Based on the analysis of morphological and morphometric data, the clinical and experimental results of the effect of hypoxia on the wall of the small and large intestine in newborns are presented. The clinical part is based on the study of 58 case histories of patients with necrotizing enterocolitis, which the operating material (resected sections of the small intestine, large intestine) was studied in detail. The experimental work included the modeling of chronic hypobaric hypoxia in different trimesters of pregnancy in 4 groups of white rats (24 females). The offspring was taken out of the experiment at 4-5 days after birth, followed by collection of the small and large intestine areas to study histoarchitectonics. It is proved that hypoxia affects the number of newborn offspring, its weight. The small intestine is most vulnerable to the effect of this factor. Analysis of the morphological and morphometric picture of the operating and experimental material convincingly proves that under the influence of hypoxia the destruction of the intestinal mucosa occurs and the growth of the connective tissue component in the muscle layer occurs. Changes from the microcirculation of blood and lymph provoke the development of pre-ulcerative, ulcerative defects and the formation of necrosis. Disturbance of the drainage function promotes the spread of destruction in the intestinal wall.
Background. Ureterocele is a cystic dilatation of the distal ureter. Orthotopic ureterocele is relatively rare form of this disease, and it is commonly diagnosed in female children. The clinical picture of orthotopic ureterocele is usually not significant, and the management variants are unclear. Clinical case description. Ultrasound has revealed dilatation in the distal part of the left ureter (up to 6.5 mm) and cyst formation (diameter of 8 mm, thick walls) in the bladder in 8-months-old boy. The retrograde voiding cystourethrogram has shown no signs of vesicoureteral reflux. The evaluation of the voiding rhythm was performed: the volume of residual urine was > 30%, it indicates the infravesical obstruction. The child underwent diagnostic cystourethroscopy, transurethral resection of the ureterocele, intubation ureteral catheter in the left ureter (all procedures was performed under general anesthesia). There were no enlargements of calices-pelvis system and ureters 12 months after surgery according to urinary system ultrasound. Clinical urine test with no inflammatory changes. Voiding rhythm was without pathology.Conclusion. The widespread implementation of high-tech and minimally invasive methods of diagnosis and management allow us to achieve timely detection and provide effective treatment for children with ureterocele.
Background. KID syndrome (keratitis-ichthyosis-deafness) is an orphan genetic multisystem disease with autosomal recessive and dominant types of inheritance, it manifests in the neonatal period. The leading triad of symptoms is: skin lesions, ophthalmological diseases and hearing organ pathology. Clinical Case Description. Girl V., 17 years old, with KID syndrome applied to the hospital complaining on painful infiltrates of the parietal region. Multiple abscesses were lanced. Hyperkeratotic crusts were removed, unviable skin regions were excised, and abscesses' cavities were washed with antiseptic solution during daily dressings. Purulent discharge from wounds has been maintaining for 7 days. Conclusion. Where is no pathogenetic treatment for KID syndrome yet. Prevention of secondary surgical infections remains the crucial aspect in the management of such patients. Local wound treatment, symptomatic and antibacterial therapy are effective in case of skin infection.
Introduction. The uterine appendage torsion (UAT) is an urgent pathology accompanied by a painful abdominal syndrome and requiring urgent diagnostic and therapeutic measures. In childhood, UAT develops mainly due to organic causes and due to the specific location of internal organs in children. The literature data on organ-preserving surgeries in the long-lasting UAT is very controversial and dubious. There are no objective criteria for assessing ovarian viability after detorsion what impacts the selection of surgical intervention tactics - unjustified adnexectomy may be performed.Clinical case. Girl P., 12 years old, was admitted to the hospital with a clinical picture of long-lasting torsion of the uterus appendages. Right uterine appendages were detorsed. The child was under observation. In two years, laparoscopic appendectomy was performed for chronic appendicitis. When examining pelvic organs, the right ovary was found reduced in size compared to the left one; there were no macroscopically visible changes; single follicles were visualized in it; the fallopian tube was not changed.Conclusion. A painful sensation before surgery indicates that the uterus appendages are viable; if there is no abdominal pain, necrosis of the ovary and fallopian tube may be suspected. A surgical tactics is chosen on making a comprehensive analysis of clinical and instrumental findings.
The purpose is to present morphological and morphometric changes in the histoarchitecture of the intestinal wall in newborns with necrotizing enterocolitis considering the outcomes of the disease. Materials and methods. The PRMU clinics carried out a morphological study of histological intestinal sections of 99 operated patients with NEC from 2003 to 2017. The patients were divided into the following groups: 72 survived newborns from group I (favourable outcome) and 27 dead newborns from group II (unfavourable outcome). The object under study was surgical specimen of the ileum and large intestine. Result. The disease outcome can be predicted using morphological changes in the intestinal wall in NEC. The leading role of the drainage function of the lymphatic apparatus is established in the article. It is completely restructured in the operational specimen of patients with the unfavourable course. Changes in the cellular composition in the form of insufficient number of fibroblast cells and isolated epithelial and stromal cells enabled subsequent destruction of the bowel wall with progression of the exudative processes.
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