Intestinal intussusception in a newborn is a casuistic rarity, the clinical symptoms of which are nonspecific, and patients are regarded for a relatively long time as patients with necrotic enterocolitis. There are no unambiguous radiological signs of this pathology, especially with atypical variants of intussusception, when even pneumoirrigography is uninformative. In the vast majority of cases, the diagnosis is made only intra-operatively, when the development of intestinal obstruction or perforated peritonitis determines the need for surgical intervention. The publication presents a unique observation of preoperative echographic diagnosis and successful cure of prolonged small-intestinal invagination in a premature newborn 2 days of life, the cause of which was Meckel’s diverticulum.
Testicular torsion is a severe variant of postnatal gonad pathology in children. The speed of development of irreversible ischemic disorders determines not only the medical, but also the social significance of the problem and determines the need for accurate and rapid diagnosis and prompt provision of adequate care to the patient. The only objective method for diagnosing testicular torsion in children is ultrasound. At the same time, the characteristics of the child’s body: the small size of the object of study, low rates of intratesticular blood flow and restless behavior during the study sharply reduce the diagnostic value of the Doppler study or make it technically impossible. Thus, seroshkal ultrasound is the first stage of diagnosis of this complex emergency pathology, based on the results of which it is possible to diagnose testicular torsion with great accuracy. The publication summarizes our own experience of 110 echographic observations of postnatal testicular torsion in children older than 2 months, all cases were verified intraoperatively. A quantitative method for estimating the deformity of a twisted testicle is proposed and its statistical reliability is proved. The options presented for gray-scale changes in the structure of damaged gonads and determined their prognostic significance. The publication contains a review of the literature and is extensively illustrated.
The diagnostic significance of the color Doppler study of testicular blood flow in testicular torsion has been studied for about 40 years, however, the prognostic value of the results obtained is ambiguous, as are the actual imaging capabilities of the technique. Our own experience of 110 observations of testicular torsion in children older than the neonatal period allows us to draw statistically reliable conclusions. Made on equipment premium-class research made it possible to evaluate how visualization intratesticular vascular pattern, and whirpool-sign and submit the primitive model of the actual inversion, explaining the impossibility of rendering whirpool-sign with the greatest tight inversion. The dynamics of testicular blood flow was studied immediately after successful and unsuccessful manual detorsion and in the long term after operative detorsion and orchopexy. The publication contains a brief analysis of the literature and is extensively illustrated.
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