ABSTRACT
AIM: To analyze the diagnostics results and surgical outcomes in girls with congenital urogenital sinus. MATERIALS AND METHODS: A total of 9 girls with urogenital sinus were evaluated and treated in the clinical base of the Department of Hospital Pediatric Surgery with a course of oncology at TashPMI during the period from 2009 to 2019. RESULTS: The results of diagnostics and treatment of 9 patients with various forms of urogenital sinus are presented. In 6 cases the anterior sagittal (transanal) approach was used. The karyotype in 8 girls corresponded to 46,XX, while another girl has karyotype of 46;X0, which is typical for Turner syndrome. Severe degree of virilization was found in 2 patients, which required clitoroplasty. CONCLUSION: Traditional methods of surgical correction and modified procedures provide an optimal approach and facilitate the urethral dissection from the vagina with subsequent advancement to the perineum, significantly reducing the indications for the performing a preliminary colostomy.
Subject(s)
Adrenal Hyperplasia, Congenital , Child , Female , Humans , Male , Perineum , Urethra/surgery , Vagina/surgery , VirilismABSTRACT
Clinical manifestations and diagnostic methods of particular anatomical variants of intestinal rotation and fixation disorders were discussed by the authors in 208 children of different age groups. There was revealed the tendency to reduce rotation abnormalities diversity with the increase of age group. At the same time the frequency of occurrence of the colon fixation anomalies characterized by chronic recurrent process and progressing colostasis was enlarged.
Subject(s)
Abdominal Pain , Constipation , Digestive System Abnormalities , Digestive System Surgical Procedures/methods , Intestinal Obstruction , Radiography, Abdominal/methods , Abdominal Pain/diagnosis , Abdominal Pain/etiology , Child , Constipation/diagnosis , Constipation/etiology , Diagnosis, Differential , Digestive System Abnormalities/complications , Digestive System Abnormalities/diagnosis , Digestive System Abnormalities/physiopathology , Digestive System Abnormalities/surgery , Female , Humans , Infant, Newborn , Intestinal Obstruction/diagnosis , Intestinal Obstruction/etiology , Intestinal Obstruction/physiopathology , Intestinal Obstruction/surgery , Intestines/abnormalities , Intestines/diagnostic imaging , Male , Multidetector Computed Tomography/methods , Outcome Assessment, Health Care , UzbekistanABSTRACT
On the basis of an analysis of 122 cases the authors present options on the strategy and methods of operations depending on the anatomical patterns, the degree of anorectal malformations and the type of coexisting pathology, the technique of placing unnatural anus. Preference is given to a one-stage surgical method, the indications to the graded treatment with the formation of colostomy are described in detail.
Subject(s)
Anus, Imperforate/surgery , Colostomy/methods , Decision Making , Adolescent , Anal Canal/abnormalities , Anal Canal/physiopathology , Anal Canal/surgery , Anorectal Malformations , Anus, Imperforate/physiopathology , Child , Child, Preschool , Defecation/physiology , Female , Follow-Up Studies , Humans , Infant , Infant, Newborn , Rectum/abnormalities , Rectum/physiopathology , Rectum/surgery , Retrospective Studies , Time Factors , Treatment OutcomeABSTRACT
Under analysis are results of treatment of 38 children with liver cirrhosis. Operations were performed in 25 patients, in 13 children decompensating shunts were put between the vessels of the splenic and left renal veins. Based on the assessment of the clinical effect the authors made a conclusion that in children with portal hypertension and symptoms of hypersplenism the creation of a spleno-renal anastomosis with the retained spleen is an effective measure and considerably reduced risk of postoperative complications.
Subject(s)
Hypertension, Portal/surgery , Spleen/surgery , Adolescent , Anastomosis, Surgical , Child , Child, Preschool , Female , Gastrointestinal Hemorrhage/etiology , Gastrointestinal Hemorrhage/surgery , Hepatectomy , Humans , Hypertension, Portal/complications , Hypertension, Portal/etiology , Liver Cirrhosis/complications , Liver Cirrhosis/surgery , Male , Renal Veins/surgery , Splenectomy , Splenic Vein/surgeryABSTRACT
Anamnestic, clinical and morphological data presented concern 34 children with malformations of excretory bile ducts (15 with atresia of intra- and extrahepatic bile ducts, 12 with atresia of distal regions of the external bile ducts, 7 with cystic dilatation of ductus choledochus). Analysis of operation material revealed the presence of hepatitis in 30 cases including 16 cases with giant cell hepatitis associated with malformations. Intrauterine hepatitis B was found in 24 cases, herpetic hepatitis in 2 cases and Mycoplasma-related hepatitis in 3 cases (one of them in combination with hepatitis B). The etiology was not established in 2 cases. Accompanying bacterial infection was in 6 observations.
Subject(s)
Biliary Atresia/pathology , Hepatitis/pathology , Bile Ducts/pathology , Bile Ducts, Intrahepatic/abnormalities , Bile Ducts, Intrahepatic/pathology , Child , Child, Preschool , Hepatitis/etiology , Humans , Infant , Infant, Newborn , Liver/pathologyABSTRACT
Observations of 44 patients aged from 20 days to 15 years were used for making a classification of cystic anomalies of bile ducts. The method of choice for the operative intervention is creation of cystoduodenoanastomosis with resection of the gallbladder. A stable effect in remote terms of treatment can be obtained by endoscopic sanitation of the zone of cystoduodenoanastomosis.
Subject(s)
Biliary Atresia/complications , Choledochal Cyst/etiology , Common Bile Duct/abnormalities , Adolescent , Anastomosis, Surgical/methods , Child , Child, Preschool , Choledochal Cyst/diagnosis , Choledochal Cyst/surgery , Common Bile Duct/surgery , Dilatation, Pathologic/diagnosis , Dilatation, Pathologic/etiology , Dilatation, Pathologic/surgery , Duodenum/surgery , Female , Humans , Infant , Infant, Newborn , MaleABSTRACT
The authors report on the diagnosis, therapeutic tactics, the results of morphological studies, and the late-term results of surgery for developmental anomalies of the gallbladder and chronic cholecystitis with organic disorders of bile drainage in 53 children aged from 5 to 15 years. The findings of morphological studies showed that among the causes of impaired bile drainage developmental anomalies of the gallbladder were encountered much more frequently than chronic cholecystitis. Indications for operation were developed on the basis of clinical data and the results of auxiliary methods of examination. Clinical, radiological, and morphological comparisons showed these indications to be well-founded. The immediate and late-term results of surgical management of developmental anomalies of the gallbladder and chronic cholecystitis with organic disorders of bile drainage confirm the expediency of active surgical tactics in the presence of the proper indications.
Subject(s)
Biliary Atresia/surgery , Cholecystitis/surgery , Gallbladder/abnormalities , Adolescent , Child , Child, Preschool , Chronic Disease , Female , Gallbladder/surgery , Humans , MaleABSTRACT
At the period of from 1965 to 1988, the authors observed 20 children with cholelithiasis. Among the patients, the number of girls was predominant. Operated on were 13 patients. The indications for operative intervention, immediate and long-term results of the treatment are presented.
Subject(s)
Cholelithiasis , Adolescent , Child , Child, Preschool , Cholelithiasis/diagnosis , Cholelithiasis/surgery , Female , Humans , MaleABSTRACT
Based upon literature data and an analysis of immediate and remote results of treatment of 50 children with acalculous cholecystitis the authors point to the advisability of operative interventions in patients with organic disturbances of the bile outflow. An analysis of the clinical picture, effects of the conservative therapy and results of subsidiary investigations enabled the authors to establish indications to surgery. The surgical methods must be determined by the character of pathology of the gallbladder, bile ducts and concomitant diseases. The immediate and long-term results of the surgical treatment of chronic cholecystitis resulting from organic disturbances of bile excretion confirm expediency of active surgical tactics in the presence of indications and of strict dispensary observation after operations for this disease.
