ASSESSMENT OF MEDICAL AND DIAGNOSTIC TACTICS AT LATE DIAGNOSED DIAFRAGMA HERNIA

Abstract

Results of treatment of the patients with the congenital diaphragmal hernia which isn’t established antenatal and found accidentally at diagnostics or treatment not of surgical pathologies are presented in article. For the 9-year period in Regional children’s hospital No. 1 of Yekaterinburg 22 patients with this malformation aged from 1 days up to 14 years are treated. In gender structure girls – 12 slightly prevailed (54,54%), there were 10 boys (45,46%). Methods of visualization of defect were ultrasound examination of an abdominal cavity and pleural cavities, survey rentgenography of organs of a thorax and abdominal cavity, a passage of X-ray contrast substance up to a GIT, a computer tomography. For an exception of pathology of an esophagus and a stomach of 27,3% of patients underwent the FGS procedure. Most of children since the birth – often ill children, who repeatedly had infectious and inflammatory diseases of respiratory organs. In structure of the accompanying malformations heart diseases prevailed. All children passed the necessary volume of inspection. Despite the taped DG, 36,3% an operative measure wasn’t carried out due to the lack of a clinical picture from respiratory organs and a GIT, 63,7% of patients needed urgent or planned expeditious treatment of defect. All patients to whom expeditious treatment was shown were operated and written out from a hospital in satisfactory condition. From complications met: one patient has an early commissural intestinal obstruction – 7,1%, at two – a tension pneumothorax – 14,28%. A recurrence – at one patient (7,1%). All complications are successfully liquidated, patients are written out from a hospital in satisfactory condition. There are no lethal outcomes.