Russian Journal of Pediatric Surgery

BACKGROUND: Pancreatic pseudocysts are the most common outcome of conservative treatment of organ injury with damage to the Virsung duct. Internal drainage under endoscopic ultrasound scanning has become the first-line treatment option for pancreatic pseudocysts of various etiologies in adults. The method of endoscopic transgastric drainage of parapancreatic acute fluid accumulations in pediatric practice has also found its supporters. However, we were able to find isolated publications with reports on clinical cases in the Russian literature.

AIM: The aim of the study was to determine the effectiveness and safety of endoscopic transgastric drainage of the OSH under endoscopic ultrasound scanning control in case of pancreatic injury with damage to the Virsung duct in children.

METHODS: A single-center uncontrolled clinical trial was conducted in the period from 2022–2025. 11 patients with pancreatic injury were enrolled in the trial. All children underwent endoscopic transgastric drainage of parapancreatic acute fluid accumulations under the endoscopic ultrasound scanning control at different terms after the injury. The stent was removed at the repeated esophagogastroduodenoscopy―2–3 months after its placement.

RESULTS: There were no intraoperative or postoperative complications. The length of inpatient stay after endoscopic transgastric drainage was 11.1±5.8 (3–21) days. 9 (81.8%) patients underwent catamnestic examination within 3 months and 1 year after the endoscopic transgastric drainage, and 2 patients are still waiting for stent removal. A relapse, requiring a repeated endoscopic transgastric drainage, was recorded in 1 (9.1%) patient which was followed by the patient’s recovery.

CONCLUSION: Endoscopic transgastric drainage of acute fluid accumulations in children with the pancreatic injury and damage to the Virsung duct is a minimally invasive, safe and effective technique that ensures an uneventful course of acute post-traumatic period and prevents the development of pseudocysts.

BACKGROUND: Pelvic organ evacuation dysfunction is observed in 17–22% of all pediatric urologic visits. Of these, 32% have dysfunctional urination, which means difficult urination due to the inability of external urethral sphincter and pelvic floor muscles to relax properly. Consequently, such abnormality can be accompanied by urinary incontinence and infectious complications. Timely diagnostics and proper understanding of the pelvic floor role in urination are essential for the effective treatment.

AIM: To improve treatment outcomes in children with pelvic evacuation dysfunctions through the implementation of transperineal sonography.

METHODS: The authors present their observational, single-center, and randomized trial. The main sample included 103 children with pelvic evacuation disorders who were consulted at N.F. Filatov Children's City Hospital in Moscow from 2018 to 2025. All children underwent transperineal sonography to examine their pelvic floor, triple uroflowmetry with assessment of the residual urine, and electromyography of the perineal muscles.

RESULTS: Children were divided into two groups by gender (58 girls and 45 boys). According to the findings obtained at three uroflowmetry examinations, urinary flow rate was decreased by 27%, in average, in boys, while in girls this parameter was at the lower norm limit. Intermittent or staccato urination was seen in all children in the studied group. An electromyography curve during urination showed the increased pelvic floor muscle activity. Moreover, ultrasound examination revealed the residual urine (from 10 to 30%) in the bladder of 53 children. Transperineal sonography in children with dysfunctional voiding has found a specific feature: virtually, no displacement of the urethra and bladder neck during functional tests, which was interpreted as manifestations of the paradoxic pelvic floor muscle activity. The increased puborectal loop size, anal canal width, and the decreased size of anorectal angle indicate anal sphincter hypercontractility. These findings correlated with transperineal sonography findings.

CONCLUSION: Transperineal sonography is a simple, available and non-invasive technique which demonstrates good diagnostic values in identifying dysfunctional voiding in children.

BACKGROUND: The primary acquired cryptorchidism has not yet been adequately addressed in Russian scientific works. Theoretically, the testicle should be palpable in the inguinal region and located intraoperatively outside the inguinal canal. Obliteration of the processus vaginalis should occur after the testicle descents completely. It is expected that the unobliterated processus vaginalis should be significantly less common in patients with acquired cryptorchidism than in boys with a congenital undescended testicle.

AIM: To find out clinical and anatomical features of the acquired cryptorchidism in comparison with the congenital undescended testicle.

METHODS: The enrolled patients were divided into two groups: a studied group and a control one. The studied group included 22 boys, aged 2–11 years (mean age 7.4 years) with the primary acquired cryptorchidism, These patients were identified during a retrospective analysis of 42,749 electronic outpatient records of boys who were screened at children’s city clinics in Stavropol using our previously described and published technique. The control group consisted of 59 patients, aged 1–17 years (mean age 3.5 years), with an undescended testicle diagnosed at birth who were admitted to the department of pediatric surgery No 1 at Stavropol Regional Children’s Clinical Hospital in 2023.

RESULTS: The average age of patients with the primary acquired cryptorchidism was statistically significantly higher (p <0.01) than in the group of children with the congenital undescended testicle: 7.4±1.2 years versus 3.5±0.5 years. Clinically, the undescended testicle was palpable in the inguinal region in boys with the primary acquired cryptorchidism statistically significantly (p <0.01) more often than in the control group: 95.5% of cases (21 patients) vs. 47.5% of cases (28 patients). During the revision of the inguinal region, children with the primary acquired cryptorchidism (95.5%, 21 case) had their testicle located outside the inguinal canal significantly (p <0.01) more often than children with congenital undescended testicle (49.2%, 29 cases). The unobliterated vaginal process of the peritoneum in children of the studied group was seen significantly more often (p <0.01) (21 patients, 95.5%) than in the control group (10.2%, 6 cases).

CONCLUSION: The primary acquired cryptorchidism is inguinal ectopia of the testicle in combination with the obliterated vaginal process of the peritoneum.

Doubling of the digestive tract (duplication cysts, enterocystomas) is a rare malformation, which in some cases is manifested as complications. Most digestive tract doublings are detected antenatally, and during the first two years of life they are detected due to some symptomatic course or randomly, not at targeted examinations. Sometimes doubling can be manifested as intestinal obstruction, gastrointestinal bleeding, perforation, and more rarely, malignancy.

The article presents a clinical case of cystic doubling of the ileum, manifested by intestinal obstruction during norovirus enteritis in an infant. Doubling of the gastrointestinal tract was diagnosed antenatally: child's mother was consulted by a surgeon, and planned surgical treatment was recommended. At the age of two months, the child was admitted to the hospital with symptoms of intestinal infection; norovirus enteritis was diagnosed with lab tests. Ultrasound examination of the abdominal cavity revealed a cystic layered inclusion in the projection of the colon hepatic angle.

A clinical picture of intestinal obstruction developed within one day. Due to the pronounced swollen intestinal loops and a high risk of injury, the laparotomy was made after preoperative preparation. A cystic formation was found in the ileocecal angle, which had a common wall with the ileum and was completely blocking the ileum lumen. The ascending colon was collapsed. This cystic doubling of the ileum caused small intestinal obstruction.

Enterocyst fenestration was performed―2/3 of the cyst wall was removed. The early postoperative period was uneventful. Histological examination confirmed a duplicated cyst of the ileum.

An elective surgery would have reduced intraoperative risks and allowed to perform a minimally invasive intervention. However, intramural doubling obturation did not lead to ischemic changes in the intestinal wall, that is why the surgery was performed simultaneously, without resection of intestinal segments.

The present observation highlights the need for elective surgical correction of even asymptomatic, randomly detected doubling. Clinical manifestations may be triggered by intestinal infection, thus leading to emergency surgical tactics under developed complications.

On December 27, 2025, we celebrate the 100-th anniversary of Prof. Vsevolod A. Urusov, a pediatric surgeon, associate professor and professor at the Department of Pediatric Surgery at Irkutsk State Medical University, whose life and professional career are an example of selfless service to medicine and science.

Prof. Urusov was born in Irkutsk, finished a school and served in the army for two years, and then entered the Irkutsk medical institute. After graduating from the institute, he worked as a general surgeon in one of the district hospitals in the north of the Yakutia for five years. Upon returning to Irkutsk, Dr. Urusov was appointed a head of the department of pediatric surgery in the City Children’s Hospital No 1. Under his leadership, surgical departments of various profiles were created and equipped, thus improving the quality of medical care to children in the Irkutsk region.

His scientific work has received recognition at the national and international levels. His research interests were multiple: topical issues of pediatric surgery, diagnostics and treatment of acute appendicitis, intestinal invagination in children, congenital intestinal obstruction, pathology of the colon, and urological diseases. Under his leadership, many talented specialists were trained; they continued the work of their mentor.

V.A. Urusov is the author of 146 scientific papers, seven monographs, three certificates for inventions and more than two dozen innovation proposals. He was awarded the Order of the Patriotic War degree II, multiple medals and diplomas. He was also awarded the honorary title “Honored Doctor of Russia.”

Vsevolod A. Urusov legacy is still alive today. His ideas and methods remain actual and important , and his contribution to the development of medicine and medical education deserves the deepest respect up to now.