Abstract. Purpose: informing the doctors who provide aid to children of the peculiarity of the pathology. Methods: a 10-month-old boy who developed recurrent vomiting, cough, nasal discharge and fatigue was admitted to the hospital in his place of residence and diagnosed ARVI with abdominal pain syndrome. In spite of the treatment, the patient’s condition worsened, cerebral edema aggravated, and he received artificial pulmonary ventilation with a diagnosis of acute meningoencephalitis of unclear etiology, cerebral edema, and stage 3 coma. The patient was transferred to the republican hospital where his condition was stabilized using intensive care and correction of water-electrolyte and metabolic disorders. At day 9 after the disease onset, a mobile tumor-like lesion was found on palpation in the right mesogastric region. An abdominal ultrasound showed a round anechogenic lesion with distinct regular outlines (40x40 mm). A surgery was performed to eliminate jejunal obstruction with hydrogel balls. Relaparotomy was done in 6 days. Discussion: this clinical observation shows there are diagnostic difficulties that are unavoidable when a history of peroral intake of hydrogel is lacking. Being in the intestine, hydrogel granules absorbed fluid and their size increased leading to obturation intestinal obstruction. Recurrent vomiting resulted in extrarenal loss of fluid and electrolytes. The patient developed cytotoxic cerebral edema due to hypotonic dehydration. A tumour-like lesion was found on palpation at day 9 after the disease onset. Conclusions: hydrogel balls result in obturation intestinal obstruction with severe water-electrolytic disorders. This pathology requires a surgery with full revision and complete evacuation of foreign bodies from the intestine.
Currently, there is more and more data on new manifestations of COVID-19, such as multisystem inflammatory syndrome in children, which occurs with severe complications, among which cases of pneumothorax have been recorded. The article presents the experience of treating 4 newborns with a new coronovirus infection who were admitted to the clinic during 2021. In all clinical cases, children were born to mothers with a burdened obstetric history. All children had a positive RNA polymerase chain reaction for SARS-CoV-2. Children were admitted with signs of respiratory, cerebral insufficiency, gastrointestinal syndrome and metabolic disorders. The clinical picture and laboratory data corresponded to the definition of a multisystem inflammatory syndrome and was characterized not only by lung damage, but also by changes in other organs. Pneumothorax was diagnosed on days 1521. In all children, a tension pneumothorax developed on the right, in the first two cases against the background of mechanical ventilation, in the remaining two with spontaneous breathing with additional oxygenation. In one case, the pneumothorax was bilateral. Drainage of the pleural cavity in three children was carried out according to Bulau and in one case with active aspiration. Pneumothorax resolved after 414 days. Computed tomography of the chest, performed during the period of rehabilitation treatment, shows pronounced sclerotic and bullous changes in the lung parenchyma. All patients were discharged from the hospital in a satisfactory condition. Since in all the above cases, pneumothorax occurred in newborns with a burdened obstetric history of mothers, it is difficult to differentiate the occurrence of pneumothorax associated with the underlying disease, the course of labor, complications of therapy, from the disease associated with COVID-19. Stronger evidence is needed from larger datasets and rigorous analysis.
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