PECULIARITIES OF DIAGNOSTICS AND TREATMENT OF PARAPROCTITIS IN CHILDREN



Cite item

Full Text

Abstract

Relevance. Children with acute and chronic paraproctitis constitute 1-3% of hospitalized subjects with purulent surgical infection. Purpose. To study specific features of paraproctitis in children and to analyze outcomes of treatment. Material and methods. Case-histories of 218 children with acute and chronic paraproctitis were analyzed. Microbiological culture for pathogen identification was taken from paraproctitis focus, breast milk, from feces for conditionally pathogenic flora. The researchers also studied anamnesis, type of feeding, results of ultrasound examination of the perianal area and histological test of the material taken during surgery. Results. Patients with subcutaneous and subcutaneous-submucous paraproctitis constituted 95.5% [1]. The majority of patients with subcutaneous and subcutaneous-submucous paraproctitis - up to 62,5% - were children of the first 6 months of their life. The researchers defined age and etiopathogenic aspects of paraproctitis in children; the impact of provoking factors at acute paraproctitis as well as the specificity of chronic paraprocitis course and its treatment. 76 patients with acute paraproctitis had bottle and mixed feeding for the first 6 months of their life with further developed intestinal dysbiosis. In 112 children, conditionally pathogenic microorganisms were identified in 91 (81,2%) at the first year of their life. Ultrasound examination was sensitive for acute and chronic paraproctitis in about 90% [2, 3]. With the developed intestinal dysbiosis and immunological features of children at their first year of life , the process of acute paraproctitis was caused by the causal anal crypt and abnormal ducts of anal glands. It is considered to be the first step in fistula formation (fistulous abscess) [4-6]. The Gabriel surgery performed in acute paraproctitis was pathogenically verified because due to it one of the pathogenic steps was erradicated- pararectal fistula formation [7-11]. Disease relapse (pararectal fistula) was met in 7 patients. In average, hospitalization lasted for 7.1 days in acute paraproctitis and 8.4 in chronic paraproctitis. Conclusion. On analyzing etiopahogenic features of acute subcutaneous and subcutaneous-submucous paraproctitis, the authors recommend to perform a one-step surgical intervention.

About the authors

A. I. Kuzmin

Federal State Budgetary Educational Institution of Higher Education «Samara State Medical University» of the Ministry of Healthcare of the Russian Federation

Author for correspondence.
Email: noemail@neicon.ru
ORCID iD: 0000-0003-0306-5312
Россия

A. G. Munin

V.D. Seredavin Samara Regional Clinical Hospital

Email: noemail@neicon.ru
Россия

M. A. Barskaya

Federal State Budgetary Educational Institution of Higher Education «Samara State Medical University» of the Ministry of Healthcare of the Russian Federation

Email: noemail@neicon.ru
ORCID iD: 0000-0002-7069-7267
Россия

M. I. Terekhina

Federal State Budgetary Educational Institution of Higher Education «Samara State Medical University» of the Ministry of Healthcare of the Russian Federation

Email: noemail@neicon.ru
ORCID iD: 0000-0001-5967-2408
Россия

V. A. Zavyalkin

Federal State Budgetary Educational Institution of Higher Education «Samara State Medical University» of the Ministry of Healthcare of the Russian Federation

Email: zavv@rambler.ru
ORCID iD: 0000-0001-9555-8979
Россия

G. I. Shifrin

V.D. Seredavin Samara Regional Clinical Hospital

Email: noemail@neicon.ru
Россия

References

  1. Шангареева Р.Х., Еникеев М.Р., Неудачин А.Е., Зайнуллин Р.Р., Бацаев С.М., Солдатов П.Ю. Тактика лечения острых парапроктитов у детей. Российский вестник детской хирургии, анестезиологии и реаниматологии. 2017; 7: 179.
  2. Орлова Л.П., Кузьминова А.М., Полякова Н.А., Минбаев Ш.Т. Ультразвуковая семиотика хронического парапроктита. Колопроктология. 2007; 1: 4-6.
  3. Пыков М. И., Галкина Я. А., Дёмина А. М. Ультразвуковые критерии дифференциальной диагностики воспалительных заболеваний кишечника у детей. Колопроктология. 2017; 2: 37-48.
  4. Абаев Ю.К. Парапроктит у грудных детей: эпидемиология, патогенез, лечение. Детская хирургия. 2003; 2: 9-12.
  5. Бушмелев В.А., Кораблинов О.В., Головизнина Т.Н. Методы лечения гнойного парапроктита у детей. Детская хир. 2004; 5:12-7.
  6. Корниенко Е.А., Крупина А.Н., Калинина Н.М., Бычкова Н.В. Особенности иммунологического статуса у детей с воспалительными заболеваниями кишечника. Вопросы детской диетологии. 2016; 3: 51.
  7. Детская колопроктология: Руководство для врачей. под общ. ред. Гераськина А.В., Дронова А.Ф., Смирнова А.Н. М.: Контэнт; 2012: 549-60.
  8. Жуков Б.Н., Исаев В.Р., Савинков А.И., Чернов А.А., Кудряшов С.К., Поликашин Н.Н., Евстигнеева Т.М. Хирургические аспекты лечения хронического парапроктита. Колопроктология. 2004; 4: 3-7.
  9. Жуков Б.Н., Исаев В.Р., Чернов А.А. Основы колопроктологии для врача общей практики. Самара: Офорт; 2009.
  10. Хамраев А.Ж., Умаров У.X. Хронические рецидивирующие свищи промежности у детей. Детская хир. 2005; 2: 21-5.
  11. Хирургия живота и промежности у детей: Атлас. Под ред. Гераскина А.В., Дронова А.Ф., Смирнова А.Н. М.: ГЭОТАР-Медиа; 2012: 485-500.

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2020

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies