better performed in the surgical department of the hospital in order to eliminate the risk of unforeseen complications.

The essence of the method is to expand the narrowed esophagus by inserting into the affected area a probe having a conical shape. When the bougain is fed into the channel due to the conical execution, the inner cavity is gradually expanded. For such an event, flexible or hard type boogers of different lengths can be used, the choice of which is performed by a gastroenterologist after preliminary studies.

Buzhirovanie can be made in the following ways: blindly, i.e.solely by the intuition and experience of the doctor;on the thread as a guide;retrograde, for the thread;on a metal string with radiographic observation;using endoscopic methods. The most common methods are bougie with the use of a metal string as a guide and an endoscopic method.

2 When is diagnostics assigned?

A number of pathologies of a congenital or acquired character cause stenosis of the esophagus, which complicates the process of digestion and stool removal, causing painful and dangerous symptoms. Such manifestations can occur at any age, and the degree of their danger is assessed by the doctor. He after exact diagnosis, if necessary, assigns bougie.

This procedure is indicated for the following pathologies: chemical burns caused by acids and alkalis, causing the appearance of scars from connective tissue;thermal burns when consuming very hot food;mechanical trauma caused by penetration into the esophagus of solid foreign bodies;infectious lesions( tuberculosis, syphilis) with the formation of granulomas;a peptic ulcer that occurs with reflux of gastric acid;Inflammatory reaction of an infectious nature caused by streptococci, staphylococci, E. coli, in the form of periesophagitis with the formation of an infiltrate;esophagitis of chronic course;benign tumors;congenital stenosis and atresia of the esophagus, detected in children.

Although bougie is considered to be a minimally invasive procedure, it should take into account contraindications when it is prescribed.

Absolute contraindications include the following anomalies: mediastinitis( inflammatory process in the mediastinum);esophagitis and pereezophagitis in the phase of exacerbation( prior to arresting the acute phase);exacerbation of chronic diseases of internal organs of somatic nature;poor coagulability of blood in systemic diseases;any oncology;manifestation of general intoxication and febrile state due to infectious processes in the body;mental abnormalities in the severe stage.

3 Therapeutic actions

The procedure of bougie is conducted in several stages with gradual expansion of the esophagus. This is achieved using bougie of different diameters. The first procedure is provided by the tool with the smallest diameter. After 1-3 days, a larger bougie is introduced. In total, up to 15 procedures can be performed depending on the degree of stenosis.

The bougie( flexible or hard) is a hollow probe with a length of about 70 cm and a diameter of 12 mm. Each diameter of the bougain corresponds to a certain number. A total of 15 instrument numbers are used. The main condition is the absolute smoothness and sterility of the probe. Sterilization of hard bougies is carried out in autoclaves, and the elastic probe is treated with a special solution. Before insertion into the esophagus, the instrument is coated with glycerin to improve slip.

The procedure is performed after a mandatory examination with the use of esophagoscopy to determine the exact location, nature and degree of stenosis. The entire bougie process can last more than 1-2 months. Bug is injected into the esophagus for a period of 5 to 60 minutes, depending on the degree of stenosis. The whole operation is performed in the morning on an empty stomach, after cleaning the esophagus.

During the exercise, the patient occupies a sitting position with a bowed head. Before the procedure, Atropine is prescribed to eliminate the urge to vomit, spasms and salivation. The initial action is the introduction of the guide. The most commonly used steel string with a springy tip. Buzh is smoothly introduced along this guide without excessive efforts. The first injection session is completed in 4-6 minutes, after which the tool is carefully removed. A day later the operation is repeated, but with the next number tool, and the exposure time increases. The final stage involves the introduction of a bougie of the largest size for a period of up to 60 minutes.

All procedures are performed under close visual control with the use of radiography or endoscopic equipment. It is important to constantly monitor and body temperature: increasing it to more than 37.6 ° C indicates the problems that have arisen. Conducting bougie is combined with the intake of antibiotics and resorptives.

4 How does therapy work in children?

In detecting congenital defects of the esophagus, the bougie procedure can be administered to a baby almost immediately after birth. Children's bougie is carried out taking into account the following special conditions:

1. Children's bougie has increased elasticity, and its tip is rounded, and the smallest numbers of the tool are used taking into account the size of the infant's esophagus.
2. Babies before the procedure are swaddled to exclude unexpected movements, while the head of the child is held by the doctor's assistant.
3. The duration of the probe inside is: the first session - about 2 minutes, the final stage - no more than 25-30 minutes.
4. The frequency of procedures is 2-3 per week, and the entire course is designed for 40-60 days.
5. During the entire course of bougainage, the toddler must be in the hospital under the constant supervision of the doctor.
6. To prevent infection, the conduct of the bougie is accompanied by the intake of antibiotics according to age.

5 Possible complications of

Buzzing of the esophagus refers to quite safe methods of treatment. The greatest number of recorded cases of complications is associated with a violation of the technology of the operation and low skill of the performer. In these cases, mechanical damage to the esophagus is possible with an overestimated diameter of the bougie, unnecessarily vigorously pushing a string or instrument into the interior, and infection of the organ with insufficient sterilization of the probe.

At the same time, complications can not be ruled out even if all the rules of the operation are observed. This is due to the individual characteristics of the body and the state of the esophagus. The most characteristic complications are: perforation of the esophagus walls, which requires emergency surgery;rupture of adhesion of connective tissues;internal bleeding with damage to small vessels;the appearance of esophagitis or pereezophagitis during infection.

It is because of possible complications after bougie that such treatment is recommended to be performed under in-patient conditions under the supervision of a doctor. The most common complication is a small damage to stenotic tissues and mucous membranes. At the first signs of this phenomenon, the procedure immediately stops, and the damaged area undergoes antiseptic treatment.

Buzzing of the esophagus is a non-surgical way of treating digestive pathologies. This technology is widely used and has proven its high efficiency, even in the treatment of newborns.