卷 23, 编号 1 (2019)

Gastrointestinal hemangioma (GIH) is a benign vascular formation located in different parts of the intestinal tube. The clinical significance of hemangiomas of the gastrointestinal tract is usually associated with the development of complications such as gastrointestinal bleeding, invagination, intestinal obstruction or bowel perforation. Aim of the study. Demonstration of a rare clinical observation of jejunal cavernous hemangioma as a cause of recurrent intestinal bleeding. Material and methods. A boy, 11 years old, admitted to the Institute with complaints of chronic anemia and recurrent intestinal bleeding of unknown etiology. There was made a complex diagnostic search, including laboratory and instrumental methods, with a video capsular study of the gastrointestinal tract and angiography of the abdominal cavity. Results. At the base of the video capsular study of the gastrointestinal tract, the vascular formation of the jejunum, which is a possible source of intestinal bleeding, is suspected. The vascular structure of the formation is confirmed by angiography. During laparoscopy, a cavernous hemangioma with a diameter of about 1.5 cm was detected. Hemangioma was located in the wall of the jejunum and prolapsed both into the lumen of the intestine and from the side of the serous membrane. Under micro laparotomic access in the umbilical region, there was performed a resection of the jejunum area with the imposition of the anastomosis "end to end". A morphological diagnosis was confirmed. The postoperative period was uneventful. Conclusion. The cavernous hemangioma of the jejunum is rare and difficult to diagnose the cause of recurrent intestinal bleeding. The use of modern diagnostic and surgical technologies ensures timely and mini-invasive treatment, which leads to rapid recovery of the patient and ensures the cost-effectiveness of treatment.

Abdominal pain is a serious problem in pediatric surgery. Abdominal pain is one of the most frequent complaints addressed by children and their parents to doctors of various specialties: pediatrician, gastroenterologist, infectious diseases specialist, pediatric surgeon, ambulance workers. Abdominal pain is a symptom of many diseases of organs of abdominal cavity. It may be of a functional nature, which does not pose a threat to the life of the child and does not require surgical intervention, and pain associated with acute pathology of the abdominal organs (acute appendicitis, invagination of the intestine, diverticulitis, intestinal obstruction, acute calculous cholecystitis, injuries of the abdominal cavity and so on. e) requiring an emergency operation.

There are presented results of therapeutic-diagnostic laparoscopy in 317 children with various pathologies of the abdominal cavity organs, aged from 2 to 15 years. Among patients there were 163 children with acute appendicitis and its complications, 68 girls with acute pathologies of pelvic organs, 39 cases with the acute adhesive intestinal obstruction, 14 - with intussusception, 11 patients with pathology of Meckel diverticulum, 5 - with acute cholecystitis, 5 - with cystic doubling intestine - and 6 - with intestinal mesentery tumor. Diagnostic laparoscopy also revealed acute mesadenitis in 4 cases, and urolithiasis was diagnosed in 2 cases. In the treatment and diagnostic laparoscopy, the switch to the conversion was noted in 19 (5.9%) cases. In 298 (94.1%) cases, the treatment and diagnostic laparoscopy was effective and in these patients positive results were noted

In children, foreign bodies of the gastrointestinal tract (GIT) are common, 80-90% of them pass through the GIT without any problem. However, in some cases the clinical picture of peritonitis, intestinal obstruction, bleeding develops, which requires surgical treatment. Described in the article the clinical observation of acute intestinal obstruction in an 11-month-old child, after he has swallowed a hydrogel ball, will be useful for practicing pediatric surgeons.

There is presented a clinical observation of such rare form of Hirschsprung’s disease in a newborn -as terminal aganglionosis of the ileum and hypo-ganglionosis of the cecum, manifested by acute intestinal obstruction. Resection of the ileocecal angle and leaving the distal colon in the child’s body with good functional results in the long-term postoperative period made it possible to affirm the existence of high isolated segmental forms of Hirshprung’s disease.