Meckel’s diverticulum is the most common variant of anomalies of incomplete obliteration of the yolk duct. Among the various malformations of the digestive tract, which can cause intestinal obstruction, Meckel’s diverticulum ranks first and is 1.7%. Purpose – to generalize the results of treatment of children with intestinal obstruction caused by Meckel’s diverticulum. Materials and methods. The experience of treating 183 children with Meckel’s diverticulum and related pathology is summarized. The main complications of Meckel’s diverticulum were intestinal obstruction, bleeding from a peptic ulcer, diverticulitis. In 100 children, the diverticulum was asymptomatic and was an accidental finding during surgery on the abdominal organs for other pathologies. Results. Intestinal obstruction caused by Meckel’s diverticulum accounted for 20.8% of all cases and 45.7% of all diverticulum-related complications. Strangulative intestinal obstruction was diagnosed in 18 patients: in 16 Meckel’s diverticulum caused internal compression, in 1 – torsion of the loops of the small intestine around the fixed diverticulum, in 1 – nodulation. In 5 observations, Meckel’s diverticulum caused the phenomenon of partial intestinal obstruction. Intussusception was detected in 15 children (small intestinal in 6 cases and ileocecal in 9). Clinical cases demonstrating the difficulties in diagnosing intesti nal intussusception caused by Meckel’s diverticulum in older children and small bowel entrapment in the mesodiverticular ligament are presented. A method of subserous diverticulectomy and one-step decompression of the small intestine was proposed. Conclusions. Meckel’s diverticulum should be considered as a probable cause of acute intestinal obstruction in children older than 2 years and who have not previously undergone surgery on the abdominal organs. In the surgical treatment of pathology caused by Meckel’s diverticulum, it is possible to use one-time decompression of the small intestine by diverticulotomy and subserous removal of the diverticulum. The research was carried out in accordance with the principles of the Helsinki declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: Meckel’s diverticulum, intestinal obstruction, children.
Purpose - to develop a method of otoplasty in children with underdevelopment of the antihelix. Materials and methods. Otoplasty in our own way in case of underdevelopment of the antihelix was performed in 47 children (30 girls and 17 boys) aged from 6 to 16 years. All patients had bilateral deformity. The postoperative follow-up period was to 5 years. Results. Otoplasty in children with underdevelopment of the antihelix was performed by our own method, which included detachment of the skin on the posterior and anterior surface of the auricle from the cartilage with an anesthetic solution, excision of the skin in the form of an ellipse on the posterior surface of the auricle, cutting the cartilage to the perichondrium along the outer edge of the antihelix, and making staggered notches on the entire thickness of the cartilage, forming the antihelix with U-shaped sutures. The result of the correction was the correction of proportional disorders, ensuring the symmetry of both ears. First of all, the excessive protrusion of the upper part of the auricle was eliminated, since some protrusion of the middle and lower parts may be acceptable. The full-face helix of both auricles was visualized through an antihelix. An even and smooth contour of the antihelix along its entire length was provided. The nuchal recess was not reduced too much, while its shape was not violated. Excessive pressing of the auricle against the head was avoided. Staggered notches help to reduce the excessive pressure on the suture, prevent tension of the ear cartilage and overcorrection during the formation of the antihelix. Conclusions. The proposed method provides minimal trauma, promotes the formation of a natural antihelix shape and provides a good cosmetic result in children with protruding ear with underdeveloped antihelix. The research was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethical Committee of the institution mentioned in the work. Informed consent was obtained from the parents of the children (or their guardians), children. No conflict of interests was declared by the authors.
Injury is the leading cause of death among children and adolescents, with about 10% of injuries being penetrating. Penetrating injuries that occur if a child falls or sits down on a long, sharp object are rare by their mechanism. So far we have experience in treating 5 children with penetrating injuries to the abdominal organs involving long sharp objects. 3 children were injured by falling on a metal fence, and the other 2 by sitting down on a metal pin and a scythe. The consequences of the injuries were damage to the small intestine (1), colon (4), stomach (1), kidney (1), urinary bladder (2). Clinical cases. Two brothers, aged 11 and 12, who fell out of a tree on a metal fence from a height of about 3 meters, were brought Pediatric Municipal Clinical Hospital of Poltava Municipal Council with metal rods in their bodies. After preoperative preparation, the children were operated on. Removal of the foreign objects was performed in the operating room. One of the boys was found to have damage to the stomach, transverse colon, kidney crushing. Suturing of wounds of hollow organs, and nephrectomy were performed. The second boy was found to have damage to the rectum, a colostomy was performed with its subsequent closure. A 16-year-old girl was injured when she sat down on a vertical scythe blade. During the operation, wounds of the ileum and mesentery of the hungry intestine were revealed, the wounds were sutured. All children were discharged after they recovered. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: penetrating abdominal trauma, children.
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