[Acquired diaphragmatic hernia in a child with a related liver transplant]. / Priobretennaya diafragmal'naya gryzha u rebenka s rodstvennoi transplantatsiei pecheni.

Acquired diaphragmatic hernia in children is rare. Even less often, this disease occurs after liver transplantation for biliary atresia. In our case, diaphragmatic hernia was acquired, since the patient underwent repeated chest X-ray examinations including CT prior to liver transplantation. There were no signs of hernia. Clinical manifestations of diaphragmatic hernia were absent throughout 9 months after liver transplantation and manifested acutely with combination of symptoms of respiratory failure and intestinal obstruction. Surgical treatment was performed after emergency consultation with attending doctor.

[Hemostasis for central rupture of liver in a child]. / Gemostaz pri tsentral'nom razryve pecheni u rebenka.

Blunt abdominal trauma in children accompanied by liver damage occurs in 18-20% of cases. Endovascular embolization is the most common approach for bleeding following central ruptures of liver. Foreign authors published few case reports devoted to successful embolization for central liver ruptures in children. In Russian-language literature, there is one similar report with complicated postoperative period. We present a child with class II blunt liver injury, marginal rupture and central hematoma. The patients underwent suturing of marginal rupture and endovascular embolization without postoperative complications.

[Ladd's syndrome in older children]. / Sindrom Ledda u detei starshego vozrasta.

Most often, Ladd's syndrome clinically manifests within the first month after birth. There are few reports devoted to diagnosis of this syndrome in patients aged 6-10 years. We present 2 children with Ladd's syndrome. The disease manifested at the age of 14 years in both patients. One child was diagnosed before complications that made it possible to carry out successful surgical treatment with subsequent recovery. The second child had necrosis of rotated small bowel. This child died in long-term postoperative period due to short bowel syndrome despite adequate treatment. In some cases, Ladd's syndrome manifests in puberty. Contrast-enhanced X-ray examination of gastrointestinal tract is indicated in children for periodic abdominal pain associated or not associated with vomiting.

[Renal abscess in children].

INTRODUCTION: Renal abscesses are relatively rare in children, but they can lead to prolonged hospital stay and life-threatening complications. Scrutiny of the literature over the past two decades indicates the absence of a unified tactic for the treatment of purulent-destructive forms of pyelonephritis in children, while more and more articles are appearing in terms of a low -key approach to the treatment of renal abscess in children. MATERIALS AND METHODS: From 2005 to 2019, we treated 59 children with the renal abscess. Among the patients were 22 (37.3%) boys and 37 (62.3%) girls. The location of the abscess on the right was determined in 30 (50.8%) children, on the left, in 29 (49.2%). The average age of the patients was 109 months. The median size of kidney abscess among all patients was 29 [21; 42] mm (range from 12 to 69 mm). RESULTS: The results of treatment were evaluated in the period from 3 months to 5 years. In 27 (45.8%) patients, conservative treatment gave a positive effect, while in 32 (54.2%) abscess puncture was performed under ultrasound guidance. The median hospitalization in patients after an abscess puncture was 15 [14; 18] days, against 13 [9; 17] days for children receiving only antibiotic therapy. The duration of hospital stay was significantly longer in the group of patients who underwent puncture (p=0.019). The effectiveness of conservative therapy was a lot lower in patients with a kidney abscess of more than 3 cm, 60% versus 31% (p=0.026). All 59 patients recovered completely, and none of them required an open surgery to drain a suppurative focus of a kidney or nephrectomy. CONCLUSION: Conclusion. Our experience confirms the literature data, indicating the need to use a conservative approach to the treatment of patients with the renal abscess as a first-line therapy. Identification of an abscess with a diameter of more than 3 cm in patients considerably increases the likelihood of using an abscess puncture with the absence of the efficacy of a conservative approach.

[New coronavirus infection (COVID-19) associated with kidney infarction in a seventeen-year-old child].

In December 2019, a new SARS-CoV-2 virus, called COVID-19, was identified in the Wuhan province of China, the spread of which determined the development of a pandemic. The lack of publications with evidence-based clinical studies dictate the necessity to cover various, including rare, pathological effects of the virus on the human body and the subsequent effect on it. Nowadays, there is already evidence that the SARS-CoV-2 virus causes specific damage to the vessels (endothelium), myocardium, and kidneys. The pathophysiologic mechanisms leading to acute kidney injury during COVID-19 infection are unclear, but may be due to direct exposure of the kidney tubules and endothelial cells to the virus. We present a clinical case of a kidney infarction in a 17-year-old girl with a severe course of a new coronavirus infection. At the time of the description of this clinical case, there are no publications on COVID-19 associated with kidney infarction in children in the Russian and foreign literature which is available to us.

[X-ray diagnosis of acute respiratory distress syndrome in acute hematogenous osteomyelitis in children].

OBJECTIVE: to analyze the x-ray signs of acute respiratory distress syndrome (ARDS) in children with the septicopyemic form of acute hematogenous osteomyelitis (AHO) for the first time, by using the authors' material. METHODS: X-ray study of respiratory organs was conducted in 221 children with AHO. SUBJECTS AND BASIC RESULTS: ARDS had a rather characteristic x-ray pattern that permitted a differential diagnosis of this condition and another abnormality, that with septic pneumonia in particular.

[X-ray diagnosis of different forms of Hirschsprung's disease in children].

The purpose of this study was to examine and compare X-ray signs and roentgenometric parameters in different forms of childhood Hirschsprung's disease for their more accurate diagnosis. A hundred and thirty-eight children with different forms of Hirschsprung's disease were followed up. Among them, the children with a supershort segment of the disease amounted to 55%. All the children underwent a comprehensive examination including barium irrigography according to the procedure described by M.D. Levin, followed by an estimation of roentgenometric parameters. The long forms of Hirschsprung's disease had characteristic X-ray symptoms and their appropriate roentgenometric parameters. The supershort segment of the disease had not a complete complex of characteristic X-ray symptoms and its roentgenometric parameters were in direct opposition to the similar parameters in the long form of this disease.

[A rehabilitative method for children operated on for Hirschsprung's disease]. / Metod reabilitatsii detei, operirovannykh po povodu bolezni Girshprunga.

The method of acupuncture may be used for postoperative rehabilitation of patients operated upon for Hirschsprung's disease. It can be one of main methods of treatment of postoperative complications which are of functional character. If there was no effect of the repeated course of acupuncture in patients with a long hypoganglionic zone of the descended gut, the latter must be resected within the healthy limits.

[Fecal incontinence in Hirschsprung's disease in children]. / Nederzhanie kala pri bolezni Girshprunga u detei.

Among the criteria of evaluation of the results of operative treatment of Hirschsprung's disease in children, along with the absence of constipation is the function of defecation control. The authors examined 27 patients with fecal incontinence after Duhamel's operation. It was established that fecal incontinence in children after operative treatment of Hirschsprung's disease may be caused not only by affection of the external sphincter muscle of the anus, the nerve plexuses, and adaptation of the rectum to the new conditions after the pull-through operation, but also by trauma inflicted to the levator ani muscle. In children with severe damage to the levator group of muscles consequent upon operative treatment of Hirschsprung's disease, operative intervention for creating the anorectal angle is indicated.

[The diagnosis and treatment of complications in the late periods after operations for Hirschsprung's disease in children]. / Diagnostika i lechenie oslozhnenii v otdalennye sroki posle operatsii po povodu bolezni Girshprunga u detei.

On the basis of examinations of 15 children the authors consider that recurrent constipation and fecal discharges as complications of a remote postoperative period take place more frequently than incontinence of feces. One of the causes of constipation after radical operation for Hirschsprung's disease may be a long hypoganglionic zone of the distal portion of the colon. To solve the question about reoperation of children with Hirschsprung's disease the complex examination must necessarily include the determination of activity of tissue acetylcholinesterase in colon mucosa biopsies, balloon proctography, sphincterotonometry, endoscopic examination of the colon in addition to irrigography.

[Ultrasonic study of the large intestine in Hirschsprung's disease in children]. / Ul'trazvukovoe issledovanie tolstoi kishki pri bolezni Girshprunga u detei.

The authors have proposed a method of ultrasonic control of the dynamics of the colon size in children with Hirschsprung's disease with the filling of the colon with a 1% solution of sodium chloride. The method may be used as an independent examination.