Background. Lymphangiomas are non-specific malformations that develop from the lymphatic vessels. Usually, the disease is asymptomatic, but there may be complications requiring emergency care. In the literature there is no consensus about the method of choice in the treatment of these formations. Description of A Case Series. The article is devoted to the evaluation of the efficacy of surgical treatment of lymphangiomas in children. There are also several clinical cases showing mediastinal lymphangioma with a clinical picture of respiratory failure, lymphangioma of the abdominal cavity, imitating the symptoms of an acute abdomen and lymphangioma of a rare anatomical localization. The results of treatment of 48 children for the period from 2008 to 2017 were analyzed at «Morozov Children Municipal Clinical Hospital» (Moscow). The basis of treatment was the removal of education within healthy tissues. When the radical intervention was impossible in 5 (10.4%) children we used resection of the tumor with sparing coagulation of the surface of the formation. Infectious complications arose in 3 (6.3%), lymphorrhea — in 13 (27.1%) patients. Recurrences of lymphangiomas developed in 2 (4.2%) patients. In the case of lymphorrhea, expectant management and parenteral nutrition were used. The repeated operations were performed with recurrences. The catamnesis ranges from 6 months to 10 years. Conclusion. Radical removal of lymphangiomas of internal organs can be recommended to children of any age as an effective way to treat this disease.
Doc. of Med. Sci., professor, head of the department of pediatric surgery, pediatric surgeon; Scopus Author ID: 56925375800 Резюме Основные методы диагностики врожденной непроходимости кишечника (ВНК)-рентгенологические. УЗИ играет вспомогательную роль при проведении дифференциальной диагностики. * Иллюстрации к статье-на цветной вклейке в журнал. * Illustrations to the article are on the colored inset of the Journal. Диагностика и лечение врождённой кишечной непроходимости… | Diagnostics and treatment of newborn intestinal obstruction… Заключение: УЗИ выявляет патологию, не определяемую рентгенологическими методами, но требующую немедленных действий (заворот, перитонит), исключает обследования с контрастом, когда они противопоказаны (перитонит), не требует транспортировки пациента, специального положения для выполнения исследования, существенно сокращает лучевую нагрузку. УЗ-контроль позволяет безопасно выполнить малоинвазивное лечение: дренирование брюшной полости при перитоните.
Chylothorax in children is a fairly rare but at the same time serious pathology. Accumulation of a large amount of fluid in the pleural cavity leads to the development of respiratory, cardiovascular failure, and even death. In some children, this process can be initiated even before birth. The main components in the treatment of chylothorax are as follows: conservative measures aimed at reducing the amount of chyle, paracentesis, and drainage of the pleural cavity, mini-invasive surgery. To date, universal approaches to the management of patients with chylothorax have not been fully developed, there are no common diagnostic algorithms, terms, and optimal treatment tactics. There are only a few publications on this issue in literature, which are descriptive in nature and based on a small number of observations. The low prevalence of chylothorax in newborn infants, different etiology, various pathogenetic mechanisms of the disease make it difficult to conduct large-scale randomized trials in this area that would fully meet the modern requirements of evidence-based medicine. In this article, the authors demonstrate a multidisciplinary approach to treating a child with congenital chylothorax.
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