Necrosis and perforation of the stomach in newborn babies and infants

The Objective of the study was to identify the clinical features of newborns and infants with perforation of the stomach, and to justify the possibility of organ-preserving operations even with extensive gastric necrosis.Methods and Materials. The results of treatment of 32 newborns with stomach perforation was analyzed: not only the risk factors that cause this condition, but diagnostic methods and variants of surgical treatment. All patients with extensive necrosis of the stomach wall underwent an atypical resection within healthy tissues, a gastric «tube» was formed on the drainage probe with a significant decrease of organ volume. In cases of the local damage of the gastric wall, the perforated area was sutured after the excision of the edges of the defect.Results. Mortality rate was 36.5 % (n = 12). The cause of death in 5 children (15 %), in 3 to 8 days after surgery, was multiple organ failure syndrome. In 7 patients (22 %), a fatal outcome occurred due to the severe post-intensive care syndrome at the age of 3 to 12 months of life.Conclusion. The mechanism of perforations of the stomach in newborns and infants is multifactorial. All children with stomach perforation need preoperative preparation. The operation of choice for the stomach perforation is an organpreserving surgery. The function of the stomach is restored in all children after extensive resection of the stomach

STRUCTURE FUNCTIONAL STATE OF DAMAGED SPLEEN IN CHILDREN AFTER NONOPERATIVE TREATMENT

The results of treatment of 75 children with spleen damage were studied. The conservative treatment was applied in 69 (92%) cases. A restoration of spleen structure was noted in case of spleen injury on 3-4 weeks. The complete normalization of the spleen structure occurred in terms of 3-4 months after trauma. Posttraumatic cysts appeared in case of large defects and hematomas after 2-3 weeks and disappeared by 5-6 months. The regenerative process of shallow ruptures was registered after 3-10 weeks, but the deep ruptures were healed after 6-30 weeks. The preservation of the spleen after trauma have led to structure and function recovery and could be considered as primary prevention of asplenism

Recurrent intussusception in children

OBJECTIVE. The study considered the rate and clinical features of recurrent intussusception in children. MATERIAL AND METHODS. Retrospective analysis was made in all patients with intussusception at the period from 2006 to 2016. RESULTS. There were observed 45 cases of intussusception recurrence in 39 (14,5 %) children out of 268. Relapse of intussusception was three times more frequent in boys compared with girls (29 (74,4 %) vs 10 (25,5 %) and it was four times more frequent in children older than one year. The majority of patients (28 (71,8 %) have been admitted to hospital at the first 12 hours since onset of disease. Recurrence of intussusception was more frequent after conservative disinvagination compared with surgery (17,8 % vs 2,5 %; p = 0,026). Pathological formation of the intestine (Meckel’s diverticulum, doubling of the small intestine) were detected in 3 (7,7 %) out of 39 patients with relapse intussusception compared with 3 (1,3 %) out of 229 patients without recurrence (p = 0,05). Conservative treatment was conducted in 23 (59 %) patients and 16 (41,0 %) patients underwent surgery. There weren’t noted severe complications of lethal outcomes. CONCLUSIONS. The authors observed the tendency of frequent recurrence of intussusception in children, especially after conservative treatment

Additional lung – a rare malformation

Additional lung is an extremely rare malformation. At an early age the course is often asymptomatic, but sometimes the additional lung may lead to life-threatening clinical manifestations. In these cases, early surgical treatment is required. We describe our own clinical cases with histological verification of the diagnosis of «Additional lung», the timing and algorithm of postnatal radiation examination, the method of treatment

Pediatric laparoscopy: Facts and factitious claims

<b>Background:</b> Pediatric laparoscopy (LS) is claimed to be superior to open surgery (OS). This review questions the scientific veracity of this assertion by systematic analysis of published evidences comparing LS versus OS in infants and children. <b>Materials and Methods:</b> Search of PubMed data base and the available literature on pediatric LS is analyzed. <b>Results:</b> One hundred and eight articles out of a total of 426 papers were studied in detail. <b>Conclusions:</b> High quality evidences indicate that LS is, at the best, as invasive as OS; and is at the worst, more invasive than conventional surgery. There are no high quality evidences to suggest that LS is minimally invasive, economically profitable and is associated with fewer complications than OS. Evidences are equally distributed for and against the benefits of LS regarding postoperative pain. Proof of cosmetic superiority of LS or otherwise is not available. The author concludes that pediatric laparoscopy, at the best, is simply comparable to laparotomy and its superiority over the latter could not be sustained on the basis of available scientific evidences. Benefits of laparoscopy appear to recede with younger age. Concerns are raised on the quick adoption, undue promotion and frequent misuse of laparoscopy in children