卷 5, 编号 2 (2015)

The purpose of this article is to demonstrate a rare complication of an ileal mesenteric lymphangioma. This example clearly demonstrates a rare complication in the form of suppuration of the mesenteric root lymphangioma.

This article summarizes the clinical experience in diagnostics and treatment of destructive pneumonia in 258 children. The presented algorithm enables to make a timely diagnosis and provide necessary therapeutic aid including mini-invasive interventions to children with pulmonary and pleural complications of pneumonia. The single port thoracoscopy and ultrasound irrigation of the pleural cavity with the antibiotic-containing solution free the lung from fibrin coating, deliver the preparation to the focus of inflammation and remove the inflammatory exudate. Ultrasound screening used during treatment considerably expands the possibilities of pathology diagnostics and invasive methods of treatment.

TIP (Snodgrass) procedure is most common for the correction of distal and midshaft hypospadias. The technique is simple and has excellent cosmetic results. However, many authors point to the signs of narrowing of the distal urethra and reduced flow of urine in the postoperative period. For the period 2012-2014 operated 120 children with hypospadias at the age of 10 months to 17 years. The study included previously operated patients. With distal hypospadias (DH) were 101 patients, with the midshaft form of hypospadias (MH) - 19. Patients divided into 2 groups. The children in the groups did not differ in age and form of hypospadias. The first group included patients (60) who underwent standard surgery TIP. The second group consisted of boys (60), which were optimized approach to the correction of distal hypospadias with a modification of the technique TIP. Performed increasing the length of the wings of the glans penis by applying longitudinal incisions and stitching wings of glans surface at a depth of 2 mm to short for 5-8 mm in the upper half of the glans. Deeper longitudinal incision of the urethral plate. Economical foreskin resection with preservation of the stock of skin on the ventral surface. Sequential drainage of the bladder catheter with end hole (feeding tube) for 7 days. Then the catheter was pulled up and transferred to the stent, which was removed on the 14th to 17th day after surgery. Conducted preliminary preparation of patients with hypospadias testosterone drugs to increase penis size and improve circulation of the skin of the trunk and the foreskin. Outcomes were systematized during the follow up (6 months up to 1,5 years). The complications in the first group such as fistula and urethral stenosis were observed in 11 (18%) patients. In the second group we have not observed urethral stenosis, urethral fistula was diagnosed in 3 patients (5%). Proposed measures to optimize the treatment of patients with distal hypospadias by TIP method allowed us to improve the results of hypospadias repair and to reduce the number of postoperative complications more than tripled, from 18 to 5% and to ensure the prevention of violations of the flow of urine after these operations.

At Moscow Research Centre of Providing Medical Assistance to Children they have been treating hydrocephalus using Richard Wolf and Karl Storz endoscopes since 1999. The structural and functional modernization of the clinic during 15 years enabled to increase the specific gravity from 8.43 to 28.2% in those neonates who underwent surgery and from 75.9 to 93.4% in infants. Types of endoscopic manipulations were diversified during these years (3 to 30) and their amount rose from 20 to 600 a year. The surgeries are performed irrespective of liquor composition starting from 28 weeks of gestation and in 1,000 g of weight. A set of introduced, modernized and developed endoscopic manipulations developed by us can be applied in children of any age in different etiology and types of hydrocephalus enabling to eliminate and/or prevent intra- and extraventricular occlusions, senate liquor and restore its ventriculosubarachnodial passage in supra-, subtentorial and spinal subarachnoid spaces with the integration of the latter, remove the pathological content from the brain ventricles, restore the function of the shunts and lumen of the ventricles, decrease liquor production, ensure regular drainage of liquor spaces and eliminate the corresponding pathology. The manipulations are easily compatible and are carried out using one approach. Complex application of endoscopic methods demonstrated their effectiveness in case of multi-level noncommunicating hydrocephalus in 54% of cases, and it reaches 75% in one-level noncommunicating hydrocephalus increasing the effectiveness of endoscopic methods in their isolated application.

This article presents the results of the comparative analysis of use of synthetic film wound coatings in the treatment of infants with burns.

A comparative study of peculiarities of a concomitant injury in childhood was conducted based on the materials of postmortem examinations in 147 children and 110 adults who died while falling from height. It was established that the scope of damages obtained while falling from height was less in children than in adults. It was explained by a smaller frequency of separate injuries and lesser number of injured body areas. Concurrently, such concussion manifestations as the damage of a fixing appliance of the chest and abdomen are more pronounced in children. There are no significant differences in the redistribution of damages between the body areas in children and adults.

A significant amount of publications devoted to disturbances of involution of the urachus has been accumulated lately. However, world literature data related to obliteration terms and frequency of the urachal anomalies vary considerably hampering risk assessment of complications. No consensus is reached over the issue of patient’s management as well. This article analyzes medical literature and most prominent Internet sources related to disturbances of involution of the urachus and treatment of related conditions.