Трудности дифференциальной диагностики заболеваний толстой кишки в инфекционной практике

The paper presents an algorithm of differential diagnosis of inflammatory bowel disease with infectious and parasitic diseases, described the case of diagnosis of Crohn's disease in the infectious department general hospital with a sequence of examinations of the child in the gastroenterological department, showing features of the development and course of Crohn's disease in a child 16 years with the debut on the background intestinal infections.В статье представлен алгоритм дифференциальной диагностики воспалительных заболеваний кишечника с инфекционными и паразитарными заболеваниями, описан случай диагностики болезни Крона в инфекционном отделении многопрофильного стационара с последовательностью обследований ребенка в гастроэнтерологическом отделении, показаны особенности развития и течения болезни Крона у ребенка 16 лет с дебютом на фоне кишечной инфекции

Роль ультразвуковой оценки коэффициента массы селезенки в динамике наблюдения детей с хронической формой ВЭБ-инфекцией

Purpose of the study: to show the significance of ultrasound diagnostics in assessing the dynamics of the spleen mass coefficient in children of various age against the background of a chronic form of EBV virus.Materials and methods. The study was performed on 146 children aged 3 to 18 years suffering from chronic EBV virus. Depending on age, the children were divided into 3 groups. Group 1 included 63 patients aged 3 to 7 years; Group 2 consisted of 28 children aged 8 to 11 years; Group 3 included 55 children aged 12 to 18 years. The clinical, laboratory and ultrasound examination was conducted including ultrasound of the spleen with the further determination of its mass coefficient (SMC).Results. In the acute period of EBV virus, children of all age groups revealed an increase in SMC, while the maximum increase was observed in children aged 3 to 7 years and amounted to 6,88. Against the background of a complete clinical and laboratory recovery in this age group, the SMC remained at the level of 4.66 and did not reach the average values of healthy children of the same age. The follow-up dynamics for 15–18 months demonstrated the normalization of the SMC to the average values of healthy patients in accordance with their age (in children aged 12 years and older).Findings. Children in the age group from 3 to 7 years old had the maximum value of the spleen mass coefficient, both in the acute period and after complete clinical and laboratory recovery. The use of ultrasound technique with the assessment of the spleen mass coefficient in the chronic course of EBV virus allows expanding and determining the children contingent for further dynamic monitoring for prevention of possible complications.Цель исследования: показать значимость ультразвуковой диагностики  в оценке динамики коэффициента массы селезенки у детей различных возрастных групп на фоне хронической формы ВЭБ - инфекции.Материалы и методы. В исследование включили 146 детей в возрасте от 3 до 18 лет с хронической формой ВЭБ - инфекции. В зависимости от возраста, дети были разделены на 3 группы. В 1-ю группу вошло 63 пациента от 3 до 7 лет; 2 – ю группу составили 28 детей с 8 до 11 лет; 3 – ю группу - 55 детей от 12 до 18 лет. Проводили клиническое, лабораторное и ультразвуковое обследование, включая ультразвуковое исследование селезенки с определением коэффициента массы (КМС).Результаты. В остром периоде ВЭБ инфекции дети всех возрастных групп имели увеличение КМС, при этом максимальное увеличение отмечалось у детей от 3 до 7 лет и колебалось в диапазоне от 4,9 до 9,2. При наличии полного клинико-лабораторного выздоровления у данного возрастного контингента КМС оставался на уровне 4,2-5,8 и не достигал средних значений здоровых детей данного возраста. Динамика наблюдения в течение 15-18 месяцев выявляла нормализацию КМС до средневозрасных значений здоровых пациентов у детей 12 лет и старше.Выводы. Дети в группе от 3 до 7 лет имели максимальное значение коэффициента массы селезенки, как в остром периоде, так и после полного клинико - лабораторного выздоровления. Применение ультразвуковой методики с оценкой коэффициента массы селезенки при хроническом течении ВЭБ-инфекции позволяет расширить и определить контингент детей для дальнейшего динамического наблюдения с целью профилактики возможных осложнений

ULTRASONIC DIAGNOSTICS OF ALTERATIONS IN BOWEL FUNCTIONS IN CHILDREN

50 subjects with functional bowel disturbance and 20 subjects with irritable bowel syndrome were examined. The control group consisted of 30 patients who had no clinical or laboratory signs of the gastrointestinal tract disorders. Ultrasonic investigation of bowel was performed without contrasting. 20 patients with functional bowel disturbance underwent pre-medication to reduce gaseous distention. It was revealed that the parameters of the thickness and structure of the intestinal wall in patients from the pathology groups are similar to those from the control group in 100% of cases. Comparison of the parameters for vascularization, presence of ascites, lymph nodes sizes, changes in gaustration revealed no significant differences either

Integrated approach of follow-up observation of children under 3 years old born with very low and extremely low body weight

Annually more than 15 million children are born prematurely in the world. The clinical case illustrates the importance of an integrated approach for follow-up observation of children from 0 to 36 months old, born with very low and extremely low body weight. We studied the effectiveness of the Rehabilitation Center for children born with very low and extremely low body weight on the basis of a large multidisciplinary Bashlyaeva children’s hospital in Moscow 2012–2018. This center is necessary for a comprehensive assessment of the health status of children born with very low and extremely low body weight, as well as for the dynamic and timely diagnostics and the application of optimal treatment of revealed pathological changes. The development of differentiated programs for medical examination and rehabilitation of this group of children should include an optimal protocol of dynamic monitoring. It will reduce both the rate of incidence and disability, and improve the quality of life and social adaptation of children

Radiation diagnosis of chronic constipation in children

Chronic constipation is one of the biggest problems in pediatric gastroenterology. The reasons for these diseases are currently a number of conditions, described in the article

Diagnostics and observation tactics of newborns with arteriovenous malformation of Galena vein in a multidiscipline children hospital

The authors analyzed the results of diagnostics and treatment of arteriovenous malformations of the Galena vein in 6 newborns at the Bashlyaeva Children City Clinical Hospital in 2018–2019. They described the main methods of early and accurate topical diagnosis of the disease, clinical manifestations depending on the size and type of malformation, treatment options and their results in the near future and long-term perspective. The authors have concluded that a multidisciplinary approach involving a resuscitator, cardiologist, neurosurgeon and radiologist plays the most important role in preparing patient for surgery

New prospects for ultrasound examination of abdominal organs state in newborn children with gastroschisis

Gastroschisis is a complex anterior abdominal wall defect requiring urgent surgical repair. Oneor two-stage surgery to return the intestines to the abdominal cavity may result in developing acute renal failure. Preservation of the Arantsiev duct lumen provokes serious changes in the portal vein system. The state of the microcirculatory bloodstream in the intestinal wall clearly correlates with the clinical data indicating the restoration of the passage through the gastrointestinal tract

ULTRASOUND DIAGNOSIS OF NECROTIZING ENTEROCOLITIS

The necrotizing enterocolitis remains the basic disease leading to a mortality of mainly prematurely born children with low and extremely low body weight. The percent of newborns with a necrotizing enterocolitis in recent years tends to increase that is connected with intensive development of a neonatology and resuscitation. The high prevalence of the necrotizing enterocolitis and the lethality accompanying it among prematurely born children remain at the high level, despite numerous researches on optimization of the principles of nursing and treatment, and in most cases meets at children at a stage of perforation of a wall of a gut and mekonialny peritonitis. Diagnostics at early stages of the begun pathological process in digestive tract at small children is extremely complicated. Recognition of precursory symptoms of a terrible disease is one of the first tasks of children’s surgeons and neonatolog. Radiodiagnosis serves as the most reliable diagnostic method at emergence of a clinical picture of a necrotizing enterocolitis. Definition of the most significant ultrasonic symptoms of a necrotizing enterocolitis remains an important task for ultrasonographers, neonatolog and children’s surgeons

Difficulties of Differential Diagnosis of Colon Diseases in the Infectious Practice

The paper presents an algorithm of differential diagnosis of inflammatory bowel disease with infectious and parasitic diseases, described the case of diagnosis of Crohn's disease in the infectious department general hospital with a sequence of examinations of the child in the gastroenterological department, showing features of the development and course of Crohn's disease in a child 16 years with the debut on the background intestinal infections

LAPAROSCOPIC SPLENOPEXY FOR A CHILD WITH TORSION OF WANDERING SPLEEN (CLINICAL OBSERVATION)

Torsion of wandering spleen in children is a rare disease, one of the symptoms of acute ischemia of abdominal organs. The article describes clinical observation of a patient operated on urgently after a clinical and instrumental examination during which torsion of wandering spleen was suspected. Results of the conducted instrumental examination were not specific for the presumptive diagnosis, therefore, indications for laparoscopy were formulated during which the diagnosis was confirmed. The effectiveness of laparoscopic techniques in managing splenic torsion and fixation of the organ is demonstrated