Influence of surgical correction of inguinal hernia and hydrocele on testicular blood flow in children

Inguinal hernia and hydrocele affect the blood circulation of the testicle. Surgical trauma may change testicular blood flow. Objective. To study changes in blood flow parameters in children with pathology of the processus vaginalis, requiring surgical correction, using the analysis of ultrasound data. Materials and methods. We observed 87 boys from 3 to 17 years old, operated for congenital inguinal hernia and hydrocele. As a control group we examined 34 boys without pathology of the reproductive system. Patients held Doppler ultrasound the day before surgery, at 1 and 7 days after. Peak systolic flow velocity, end-diastolic flow velocity and resistance index were studied. Results. The resistance index on the affected side was higher compared with the control group before operation (p<0,05). The values of peak systolic and end diastolic blood flow velocities were lower than in the comparison group (p<0,05). Resistance index increased compared with preoperative period 1 day after surgery (p<0,05). Values of flow velocity parameters decreased to 4-9 % compared to values before the operation. The resistance index decreased (p<0,05) to near baseline figures a week after the operation. Peak systolic and end-diastolic flow velocity raised to 15-21 % compared to the preoperative period. However, the intensity of the blood flow in the affected testicle remained lower than in the control group (p<0,05). Conclusions. The blood flow of affected testicle in children with inguinal hernia and hydrocele is initially decreased. Early postoperative period is characterized by intensification of testicular parenchyma’s ischemia. Postoperative blood flow in the affected testicle is improved a week after surgery, but the lack of blood supply to the testicle is retained

Prolonged drainage of the lower urinary tract in the treatment of refluxing megaureter in children

The main purpose. To substantiate the need for conservative therapy as the first stage of treatment refluxing megoureter in newborns and infants. Materials and methods. Analyzed result s of treatment 19 children (25 ureters) with different levels of the disease. The evaluation criteria were the ultrasonographic researchers, determining the degree of dilatation of the ureters, the cup-and-pelvis system and the thickness of the kidney parenchyma, as well as the presence of an urinary tract infection. Treatment based on prolonged drainage and lower urinary tract catheter Folleya (up to 1 month), with the interleave instrument natural urination (also up to 1 month, or until the secondary acute pyelonephritis). Medication support was in an antibiotic therapy, taking into account with the sensitivity of microflora and preventive treatment uroseptics. There were regularly monitoring the degree of activity of the secondary flow of pyelonephritis and excretory function of the kidney. Excretory urography and cystography used in suspected degradation of structural parameters and renal function. Indications for surgical treatment were indestructible inflammatory process within one month, the progression of dilatation of the ureters and renal pelvis system, thinning and disruption of parenchymal renal excretory function. Results. In 6 (31,6%) of children to the age of 2 years were revealed a complete disappearance of dilatation of the ureter. In 3 cases of them survived vesicoureteral reflux 1- 2 degrees without renal impairment and without bladder syndrome, which can be considered as a positive treatment outcome. Conclusion. Treatment the newborns and infants with refluxing megaureter should begin with conservative therapy, including prolonged drainage of the lower urinary tract

Renal Endometriosis in a Child

The problem of extragenital endometriosis was discussed in this article. We describe a rare case of renal endometriosis in 13-year-old child. Questions of diagnosis and therapeutic approach in this pathology were discussed

Therapeutic Approach in Complications of BCG Vaccinations in Children

This article provides an experience of treatment of 206 patients with post-vaccination with BCG-affected lymph nodes (202 observations — 98.1 %) and children with post-vaccination tuberculous osteitis (4 patients — 1.9 %) aged from 1 month to 3 years, who were operated during the period from 2009 to 2011. There were 127 (61.7 %) boys, and 79 (38.3 %) girls. The article also raises questions of choice of surgical tactics in the treatment of complications of BCG vaccination in children. Doppler ultrasound can determine the nature of changes in the lymph nodes (from initial infiltration to total purulent fusion) to select a rational treatment strategy

Long Exposure to Sun in Adolescent as a Trigger for Onset of Systemic Lupus Erithematosus. Case Study

The article describes the case of the clinical observation of the patient with systemic lupus erythematosus, admitted to a hospital with misdiagnosis «photocontact dermatitis, community-acquired pneumonia». Due to multiple organ lesioans and clinical and medical history data we could certain the diagnosis in short terms, and to refer the child to a specialized clinic

Conservative Approach Efficacy in Closed Injuries of Parenchymal Abdominal Cavity Organs in Children

This article summarizes the experience of the conservative approach application in closed injuries of parenchymal organs of the abdominal cavity in children. In our clinic 53 patients with closed injuries of the spleen and liver underwent treatment in 2004–2011. The age of patients ranged from 2.5 to 17 years. Spleen injuries detected in 38 patients (71.7 %), liver damages — in 12 patients (22.6 %), concomitant injury of the liver and spleen occurred in 3 cases (5.7 %). Conservative approach was used in 50 patients (94.3 %), it was successful in 47 cases (94.0 %). Sonographic examination enables to identify and determine accurately the origin of the organ injury, and ultrasound monitoring makes it possible to predict the risk for intraabdominal bleeding and to assess the evolution of the initially identified damages in dynamics

Case of Rosai — Dorfman Disease in a Child

Sinus histiocytosis with massive lymphadenopathy is rare in children. The article describes a case of Rosai — Dorfman disease in 3-year-old boy. The emergence of lymphadenopathy, mainly cervical one, with synchronous lesion of extranodal area — spleen, enabled to suspect Rosai — Dorfman disease. To clarify the diagnosis, ultrasound has been used. The final diagnosis was established as a result of surgical removal of the lymph nodes of the neck, histological and histochemical study. Following the surgery, the child was discharged for further treatment at the department of oncohematology

Extra Lobes of Liver and Congenital Anomalies of Diaphragm in Children

The literature data on hepatic congenital anomalies in children are summarized in this article. Three clinical observations of transposition of extra lobe of the liver (ELL) into the thoracic cavity in children were analyzed. The true diaphragmatic hernia was found in all cases. Clinical manifestations of this disease depend on the severity of the compression of mediastinum organs. Indications for surgical correction were determined individually. ELL move into the abdominal cavity, excision of the hernia sac and alloplasty of the diaphragmatic defect were performed for one patient. Possible mechanisms for the formation of these complex congenital malformations were discussed based on the comparison of clinical data with the stages of embryogenesis liver, diaphragm and heart