[Treatment tactics in intussusception in children].

Results of treatment of 235 patients with intussusception are analyzed. The treatment tactics in different period of disease is described in details, the role of echography is emphasized. For the first time the conception of functional (reversible) intussusception was offered, treatment tactics were determined. Results of treatment were studied, conservative and surgical tactics of treatment were substantiated.

[Diagnosis and treatment of renal injuries in children].

A total of 154 children with renal injury have been treated in 1994-2004. In addition to standard examination all the children have undergone ultrasound examination with doppler investigation of renal flow. By severity of renal damage, the patients were divided into three groups. Group 1 consisted of 117 (75.9%) children with lesions of degree I and 11; group 2 (n = 31, 20.1%) - of degree III and IV; group 3 (n = 5, 3.2%) - of degree V. Group 1 children had contusion of the kidney and local subcapsular ruptures of the kidney. They were treated conservatively. Conservative-expectant policy was employed for patients of group 2 who had deep ruptures of the kidney without urinous infiltration or trauma with minimal accumulation of urine. Thirty children were operated. Urgent surgery was indicated in signs of active hemorrhage, hemorrhagic shock.

[Potentialities of echography in the diagnosis of uncomplicated acute appendicitis in children]. / Vozmozhnosti ékhografii v diagnostike neoslozhnennykh form ostrogo appenditsita u deteí.

Ultrasonography was performed in 97 children admitted to hospital for suspected acute appendicitis. According to the results of primary surgical examinations and the magnitude of clinical manifestations, all the patients were divided into two groups. Group 1 comprised 53 patients with clinically diagnosed acute appendicitis and with a worded indication for an emergency surgical intervention; this group was formed for describing the ultrasonic semiotics of different types of acute appendicitis in children. Group 2 (n = 44) was enrolled to study the differential diagnostic potentialities of echography in the primary diagnosis of acute appendicitis in children with acute stomach ache and they are diagnostically unclear. All echocardiographic findings are supported by intraoperative data and pathohistological evidence. The ultrasonic semiotics of different forms of uncomplicated acute appendicitis is described, the optimal procedure has been developed for examining children with this pathology. The results of the study confirm the high informative value of the proposed algorithm of an echographic examination and sensitivity of the method as to the patients of this group. Thus, the sensitivity of the echographic method in uncomplicated acute appendicitis was 88%.

[Restoration of continuity of the large intestine after large resections in children]. / Vosstanovlenie nepreryvnosti tolstoi kishki posle obshirnykh rezektsii u detei.

The continuity of the large intestine in wide resections in children aged from 7 months to 14 years was restored by rotation of the cecal cupula and ascending part through the lateral canal on a vascular pedicle. Experience in 20 operations and different variants of colorectal anastomosis is discussed. Three children had complications in the form of stenosis of the anastomosis and necrosis of the distal part of the transposed intestine as the result of disturbed circulation.

[Method for creating colorectal anastomoses in children]. / Sposob vypolneniia kolorektal'nogo anastomoza u detei.

A variant of two-stage formation of a colorectal anastomosis in children with Hirschprung's disease and megarectum is suggested. Low resection of the rectal ampulla and stitching of its muscular wall with the downwardly displaced area of the colon is conducted in the first stage. The second stage is performed 2 weeks later and consists in removal of the excess part of the intestine from the direction of the perineum. The operation was carried out on 23 children aged from 8 months to 13 years. No complications were encountered in the immediate postoperative period and in the long-term period.

[Characteristics of surgical tactics in children with acute appendicitis]. / Osobennosti khirurgicheskoi taktiki pri ostrom appenditsite u detei.

There were 849 children with various forms of acute appendicitis under observation in 1988. Generalized and circumscribed peritonitis was found in 44.2% of cases. The new clinical approach-based introduction of a previously elaborated surgical tactics showed it to be rational. The changing conditions led to a wider use of diagnostic laparoscopy, rejection of the "lavage" system in the postoperative period, and introduction of the method of laparostomy which is simpler and more effective.

[Diagnosis and surgical treatment of intussusception in children]. / Diagnostika i khirurgicheskoe lechenie invaginatsii kishechnika u detei.

The article discusses the methods of diagnosis and surgical treatment of intussusception of the intestine in children according to the stages of the disease. Colonoscopy is recommended for wide use; it helps in making the precise diagnosis in an atypical clinical picture of intussusception in the early periods, revealing the indications for operative treatment, and determining the volume of the intervention on basis of objective control of the degree of injury suffered by the strangulated intestine.

[Psychophysiologic analysis of painful emotional stress in children with abdominal pain syndrome]. / Psikhofiziologicheskii analiz émotsional'no-bolevogo stressa u detes abdominal'nym bolevym sindromom.

Psychophysiological signs of the stress reaction were found in children referred to surgical hospital for the abdominal pain syndrome. It was ascertained that it is expedient to take a comprehensive approach to the detection of the magnitude of a child's stress tension.