卷 23, 编号 5 (2019)

Introduction. Pancreatic pseudocysts are encapsulated fluid sacs in the omentum having no epithelial lining; they appear in the pancreas after injury and inflammation. Recently, there has appeared a trend to treat pancreatic pseudocysts with laparoscopic surgical interventions. The article describes laparoscopic treatment of pancreatic pseudocysts in 10 children. Objective. To evaluate the effectiveness of laparoscopic interventions in children with pseudocysts in the pancreas. Material and methods. In 2013-2018, 10 laparoscopic surgeries in children, aged 4-17 (5 boys and 5 girls), with pancreatic pseudocysts were performed at the department of pediatric surgery in the Russian Medical Academy of Continuous Professional Education. Indications for surgery were: pancreatic pseudocysts having diameter more than 6 cm and wall thickness more than 3-4 mm, no effect after the conservative therapy , cyst formation more than 3 months, persistent pain syndrome. Results. The choice of a surgical technique was defined by pseudocyst etiology and location. The children had six laparoscopic cystoeunoanastomoses, two partial cystectomies with a distal pancreatojejunoanastomosis and two partial cystectomies with a longitudinal pancreatojejunoanastomosis when the cyst was formed at the chronic pancreatitis. No intraoperative complications were seen. Early postoperative complications occurred in 2 patients: an external pancreatic fistula at the drainage site (1) and intestinal obstruction (1) at the level of the intestinal anastomosis. Conclusion. Laparoscopic surgeries in children with pancreatic pseudocysts are effective and less traumatic. The laparoscopic technique allows to make a complete revision, to perform sequestrnecrectomy , if necessary, as well as to take the material for histological examination and to ensure a reliable long-term drainage.

Arthritis in children is a group of diseases that are encountered by various specialists. It is a pediatrician, who starts the diagnostic search, in most cases. The definition “arthritis of the hip joint” implies a number of pathologies. In the article, the researcher discusses the basic aspects of epidemiology, etiology and pathogenesis of such forms of arthritis as septic, transient, reactive as well as the arthritis in orthopedic pathologies.