Pediatric surgery. Features of treatment of children with surgical diseases (the most important)

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Pediatric surgery. Features of treatment of children with surgical diseases (the most important)

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1. Features of the treatment of children with surgical diseases

Successful treatment of children with acute surgical diseases primarily depends on timely diagnosis and early implementation of the necessary set of therapeutic measures.

Complexity diagnostics many surgical diseases and malformations are mainly associated with the mental immaturity of the child and the functional characteristics of its systems and organs.

General symptoms do not always arouse the alertness of the attendants, since they are too often observed in various physiological conditions and functional disorders.

In infants, for the recognition of acute surgical pathology, the correct evaluation changes in the child's behavior.

Periodic restlessness, sudden "unreasonable" cry, refusal to eat - everything should be taken into account by the surgeon when examining the patient.

General symptoms diseases (deterioration, high body temperature, vomiting, etc.) in some cases play a lesser role in establishing a diagnosis than "insignificant" objective data.

X-ray examination of the digestive tract in newborns is carried out in a vertical position by a non-contrast method.

For certain indications, contrasting is carried out with iodized oil or a 20% solution of sergosin. Examination using barium sulphate can cause severe complications.

In older children, more complex methods of X-ray examination (retropneumoperitoneum, pneumomediastinography, angiography) should be used.

However, the interpretation of the data should be made taking into account age-related anatomical features (physiological enlargement of the thymus gland, various periods of the appearance of ossification nuclei).

Special and instrumental research methods (esophagoscopy, bronchoscopy, splenoportography) are widely used in emergency surgery.

The choice of the method of surgical treatment, as well as medical tactics, is impossible without taking into account the peculiarities and originality of the further development of the growing body of the child.

In acute surgical diseases, the need for surgical treatment is usually dictated by absolute indications. However, in debilitated and preterm infants with severe malformations or comorbidities, surgery may sometimes be abandoned in favor of less risky conservative treatments.

To absolute contraindications, which are encountered extremely rarely and only in newborns, refers only to the obvious non-viability of the child, for whom surgical intervention will obviously not benefit. It should be noted that thanks to the rapid development of pediatric surgery and the improvement of surgical treatment methods, the scope of absolute contraindications to interventions is steadily narrowing.

Authors: Drozdov A.A., Drozdova M.V.

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