Russian Journal of Pediatric Surgery, Anesthesia and Intensive CareRussian Journal of Pediatric Surgery, Anesthesia and Intensive CareРоссийский вестник детской хирургии, анестезиологии и реаниматологии2219-40612587-6554Eco-Vector98910.17816/psaic989Case reportsКлинические случаиResearch ArticleIdiopathic omentum infarction in children — the law of "paired cases": cases reportИдиопатический инфаркт сальника у детей — закон «парных случаев»: клинические наблюденияhttps://orcid.org/0000-0002-2066-19441546-5236ShidakovIslam H.ШидаковИслам Хусеинович
Russian Federation

Pediatric Surgeon

детский хирург

islam_shidakov@mail.ruhttps://orcid.org/0000-0002-4030-74752209-6275KalniyazovBakhtiyar M.КалниязовБахтияр Максетович
Russian Federation

Deputy Chief Physician for Surgery

заместитель главного врача по хирургии

kalniyazov@mail.ru5163-2179UrusovaMaryam N.УрусоваМариам Науаровна
Russian Federation

anesthesiologist

врач – анестезиолог-реаниматолог

mariam13072016@gmail.comRepublican Children’s HospitalРеспубликанская детская многопрофильная больница131020211134034080308202116082021Copyright ©; 2021, Shidakov I.H., Kalniyazov B.M., Urusova M.N.Copyright ©; 2021, Шидаков И.Х., Калниязов Б.М., Урусова М.Н.2021Shidakov I.H., Kalniyazov B.M., Urusova M.N.Шидаков И.Х., Калниязов Б.М., Урусова М.Н.https://creativecommons.org/licenses/by-nc-nd/4.0https://rps-journal.ru/jour/article/view/989

BACKGROUND: One of the rare causes of abdominal pain in children is an omental infarction. In the literature, there are few descriptions of this pathology in childhood. The disease is often diagnosed only intraoperatively because of its nonspecific clinical picture. Therefore, the clinical cases presented in the article may be of interest to pediatric surgeons.

CASES REPORT: In the pediatric surgical department of our clinic, two patients aged five and six years old were treated after being admitted with abdominal pain syndrome, the clinical picture of which did not allow to exclude an acute surgical pathology. A laparoscopy was performed to clarify the diagnosis. Isolated lesions of the segments of the greater omentum were revealed without signs of torsion and pathology of other organs. The operations were completed by resection of the altered omental sections. Histopathological examination revealed hemorrhages and tissue necrosis.

DISCUSSION: The localization of pain in the right abdomen necessitates differentiating the disease from acute appendicitis, cholecystitis, and acute gynecological pathology. In the treatment of patients with omental infarction, there are supporters of conservative and surgical strategies. We performed a resection of the affected omental segment, which enabled us to achieve complete recovery in both cases.

CONCLUSION: Laparoscopy in unclear diagnostic situations permits the timely diagnosis of an omental infarction, and surgical minimally invasive intervention leads to a successful cure.

Введение. Одной из редких причин болей в животе у детей является инфаркт сальника. В литературе можно найти немногочисленные описания этой патологии в детском возрасте. Имея неспецифическую клиническую картину, заболевание зачастую диагностируется лишь интраоперационно. Поэтому клинические наблюдения в данной статье могут представлять интерес для детских хирургов.

Описание наблюдения. В детском хирургическом отделении Республиканской детской больницы г. Черкесска находились на лечении двое больных 5 и 6 лет, поступивших с абдоминальным болевым синдромом, клиническая картина которого не позволяла исключить острую хирургическую патологию. Для уточнения диагноза проведена лапароскопия, при которой выявлены изолированные поражения сегментов большого сальника без признаков перекрута и патологии других органов. Операции завершены резекцией измененных участков сальника. На патогистологическом исследовании обнаружены кровоизлияния и некроз тканей.

Обсуждение. Локализация болевого синдрома в правых отделах живота заставляет дифференцировать заболевание с острым аппендицитом, холециститом, острой гинекологической патологией. В лечении пациентов с инфарктом сальника есть сторонники консервативной и оперативной тактики. Мы выполнили резекцию пораженного сегмента сальника, что позволило добиться полного выздоровления в обоих случаях.

Заключение. Лапароскопия в неясных диагностических ситуациях позволяет своевременно установить диагноз инфаркта сальника, и оперативное мининвазивное вмешательство приводит к успешному излечению.

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