Abdominal pain syndrome in children (echographic options). Functional intestinal disturbance in children Nursing tactics for abdominal pain in a child

Abdominal syndrome є one of the most widespread diseases of the organs of persecution in a given hour. Strong beating in the abdomen is a distressing signal. It’s trivial, stretching out for an hour, then it’s innocently turned up to fakhivtsya. On the right in the one where the ailment is given most often to develop in another row. Tobto won out for problems with the gastrointestinal tract. The course of therapy for the syndrome is part of a complex treatment aimed at the renewal of etching organs.

Classification

The belly can be divided into two main types:

• non-trivial, ale characterized by rapid development;
• chronic, as I progress step by step in the world of destruction I will become.

In addition, there is one classification of syndromes according to the type of appearance. See coming:

1. Visceral. Abdominal syndrome is recognized as a result of a spill, like a stimulation of receptors. This is a kind of pain characteristic of an increased grip in the middle of the body through the tension of the stinks.
2. Parієtalnі. Here on the first plan is the end of the nerves. The price of getting rid of it is the result of the battle of the scraps.
3. Widbit. Tse sooner visual pain. If you go through great stress, then it grows into an image.
4. Psychogenic. The development of the syndrome in a wide variety of ways is primed. Call this type of wine through depression. Most of the patients do not know about the manifestation of the problem, because it just doesn’t help. Beat in the abdomen is accompanied by some unacceptable sight in the back or head.

signs of illness

Abdominal syndrome, most often, occurs in children and young people. Wines are characterized by sickly appearances in the belly, as they do it before the hour of physical nurturing. Some people become unhappy, and children stop growing. As a result, a piece of blues is wicked, and a person is signi fi cantly involved in a vagu. Most often before the onset of pain, the patient sees the importance and discomfort in the abdomen.

Abdominal pain syndrome Do not take into account the reception of the received validol and nitroglycerin. However, tsі lykarskі preparations do not lead to problems, the stench just drowns out the bіl for an hour. For the correct diagnosis of ailments, follow the systolic murmur. I’ll see you in the navel area (a couple of centimeters in sight), and talk about the art of visceral arteries.

Most Not Safe Symptoms

There will be no signs of zagalyuvannya, when they appear, you just need to turn up to a lykar. However, abdominal pain syndrome is a characteristic thymus, but in some cases, it is necessary to have an extra surgical treatment. Troubled symptoms:

• increased frequency of sertsebitty (tachycardia);
• apathy, baiduzhism;
• more soiled;
• bagatorazova blues;
• obscurity;
• b_l will adapt to a little bit of development;
• bleeding.

As soon as such signs appear, in any case it is not possible to ignore them, if they do so, "you will pass it yourself." It is also a serious stage of becoming ill, and only a few people who have been built to help in the given situation.

Abdominal ischemic syndrome

Tse zhvoryuvannya is characteristic of the destruction of blood flow of grass organs. Winikє danian syndrome, most often, through depletion of black waste. Striking can be wicked as internal ringing, as well as in a ringing grip. Chvoroba protivykє finish quietly, step by step razvivayuchis. The syndrome is characterized by severe pain in the abdomen, thinning, as well as other symptoms of the shlunkovo-intestinal tract.

Varto mean that this is an important task. Tse is tied with that, so there are signs similar to the symptoms of other ailments of the organs of poisoning. In most cases, it is possible to diagnose ailments only for an hour. Therapy is aimed at usuning the reasons, as they did it. Blood circulation improvement is a headache for combating ischemic syndrome.

Causes to show ailments in children

We will give the sick people to suffer in the main child. At an early age, all babies are susceptible to pricks, which can become the reason for the affliction of ailments. It is recommended to periodically operate the ultrasound scan, so that any damage can be found in the organs of the future.

Abdominal syndrome in children develops through the state of the disease nirok abo slash. In many cases, ultrasound can also be diagnosed. Moreover, it is guilty that two things are carried out: with a povnim michur and a non-bargaining.

Children often suffer from abdominal pain. The stench is often the cause of the child's hospitalization. As a result of surgery, pathology appears on the appearance of appendicitis and intestinal obstruction. Previously, some pains are characterized by a conservative way of improving internal organs. In general, the involvement of licenses is not required.

In some cases, there is a lack of awareness in the stomach to indicate the development of a new product. Todi is required for the hospitalization term and the intrinsic involvement of the faculty. GDVI with abdominal syndrome is developed frequently by the last hour. If you have a problem with a headache, you should put the correct diagnosis and diagnose the most effective remedy.

diagnostics of illness

As a matter of fact, one of the most effective methods for detecting abdominal syndrome is ultrasound diagnosis. Already close to 10 rocky in lіkarі corystyuyutsya by this method, to diagnose an ailment. They haven’t come up with anything short of the Danish hour.

For the ultrasound scan, no special training is required. It is necessary to miss the reception, and to come to the procedure in just one hour. It’s worth to stay in a patient’s vіku: for example, little children have a pause of 3-4 years, and grow up - close to 8 years. Dobre bulo used to conduct ultrasonic scanning vrance, natchesertse. However, in the absence of such an opportunity, it is possible throughout the day.

Elimination of abdominal syndrome

Therapy of the whole ailment can be found without any reason, which provoked him to appear. Oh, maybe the number is great, so it needs to be clearly because of the disease. Most often it becomes stagnant in the drug, which is poured onto the reflex lance. Spasmolytics are seen with such medications. The stench is recognized by patients who have problems with the organs of poisoning.

In most cases, abdominal pain syndrome is not a disease, but a symptom. As a matter of fact, it is necessary to have a sign. Tobto, in the first place, I have a lot of respect for the normalization of the function of organs and the nervous system. Such a move is to allow the establishment of new pathologies and the elimination of old ones.

It is necessary to remember the so-called " Munchausen syndrome"If a child with special features, special features simulate or aggravates his camp, іtuyuchi bіl in the belly і" Odyssey syndrome"With hibno-positive symptoms: such" ailments "of the senses pass through a trivial way of obsolescence from the stasis of the most common diagnostic methods, the first to be susceptible to any pathology.

Medical tactics for abdominal pain in children.

Correct and accurate treatment of pain in the abdomen - the foreseeable future, some of the times associated with the execution of extra visits. In case of severe pain in the abdomen, an accurate diagnosis is necessary. A great number of ailments can be caused by the mother of catastrophic inheritances, as long as it is allowed to be allowed in the diagnosis. The folding of the interpretation of pain syndrome in the development of the optimal diagnostic algorithm.

Headquarters:

1. The stage of non-diagnostic diagnostics

2. The cliff of provincial clinics is a sign of illness, which is against abdominal pain syndrome

3. Companion of diagnostics calls

4. Frequency criterion of the population of stan_v, which is against the syndrome of a stubborn abdomen in the fallowness of children

5. The stage of superiority and informativeness of clinical and paraclinical tributes.

6. The stage and the last day of the inclusion of the most notorious ailments that prevent abdominal pain syndrome

7. Clock factor

There are many children who have hospitality in their stomach for non-surgical reasons;

Particularities of the condition of children with abdominal pain syndrome.

It’s a bit of a memory, that children until three rockies do not localize their beloved, and they always worry about the important reactions. Whether a young child sees it in the navel area, it is natural, not informative, nor a high diagnostic criterion.

Children of the senior age Also, as a rule, it is inaccurate to locate the problem, so this symptom can be easily diagnosed.

The big role is important on'є active local tributes:

look around: the zagalny viglyad of the child, the position of the body, the character of the collapse, the mimic and viraz of exposure, the configuration of the abdomen, signs of intestinal swelling, the type of bluish masses, stiles, slashes.

palpation: recording the tension of myaziv, їkh opіr, the results of rectal dosage, the nature of the pulse.

Auscultation: peristaltic noise, the noise of rubbing the ignited capsule to the organ (spleen).

Paraclinic Doslidzhennya: SHOE, leukocytosis, analysis of sech and feces, roentgenologic and endoscopic dosage, sonography.

On the first stage diagnostics enable the most important ailments, as well as help secure additional help. It has become a disaster Svidchit nasty klinichna picture: gosvre zvoryuvannya with a strong grievous development pain in the stomach and an important zagalny camp. The steps to indicate on the need for non-emergency calls: state of pain in the abdomen, bluetongue, stricken tension of the throat of the abdominal wall, an important zagalny camp with an overhanging viraz of exposing, burn your eyes, sting your nose, restlessness, meteoric collapse, gasp, gas attack.

Table 1

The stage of non-diagnostic diagnostics and clinical visits

with a provid smalltom - severe pain in the stomach.

I will not be safe in the region	Visibility of extreme security
appendicitis intestinal imperfection інвагінація gostry peritonit Hostry enteritis with eksikoz pneumonia myocarditis acetonemic bloom diabetic coma eclampsic uremia urolithiasis meningit, encephalitis detachment projected aliens ekhinokokova kista in a free black empty	polyonephritis ascariasis ailment Bornholm prodrome cortex, hepatitis typhoid fever abdominal purpura Crohn's ailment mesenteric lymphadenitis osteomyelitis krila club kistki adnexitis more ovulation premenstrual pain Virazkov's ailment "Pupkova Kolka"

At the understanding " gostry lives"include appendicitis, inflammation, intestinal obstruction and peritonitis. Tsi stays require especially retail differential diagnostics (Table 2)

Table 2

Scheme of obsozhennya with a gross stomach (Hertl M., 1990)

	The nature of the pain: kolka abo trivialy b_l blues: heart, pislya, fecal blues, house of blood, frequency The nature of the style: sleep of mucus, blood houses, watery, quantity, frequency Adjustable temperature Epidemic history: hepatitis, gastroenteritis, Bornholm ailment, cyr, whooping cough
Zagalny look	The name of the sick viglyad Kolir denouncing camp of svidomosti Emotional camp Dikhannya and yogo specialties
belly doslіgennya	look around: vipinnya, zduttya Auscultation: to be stronger or weakened by noise, visibility, especially localization palpation: repair from any club area; іnodі in different conditions; rectal dosage; reconvertize the gates. Before palpating, sprinkle the sečovy mikhur! Uwaga! Viklyuchiti ringing organs percussion: liver, spleen, intestines, the bottom of the chaff, puff radiological dosage black empty, standing position sonography
last blood	Secondary blood analysis; minimum - number of leukocytes
Perevazhny vik	see table 3
Vinatok of іnshoї pathology	Breast cell: auscultation, percussion, radiological dosage (pneumonia, pleurisy, assessment of the heart) Lumbar puncture:(Meningit) Analysis of the section: bіlok, zukor, acetone, gum pigments, sieges (nephritis, diabetes, hepatitis, urolithiasis)

Table 3

Immovableness of deacons

in children of small groups (Hertle N., 1990)

ailing	vikov group
1.intestinal imperfection
2.atresia, intestinal stenosis
3.Invagination
4. Grizzly is affected
5.Gostrius appendicitis
6.peritonitis
7.virazkov ailment	(First 3 ms.)
8.Acetonemic bloom
9.Stenosis of the collar	(First 3 ms.)

Note:

(+++) - great value

(++) - average value

(+) - low value

(-) - do not appear

Another stage of diagnostics. Pіslya viklyuchennya zahvoryuvan scho vimagayut negaynoї hіrurgіchnoї Relief conductive diferentsіalnu dіagnostiku nebezpechnih, ale not hіrurgіchnih zahvoryuvan: GOSTR enterit of eksіkozom, pnevmonіya, mіokardit, atsetonemicheskaya blyuvota, eklampsіya, urolіtіaz, menіngіt, otruєnnya, chuzhorіdnі tіla, ehіnokokova kіsta. On this stage, we are important є the joke of the leading, key signs. Laboratory and instrumental dosage in the complete minimum communication and with the whole straightforwardness. It is necessary to take the offensive positions:

1. I especially respect the beast on anamnesis(The triviality of the pain syndrome, the pain syndrome, the nature, the localization, the symptoms of the pain syndrome and the diarrhea, the dullness, the cyanosis, the bluing, the sickly stun, the feverish and the inn.

2. about'єktivnі doslіdzhennya: We'll do it as much as possible

3. Tsilove laboratory and instrumental provision, Yake will not need a significant hour

4. An hour, turning around for a roundness, reducing the possibility of adequate, non-practical therapeutic visits (not without a doubt for life!),

5. Memory about atypical forms of illness, especially in children of early age with background camps (rachitis, hypotrophy, anemia), as well as with organic disorders of the central nervous system

6. Memory about the "mischievous" stomach ("false abdominal" syndrome)

The third stage of diagnostics Mozhliviy tilki pislya viklyuchennya not secure stanіv (div. Table 1). On this stage, differentiation is made against chronic recurrent pain syndrome. Although most often gastroenterological ailments, there are many extensions available: from simple to folding methods in terms of information, accessibility, and economic efficiency. The "planned" nature of the main gastroenterological ailments allows the physician to more clearly begin to discuss the need for a provocative diagnostic hypothesis on the skin stage of the clinical analysis of ailments.

From a practical point of view, you can vikoristovuyu offensive diagnostic algorithm for identifying the causes of chronic recurrent abdominal pain.

1. Revealing of the most significant officials in the development of gastroenterological pathology (Baranov A.A. ta spivavt., 1979):

1) Spadkovo tightness according to the pathology of the organs in the slunk-intestinal tract

2) Parts of the common cold

3) History of viral hepatitis

4) Giardiasis, ascariasis

5) Dysentery in anamnesis

6) Appendectomy

7) Infections in the nasopharynx

8) Chronic illnesses of the legend

9) Alergic stanii

10) Neurotic

In children with high risk factors, it is carried out further away from the outpatient stage, yak, anamnesis (1), physical follow-up (2) and a post-syndrome history of key donors, including routine maintenance (3): Analysis of blood, slaughter, feces for egg worms, enterobiasis, giardiasis, coprogram, sowing feces for typhoid-paratyphoid group and yersiniosis.

If necessary, carry out outpatient Instrumental Doslidzhennya (4): sonography of organs of the black emptying, cholecystography (with the syndrome of "right fissure"), endoscopic obesity, the definition of the secretory-enzymatic function.

Slid of memory of the diagnostic assessment of the dermal method of prescription, more informativeness of any situation in gastroenterology in general. In addition to being overwhelmed by instrumental methods, it is often possible to formulate and appear stereotypical diagnoses of "chronic gastroduodenitis", "dyskinesia of young men" in very large children with chronically recurrent abdominal pain.

If accurate topical diagnostics at the outpatient stage is uncomfortable, stationary minds or in the diagnostic center. The spectrum of the condition on this stage begins with clinical data, unclear diagnoses, as well as foldable and rare cases of sickness: malabsorption syndrome, Crohn's disease, pancreatitis, nonspecific tract multiple creeps of mucous membranes of the intestine, chubby. Absolute indications for hospitalization є virazkov ailment with signs of bleeding. On statsіonarnomu etapі conductive endoskopіchne doslіdzhennya, sonografіyu, rentgenografіyu (holetsistografіya, іrigografіya, contrast doslіdzhennya shlunka i dvanadtsyatipaloї intestine), atsіdometrіyu, viznachennya fermentativnoї funktsії, elektrofіzіologіchne doslіdzhennya, morfologіchne vivchennya bіoptatіv, navantazhuvalnі Samples vivchennya okremih bіohіmіchnih parametrіv krovі that sechі, genetichne obsleddovanіe, vivchennya microbial landscape of the intestine, laporoscopy and in.

Chronic recurrent pain in the abdomen may be tied to the so-called false abdominal syndrome... Most of the sickness, which is accompanied by pain in the abdomen, was described earlier (div. Rozdil "pseudo-abdominal syndrome" і Table 1).

Likarsk tactics in certain countries are based on the clue of the provincial, key symptoms of extra-abdominal ailments and, apparently, in the selection of optimal instrumental-laboratory methods of pre-treatment.

It is necessary to remember and about children who cause pain in the abdomen.

Metabolic products: porphyry, uremia, addisonic crisis.

Hematological illnesses: sickle-clitinna anemia, leukemia.

Toxic reactions: otrunnya with important metals, lykarska ailment, reaction to a bite coma.

The cause of recurrent abdominal pain can be psychogenic problems without a somatic-organic component. If you are suspicious of psychogenic-speculation, abdominal syndrome (in any case, the organic nature of the illness is to blame), consultation of a psychologist, neuropsychiatrist or psychotherapist is required.

The complexity of the interpretation of abdominal pain in children, there is a great number of abdominal and non-abdominal causes of high professional knowledge. Accurate diagnosis in case of pain in the abdomen ґ

"Zusilya and the smack of the liker on the way to the correct diagnosis, the clarity of his thoughts, the gravity and the sports sense of the thought (Hertle M., 1990).

List of literature:

1. Andr'ev I., Vatsparov I., Mikhov Kh., Angeliv A. - Differential diagnosis of the most important symptoms of child diseases. - Sofia, 1981

2. Gubergrits A.Ya. Pain in the black empty and diagnostic meaning. - Kiev, 1968.

3. Darbinyan V. Zh., Egishyan R.Ye. Abdominal bill. Neurological and gastroenterological differential and diagnostic aspects. - M, 1987.

4. Kalyuzhny L.V. Systemic mechanisms of pain. // Fundamentals of physiology of functional systems M, 1983.- p. 226-242.

5. Limansky Yu.P. Physiology of Bol. - Kiev, 1986.

6. Skumin V.A. Psychogenically amoused mental deterioration in children with chronic ailments of the herbal system // Nutrition for the protection of motherhood and childhood.- 1989.- No. 8.- p. 17-21.

7. Tebenchuk G.M., UNICH N.K., Bil'ska L.G. that in. Syndrome of pain in the abdomen and its significance in pediatric practice // Pediatrics.-1988.-№7.-p.72-77.

8. Hertle M. Differential diagnosis in pediatrics. volume 1 (translated from new.) - M., 1990.- p. 60-78.

9. Chronic illnesses of organs etching and habits of food among children. Navchalnyy gossip pid ed. Alexandrovoi N.I. - Leningrad, 1989.- p.5-57.

10. the functional involvement of the herbal system in children. Navchalnyy gossip pid ed. Bilousova Yu.V. Kharkiv, 1981.

11. Dotvav D.G. Analysis of symptoms in ailments of the upper form of the herbal tract // Gastroenterology. Volume 1 (translated from English) .- M., 1988.- pp. 56-110.

12. Apley J. Family patterning and childhood disorders // Lancet. - 1967.

13. Lask B. Chidhood Illness: The Psychosomatic Approach-Chichester, 1989.

14. Lipowski Z. Review of consultation psychiatry and psychosomatic medicine // Psychosomatic medicine. 1967. No. 29. р.201-224.

Entry

Pain in the abdomen is one of the most common reasons for hospitalization of children in a hospital for medical aid. Early diagnosis in case of such children in the classroom is most often to sound like "until the end of an appendicitis" I will look at the complexity of clinical diagnostics of gastrointestinal appendicitis in children, the number of laboratory, instrumental and special methods of advanced diagnostics, however, will be deprived of the perfect world to cope with this. The most accurate method is laparoscopy (invasive dosage, if anesthesia is required). Possibilities of ultrasonic diagnostics of the most severe appendicitis in children who are interconnected with the need for organizing the cylodobous ultrasound service, singing training of patients until the principles of scanning are determined by the ultrasound specialists. In the case of a large contingent of patients, the sensitivity of ultrasonic detection in the diagnosis of a guest appendectomy of 80% is to be determined by the amount of

The role of ultrasound diagnosis (UZD) is great when it is necessary to differentiate abdominal pain syndrome in children with a clinical diagnosis of acute appendicitis. Earlier (before the wide range of ultrasonic diagnostics), such children were diagnosed with the diagnosis "intestinal kolka" or "gostry mesenteric". For some children, children were sent to specialization of the diagnosis: in case of changes in the analysis of the disease - in the nephrological diagnosis of "infection of the family", with the development of pathological changes Children with infectious diseases (GDVI, intestinal infection and in.) Became the group.

By the method of this advancement є demonstration of the possibilities of ultrasound diagnostics in the differential diagnostics of abdominal pain syndrome in children in the minds of the great diversified pediatric schoolchildren.

Doslіdzhennya results

For the period from today to the end of 2002, in the ultrasound survey of the class of 3716 children, who were hospitalized with the diagnosis "Dose for appendicitis". In 85% of patients (3159 tests), the ultrasound scan was assessed for the reason that the diagnosis was clinically apparent. Children who were not performed with ultrasound before the operative engagement of the ultrasound scan were analyzed. The frequency of evanescent changes is presented in Table 1.

Table 1... Viyavleni at ultrasonic diagnostics.

diagnosis	number of patients
	n	%
Zmіni pіdshlunkovoy zalozi	514	13,83
Mesenteric adenitis	438	11,78
gostry appendicitis	287	7,72
Deformation of the ruminant michur	143	3,84
Cystitis, cystourethritis	97	2,61
gynecological pathology	79	2,12
Anomalies in the development of nirok	74	1,99
polyonephritis	49	1,31
Chronic pyelonephritis and nephrolithiasis	41	1,10
kishkova іnvagіnatsіya	12	0,30
Calculosis, polyposis of zhovchny michur, inclusions of zhovchny michur	8	0,21
Pukhlini (nirok, zaocherevinni)	8	0,21
Hepatitis, gostry cholecystitis	6	0,16
portal hypertension	1	0,02
Alien tilo of the 12th intestine	1	0,02
Echotragenic pathology is not revealed	1958	52,69
All children looked around	3716	100,00

Deformations in Bully children are often an echographic sorcerer and not even suspected of being super-juiced by sub-active skargs. For a reliable assessment of the form, the michura was carried out strictly on the heart. With the revealed deformity of the visoneous polypositional scan, before it was lasted in ortho- and clinostasis, it allowed the differentiation of a labile character, which is practically not a key meaning. At the time of ultrasound monitoring, only the stiff deformations of the ruminant were fixed (Fig. 1 a). Also, the changes of the two stinks in the eyes of the undisturbed persuasion and the development of echogenicity were indicated.

Ecological characteristics of a finely dispersed suspension in the enlightenment of a ruminant among children of a pre-older group have developed quite a bit. In order to unify diagnostics pomp, associated with artifacts caused by gas, in case of pre-juvenile malnutrition, stagnant polypositional scan, in some cases - with an easy intestinal compression on the zone of interest

The echographic picture of the hospitable cholecystomy among children of the pre-grown group has grown rather old, and in principle it has not been seen as such among older children. On the smallest swirling panning of the michur (up to 3-4 mm, roughly - 5-7 mm), a dispersed suspension began in its enlightenment and the zone of perifocal decrease in echogenicity, which is caused by the swelling of the peripheral tissue. Likewise, by the richest echographic henchmen, there were concretions (single or multiple) and polyp of rhuman michur (Fig. 1 b, 6, d).

Small. 1. Zhovchnyi mikhura zahvoryuvannya.

a) S-shaped deformation of the shiye vіddіlu mіkhura.

b) Ditina, 5 rock_v, gostry cholecystitis. Significantly, unevenly, the growth of the stink of the ruminant, the dispersed component in the lumen, the perifocal zone of decreased echogenicity, appears to be swollen by the snail tissue.

v) Ditina, 13 years old. A concrement of a ruminant michur (the efficiency of being included in education with a clear acoustic tone.

G) Ditina, 11 rokiv, polyp of the zhovchny michur (the statement of the middle echogenicity, fixed to the point of the michur, non-displaceable, without acoustic type, in case of duplex Doppler scanned, there are indications of blood flow in the polyp.

Parenchyma parenchyma among children was often consumed, and the term "reactive pancreatitis", often stagnated by polyclinic pediatricians, does not seem to be correct. The visibility of clinical and laboratory manifestations of pancreatitis (and, naturally, the visibility of the morphological verification of the pathological process) was forced into the ultrasound protocol of the understanding of the "diffusion of the reactive nature". Similar echographic changes (unreasonable development of echogenicity in the eyes of small-point echogenic focuses) was observed in children on aphids on intestinal infections, GDVI, in case of anesthetic, asthmatic bronchitis. Moss, a morphological substrate of cich zmins є zmini stinoks of other vessels. On the current year, it will be announced that the nutritional requirements of the supplementary vaccination are given. Vlasne gostry pancreatitis in children is of a supramidal type, characterized by diffuse abnormal decrease in echogenicity of tissue, and the problem of ultrasonic diagnostics of the stun of a special discussion.

The gostriy appendicitis is able to complete the echographic picture, however, the atypical growth of the sprout (zokrem, retrocecal) significantly intervened the possibilities of the echographic diagnosis, and the mind is similar to the cut-out mechanism of the bulky. In addition, it was brought to vrahovuvati, scho:

1. only a fragment of a wormlike appendage is visible in the scan, and it is not always possible to judge about all the appendages of an appendage,
2. flatulence is significant
3. to carry out an echographic assessment of a black emptying, it is necessary to have a new one, but don’t wait for it (especially for children of an early age),
4. destructively changes a fragment of the appendix, if the differentiation of its vertices is involved, it is easily differentiated from the transformed lymph node (especially in children of the family).

The worm-like outgrowth from the firing changes is visualized at the oval-shaped structure with clearly differentiated balls (Fig. 2). The diameter of the thigh is from 8 mm to the eye. In a small outgrowth, in some cases of arterial blood flow, there is a low resistive arterial blood flow (in an uncontrolled worm-like outgrowth - a resistive arterial blood flow index is 0.7). In the education of the growth, coprolities were seen in single vypads. Children often have a small amount of non-xyroid component in the projection of the small pelvis (retropuced in lads, retromately in females).

Small. 2. Gostry appendicitis.

a, b) an unchanged fragment of a worm-like outgrowth in B-mode and in colonic Doppler mode. The transverse recession of the wormlike appendage (the fragment of the meanings with a white tricut arrow) is a round shaped structure of 5 mm in diameter from the echogenicity of the central part (mucus), a hypoechogenic mesociable ball and the periphery of the serogenous part.

Digital values: 1 - adipose tissue, 2 - straight abdominal ointment, 3 - club artery, 4 - club vein, 5 - club-transverse ointment, 6 - fragments of intestinal loops, 7 - til ridge.

c, d) Fragment of a wormlike appendage with firing changes (bila trikutna arrow), diameter - 9 mm, contour of savings, with Doppler pre-delayed appearance, the growth of the vermicular calf begins to grow in the stage of the spine fragments, the tissue of the hyperexae.

d, f) Worm-like outgrowth from ignition destruction (intraoperative - gangrenous appendicitis). The contours of a fragment of an excrescence is nervny, unclean, irregularly hyperemic, discharges with heterogeneous tissue (a fragment of the omentum, at the operation - resected).

g, h) Coprolite in the education of the worm-like outgrowth.

Progressive ignition changes, which supervise the destruction of the sprout, brought the ultrasonic picture to a change - the contours of the sprout became fuzzy, some of them were absorbed, near the sprout, when the spine of the spine began to change - Appendicular abscesses appeared at the vigels of adjacent inhomogeneous structures, and sometimes the differentiation of a fragment of the appendage appeared (Fig. 3).

Small. 3. Uskladneni form of a state of the art of appendicitis.

a, b) Gangrenous-perforated appendicitis. The contours of the sprout are unclean, it is rotten to quilt, the stinks - without the strength of the baby of the judgment, the rest of the strength in the otochuyuh fabrics;

c, d, e) Appendicular infiltration in case of pelvic growth of the growth in a child of 3 years. Duration of illness - not less than 5 dB. The walls of the sprout are reworked, the contours of it are quilted reliably.

f, g) Appendicular abscess, triviality of illness - at least 2 types. Retroactively, if to the right of the middle line, it starts heterogeneously fixed up to 6 cm in diameter, the walls of the chaff is meaningful, in education - a dispersed suspension. Vlasne worm-like growth does not appear.

h) The appendicular abscess in a child is 14 years old, the triviality of illness is close to 7 dB. The right-handed person is from the slash microchur (the stinks of the last meaningful change: swelling, sweeping), which is based on fuzzy contours, hypo-, anechogenic instead.

і) Appendicular abscess in the right half of the abdomen (bila trikutna arrow). The lower pole of the right nirka is shown on the bottom pole of the readings.

Mesenteritis (fiery transformation of mesenteric lymph nodes) is often developed in children who were hoping to go to the clinic for adolescent appendicitis. For the diagnosis of gastrointestinal surgical pathology, the diagnosis in such children is not infrequent, such as "GDVI with abdominal syndrome".

With ultrasonic examination of organs in the black emptying in the right club area, and / or even in the middle (paracaval), lymph nodes began with firing changes, as they looked like one at a time, or multiple (often - conglomerate) incorrectly rounded formations, 4 a-d). The maximum size of lymph nodes in children with banal mesentericitis reached 25-28 mm. There are 2-3 great lymph nodes in the conglomerate, before any reports are made, there are more numbers of others.

The state of firing of lymph nodes was manifested by a change in its form (it became more rounded) and a diffuse decrease in echogenicity, with Doppler pre-delayed appearance of a hypothermia of lymph nodes in the vigilance of a malignant arthritic malignancy. In the world of quietness, the state of the ignition process, the echogenicity of the lymph nodes shifted, the form became flattened, the lymph nodes step by step (tizhni, inodi - mіsyatsі) changed in size and changed. Echographic changes, roztsinyuєmo how to manifest the state of fiery transformation of lymph nodes (round form, hypoechogenic, often - more than 10-14 mm in diameter in the fallowness in the middle of a child), clinically manifested spontaneously syndrome Children did not show active scarg. In one, there is abdominal pain syndrome in a child with a swelling of the side of the intestine with the development of an erosive gastroduodenitis, mesenteric infection. The appearance of third-party lines of linear form at ultrasonic scanning є great folding and very versatile in case of retinal polyposition scanned (Fig. 4 e-h).

Small. 4. Change of lymphatic nodes and foreign body of the 12th intestine.

a, b) Pre-treatment in B-mode and Doppler scan in energetic mode in case of mesenteric adenitis. Ditina, 6 rock_v. A conglomerate of hyperaemic lymph nodes of reduced echogenicity will begin.

c, d) Improvement of the lymph nodes of the small pelvis in lymphosarcoma in a child of 5 years, a small tricky arrow of the testimony of invisibility, a fragment of a wormlike appendage.

d, f) Prescribed in B-mode and duplex Doppler scanned in the umbilical region right-handed, later access. In the intestinal lumen, there is a tubular form of the structure up to 5 cm, the thickness is close to 3.5 mm. Bleeding in the intestine

g) Preceding in B-mode in the umbilical region, right-handed, transverse access. In the intestinal enlightenment, there is a ring-like form of inclusion up to 3.5 mm in diameter (bila arrow), it is important to differentiate from fragments of the mucous intestine.

In our spooked echographically, a fragment of an alien body of a tubular form (a stick shaped like a "chupa-chups" type) is visualized with a size of 5 cm, 3.5 mm in diameter in the opening of the intestinal loop in the right half of the abdomen, and in this On the oglyadov_ roentgenogram of the pathological emptying, the inclusion did not appear, in the course of repeated dosages (3 times with a stretch of 1 add) the position of the alien body did not change, but it did not change endoscopically.

Kishkova іnvagіnаtsіya was very important in children of the early age (from 5 to 30 months of life), I want, as a casuistry, spastered and at the age of 2 months old, and at children. Vlasny dosvid shows that the pathology needs to be remembered in all cases of ultrasound prescriptiveness in nursery children with pain in the abdomen and is directed to the pathology. In the middle of a large number of vipads, an invaginate appears in the right half of the abdomen, or on the back of the belly button. With a transverse scanned invaginat there is a rounded shape (up to 25-35 mm in diameter), a sharpened structure, surrounded by differential balls of the intestinal wall (the so-called symptom of "mischief"). symptom "by leaflets pie"). The reason viniknennya іnvagіnatsії rіznі, i genesis patologії still pіr residually not viznacheny. in deyakih vipadkah іnvagіnatsіya bula sprovokovana zapalnoї transformatsієyu brizhovih lіmfovuzlіv, SSMSC entice to the structure of intussusceptum i could Buti diferentsіyovanі ehografіchno yak okrugloї FORMS gіpoehogennie structures in yogo tsentralnіy chastinі (Fig. 5). The Doppler doslіdzhennya allows you viznachiti, zberezheny chi sudinny malyunok from fragments of intestine zaluchenoї in іnvagіnat scho Bulo predictability spriyatlivoyu Find our (takі іnvagіnat zazvichay easily rozpravlyalisya at pnevmoіrrіgografіі). Vіdsutnіst sudinnogo malyunka in іnvag Іnat svіdchilo about virazhenih іshemіchnih ruins in lesions of intestinal fragments. The echographic assessment of the intestinal tract infections allowed to reduce the appearance of intestinal impairment.

Small. 5. Kishkova іnvagіnatsіya.

a) Ditina 2 rock_v, pneumoirrіgography. The head of the invaginate is shown with a white arrow.

b, c) The same child, after being lodged in B-mode. Polyposition scanned in the right sidebar. A sharuvat aperistaltic structure, an incorrect cylindrical form, appears. The transverse scan (b) is an echographic symptom of "mischief", later (c) is a symptom of a "leafy pie".

GІnsha child. The echographic symptom of "mischief", in the center of which there is an oval form of the statement of the middle echogenicity (bila shooter) - lymfovuzole due to the ignition transformation.

dІnsha child, duplex doppler scanning in color mode. Viznazhayutsya many cases in the fragments of the intestine, which confirms invaginat.

e Doppler scan in energetic mode (іnsha ditina). A fragment of the great judgment begins, in the middle of the invaginate the blood does not appear.

f The child's intestinal imbalance is 18 months old on aphids of fine intestinal invagination (ailment is 22 years old). The head of the invaginate is shown with a white tricot arrow, and a loop of the intestine (paired with a arrow) extended up to 27 mm.

Gynecological ailments in children were often consumed, in a large number of cases - in an adult age. About the processes of cystic or solid character in the projection of the patients in the consultation of a child gynecologist and treatment in a special hospital (Fig. 6). In a rare pathological condition, when an emergency (but also laparoscopic) twisting of the appendages occurs, it is necessary to start navigating the children of early age (6th step). Echographically in the projection of the appendage, an incorrectly-rounded form of a low-displacement structure (close to 4-6 cm in diameter in the fallowness from the viku deity) has begun to change, due to other anechogenic inclusion of rounded blood Sudden babies quilted only along the periphery of the egg, in the first parenchyma of the judges did not begin. The extra effort allowed to preserve the organ, and the echographic caution in the operative period - to control the results of treatment. A common pathology of pediatric disease of the hematometer and hematocolpos. Echographic diagnostics of the pathology is simple, the ultrasound picture of Bula Velmi is characteristic.

Small. 6. Gynecological illnesses.

a) Ditina, 12 rocks, scanned in the suprapubic region, oblique access. In the projection of all appendages, there is a rounded shape of up to 48 mm in diameter, thinness, with a single space, without a sign of blood flow in the middle.

b) Ditina, 13 years old. In the projection of the right appendages, there is a rounded shape of up to 56 mm in diameter, medium echogenicity, without signs of blood flow in the middle.

c, d) Hematometra, child, 13 years. Doslіgennya in B-modeі, transversely and appropriately. In the projection of the small pelvis behind the section of the michur (the last of the sharp deformations), it appears even worse than the great changes (not less than 24 x 14 x 12 cm), the incorrect form of the thinness of light, the dispersed suspension is not installed (instead of changing to rely on during the winter)

d, f) Ditina 2 rock_v. Pre-treatment in B-mode in the suprapubic area, oblique access. The projection of both appendages has an incorrectly rounded shape, with sizes up to 56x42 mm, medium echogenicity, with single, incorrectly shaped, single inclusions in the middle (torsion of the cell). Sudden babies in the projection of the transformed ovary cannot be quilted.

g, h) Gematokolpos, ditina, 14 years. In the projection of the small pelvis, behind the small michur, there are great sizes (12 x 10 x 9 cm) of the wrong form of thin light, the dispersed suspension is not installed (instead of changing when the child is forced to die), over the yaw

Frequent ultrasound znachіdkoyu boule of pathologic stanage of organs in the sevidіlnoy system. Cystitis is the cause of abdominal syndrome with approximately the same frequency of occurrence in girls and boys (Fig. 7). Dilatation of distal forms of secular diseases with manifestations of ureteritis has begun in some cases of disease. Gostriy pієlonephritis appears more often in women. The beginning of the development of two-circuit balances (nabryak) for the destruction of the cortical-medular differentiation for the rakhunok of the nabryakov-infrastructural changes of parenchyma. Intrarenal juvenile babies with a lot of savings, zones of ischemia in the parenchyma of the nirka did not appear. In more important cases, there was an onset of a middling increase in echogenicity with the second characteristic echographic malignancy of parenchyma, a local development of parenchymal blood flow with Doppler dysplasia. The appearance of such changes in the form of a secret consultation of the urologist and correction of the treatment is carried out. There are urological illnesses that are numerous, and within the framework of this dosage it is not enough for the senses to learn in detail all the versatility of the pathology. Interspersed with overwhelmed diseases: hydronephrosis - 11, polyeloecotasia - 22, ureterohydronephrosis - 2, underweight - 5, underworld nirok - 18, aplasia of nirka - 4, pyocystic deformity - 2 kinematozoa ... Approximately 2/3 of the patients received prior advice with the recommendation of caution from the fakhivts for the place of living Reshta children demanded a shift in the specialization of the information, the rigorous and formalized tactics of the given delivery.

Small. 7. Zapalnі zvoryuvannya nirok і slash mikhura.

a, b) There is a turn of diffuse changes of parenchyma nirka (cortical-brain differentiation is not quilted) on the most insignificant polyelectasis, turn of the signs of a mucous ball (bile arrow). Intrarenal vertebral tenderness of sparing.

c, d) Infiltrative form of gosstry polyonephritis in a child of 2 years. At the projection of the lower fragment of the nerve, a zone of heterogeneous movement of excitability up to 5 cm in diameter, the contour of the nerve of nerves, cortico-cerebral differentiation is clearly not visible, in the area of ​​small fever.

e) Indirect indications of cystitis: the slice grain is indefatigable, in the lumen there is a finely dispersed suspension.

e) Indirect indications of cystoureteritis: the slice of the cuticle is unstoppable, in its education there is a finely dispersed suspension;

g, h) Gostra obstruction of the secular nobles. Dilatation of the zeralny system of nirka, growth in the girdle of the sevodu (bila trikutna arrow) begins.

Pukhlini in the middle of the analyzed group of children were developed rather, ale, tim not mensh, memory about the pathology is necessary. In our sparrows, there is a small mischief in 1 vipad, there is a small mischievous pukhlina, in 3 vypadki from the comb of the right club kistka, in 3 vypadku - malignant chickens nirok, in 1 vipad - lymphosarcoma of an erythrocyte or ). Carrying out a comprehensive ultrasound examination using Doppler technologies made it possible to accurately determine the localization of the swelling and the particularity of intratumoral hemodynamics.

Small. eight. Pukhlini.

a) Ditina, 5 rockiv. Excretory urography. On the 6th sign of the function of the right, there is no nirka.

c, d) The same child, last seen in B-mode and Doppler scan in power mode, is displayed. Great sizes (up to 8 cm in diameter) begin to appear in the lower fragment of the right nirka, intrarenal juveniles to quilt at the upper fragment of the nirka;

e) Ditina, 6 rockiv. Duplex Doppler scan in Colore Doppler mode. It starts out even more than great sizes (up to 13 cm in diameter) about the decision to enter from the lower fragment of the right nirka. At the projection of chubby, a single great vessel is quilted.

e) Doppler ultrasonography of intratumoral vessels. There is an arterial type of blood flow through the inferior lower peripheral support (RI = 0.31).

g) Lymfangioma of black emptying in a child of 2 rocks (multi-chamber illumination with back-to-back dimensions close to 9x5 cm).

h) Lymphosarcoma in a child of 13 births (unclearly up to 13 cm in diameter with heterogeneous space).

A cavernous transformation appeared in a child with abdominal syndrome. Typova Ehographicheskaya picture allowed exactly differentiation zhvoryuvannya.

Negotiation

Gostriy appendicitis is the most widening of surgical illnesses in children, while the country of infestation is 3.2 per 1000 children in rіk. Apparently, if a child has a scarg on pain in the stomach, it is necessary to confirm it in some way in a short term. Relatively critical care does not require you to accurately establish a diagnosis, but rather a continuous interest before assessing the diagnostic efficiency of other additional methods of pre-examination. Laboratory methods (changes in blood analysis) are nonspecific and cannot be helped in diagnostics. Laparoscopy made an important contribution to the diagnosis of gross appendicitis in children, allowing not only the assessment of the body of a worm-like growth, but differentiation of the incapacitation of the other organs of the black waste and small waste. Only in 1.2% of cases of laparoscopy does not give an accurate assessment of the form of a worm-like outgrowth. The main shortcoming of the method of є yo invasiveness.

In the 80s, great respect for non-invasive methods of diagnostics began to be drawn to great respect, the electromyography of the anterior cranial wall became the main one, as it allows for a very clear assessment of the problems. However, the method is not absolutely accurate; it is not less than 6% of the tests to be carried out with the maximum knowledge of the robots with the patients of the assigned group of diagnostics. Hyperdiagnostics (4% of pardons) of a seizure on children with ignition processes in the black empty of non-appendicular activity (in the first place - mesenteric adenitis). Hypodiagnostics is based on atypical growths of the growth. Analogous problems in the case of thermal imaging, in order to restore the infrared visualization from the side of the anterior cervical wall. For example, in the case of electromyography, the non-appendicular ignition process is smooth or difficult to differentiate from a severe appendicitis.

Fundamentally new possibilities in diagnostics and differential diagnostics of abdominal pain syndrome external ultrasound. The emergence of high-frequency sensors made it possible for the echographic assessment of other objects, including the worm-like outgrowth. Until the end of the 70s, it was born in the region since the mid-80s. Previously, the visitor to the majestic clinical material, they confirmed the possibility of an echographic diagnosis of the hospitable appendicitis, ale vyyavili that the method was interconnected, related to the peculiarities of the development of ultrasound growth with the help of According to the data of the most recent medical reports, the accuracy of ultrasonic diagnostics of a gastric appendicitis with the most agreeable minds (Vysokorozdilna technology, a significant specialty of a doctor) among older patients does not reach 50-85%, while 70-85% Conducted in December 2019, parallel to the examination of ultrasound diagnostics and computed tomography (CT) in the middle of the children of a child with an admission to the hospice, the appendicitis was shown to the deyak perevagu CT. So, for ultrasonic scanning, the sensitivity of the fold is 74-92%, the specificity is 94-98%, and for CT - the sensitivity is 84% ​​and the specificity is 99%. For a group of older patients of the KT pass, it was more obvious: the accuracy of the ultrasonic scan was 68%, the accuracy of the CT was 94%. In the provision of Doppler technologies with the possibility of assessing the blood flow in the visualized fragment of the worm-like growth, the accuracy of the diagnosis (sensitivity - 90%, specificity - 94%). For any type of ultrasound, the clinician will be of great help: for example, the first survey of the surgeon in diagnosing a state of the art of appendicitis is 50% sensitivity and 88% specificity, and the ultrasound scan is 85% and 96%, for sure.

For 2.5 years of robotics, the ultrasonic scanning of 3,716 children with adolescence for the appendicitis, clinically diagnostics of the buv of admission in 3159 children, and only in 557 children of the class of the hospitable appendicitis, the diagnosis was made abo. In 287 cases of echographic symptoms, bouts of pinkness have shown a severe appendicitis. In all, 337 children were operated on in the pre-adult group of patients, intraoperatively diagnosed with acute appendicitis (new clinical forms and stages) in 298 cases. Rozpodil ultrasound doctors of "gostry appendicitis" we will attack:

• true-positive results - 275 vipadc,
• hibopositive - 12 vipadkiv,
• true-negative - 247 vipads,
• hibno-negative - 23 types.

Apparently, the indicators of diagnostic efficiency of ultrasonic scanning in our clinic for the last 2.5 years should be advised:

• sensitivity - 92.3%,
• specificity - 95.4%,
• predictability of a positive result - 95.8%,
• predictability of a negative result - 91.5%,
• accuracy - 93.7%.

Hybnopositive results were not only respected, since the intraoperatively predictable worm-growing growth (4 ways), but the drop, if the graphical signs of the initial transformation of the worm-growing supernatant were inadequate With dynamic ultrasonic control in 2 drops, the echographic picture did not change, in 6 drops - a worm-like growth after 2-5 dB did not appear.

High indicators of diagnostic efficacy of ultrasound diagnostics of gastric appendicitis in their own prelude can be explained by decilcom factors:

1. adequate training of patients. At the same time, it is necessary to ensure the value of adequate interoperability of diagnostic services (UZD) and surgical information, so that the preparation of patients is not guaranteed,
2. significant advise of robots with a contingent of patients, knowledge of ultrasound scanners of technical receptions and key features of the hospitable appendicitis in children,
3. for high-resolution ultrasonic technology, multi-frequency transducers, including the line 5-8 MHz.

It is impossible to ignore the great importance of ultrasound diagnostics for the detection of "non-appendicular" pathology. When considering laparoscopy (the most accurate method for diagnostics of grievous appendicitis for the current day), an echographic assessment is available not only of the organic waste of the small pelvis, of the simple In recent and foreign literature and the mass of publications assigned to ultrasonic diagnostics of young illnesses in case of regular patients, they were admitted to the hospital for admission to the hospital. In the main, the disease of the hepatobiliary system and ailments of the gastroenterological profile. At the age of their children, who were hoping to go to the hospital for the end of the day for the hospitality of the appendicitis, ehographically boules know: the flare-ups and anomalies in the development of some and other common hepatitis, the seizure of the systemic Presented in this publication, the results and the hunt for only 2.5 years of the last rock and only in the same Moscow class, a little bit of trouble and a little bit of illness, even when it was clear about the value of the abdominal pain syndrome at home.

In such a rank, ultrasound treatment of children who were admitted to the hospital for admission to hospital for appendicitis, allowing not only to confirm the presence of the diagnosis, but also to establish the cause of the pain syndrome of chronic hospitals. Dosvіd robot vіddіlennya ultrazvukovoї dіagnostiki bagatoprofіlnogo shvidkodopomogovih Dityache statsіonaru dozvolyaє stverdzhuvati scho SPL organіv cherevnoї porozhnini, i zaocherevinnogo expanse of small pelvis shown vsіm patsієntam scho nadіyshli in statsіonar of pіdozroyu on GOSTR apenditsit, navіt in razі vіdsutnostі klіnіchnih proyavіv gostroї abdomіnalnoї patologії. As a matter of fact, at the presentations of the illustrious saints, they see food about the further development of the child, or the transfer to specialization of the information, as a result of more and more early events of the year.

literature

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In medicine, it is accepted to name a complex of symptoms, the main criterion for those who have a beating in the abdomen. Immediately, it means that there is often not a direct link to any surgical pathology, but rather to be affected by organ problems, scattered in black empty spaces, or problems with the nervous system of the patient's patient, the patient's body. It is called provokuvati that there can also be a firing process in the throat, wicked intoxication of toxic speeches, and we have a problem with the body.

In some cases, abdominal syndrome develops

Abdominal pain syndrome can achieve a foldable classification. Cleverly, it is possible to bring in people who are ill, on the smallest wines and to manifest themselves.

• There may be ailments of organ etching - hepatitis, cirrhosis of the liver, stenosis of the gullet of the duodenal intestine, etc.
• Named abdominal pain can also be associated with abnormalities of the breast organs - pneumonia, myocardial infarction, diverticulosis, stravohode and other.
• The manifestation of an abdominal syndrome was mentioned in cases of infectious or viral ailments - syphilis, operative herpes and in.

In a special group of pathological conditions, which form the development of the described pathology, it is necessary to bring ailments, to the broken words of the immune system - diabetic diabetes, rheumatism and porphyry.

Yak is manifested bіl in case of different factors

Abdominal pain syndrome develops as a result of pain. The very tsya of the sign often helps the fakhivtsy to put the correct diagnosis and to establish the cause of the ailment. Struggle for an additional check-up of the patient, biochemical analysis of blood, ultrasound results, as well as X-ray of the organs of the breast and the black empty.

1. Rise of spasticity, such as detecting and knowing rapt, are of the nature of a painful attack. Smells often radiate to the back area, down to the shoulder blade, across or across the lower edges, and supravly with tediousness, blues, and the like, usually, they provoke the firing processes in the middle
2. As well as the syndrome of wickedness to the stretching of empty organs, it is more aging and difficult.
3. And in case of structural changes, or even posed organs, peritoneal pain occurs. In the medical stench, one gets the most insecure and gets the name "gostry zhivit". Such a beat is rapt, it is poured out, it is supervised by gallant nezuszhannyi and strong blues. With a change in the position, a cough or a cough - you can do it.
4. they are diagnosed with pneumonia, infarction, pleurisy, etc. Before an hour of such attacks, a sickness to the body, what a bi posture of an empty stomach, to get alive. Until then, you are prone to admit it and on the smallest development of descriptions of the syndrome - fever (as an infection), or in the slopes (with ischemic disease of the heart, or rheumatism), etc.
5. And not tied with ailments of internal organs. Smells є neurotic and suffer the most frequent stresses, shocks and depressive camp of a sick person.

I would like to admit that if pain in my stomach was to blame, it would be the cause of the brutality to the drug, for that abdominal syndrome, as you crossed over, maybe I’ll get to know it, if I’m going to get a thermal operation and I will block the life.

Features to exhibit chronic abdominal pain

The syndrome of abdominal pain can manifest itself as malnourished and rapidly develop by attacks, or it can be of a protracted chronic nature.

In the last fall, as a rule, a build-up step-by-step and recurrently stretching out decimals and naval months. First of all, the chronic form of the syndrome is mainly formed in the presence of psychological factors, and not in the step of a lusty inflow. That is, pathology is given in the world as it ceases to represent the steps of the main incapacitation and begins to develop according to its own laws.

Pre-adolescents vvazhayut that chronic abdominal syndrome often appears as a provoked camp of admitted depression. Such patients, as a rule, skarzhayutsya at the same time of the early localization of the big visions - for example, they can have headaches, back pains, live, etc. The stink of this is often characterized as follows:

True, not all chronic pains in the stomach are affected by mental breakdowns - the stench can occur on the smallest oncological ailments, ailments of loam, and ischemic ailments of the heart. Ale in tsyom vypadka syndrome of a swab is surrounded by localization.

Manifest an abdominal syndrome, as a result of the term hospitalization

Yak already lost earlier, the abdominal syndrome in some cases can be familiar with the serious deterioration of the functioning of the organs in the black empty or her posture. To that, for that, I can’t give myself a chance to be safe when there is a pain in the stomach, followed by the nobility, in some kind of droppings of the term “beast” for medical aid.

• as at once with pain there is a strong weakness, spoiled and apathy;
• there are many pediatric hematomas on those;
• torment a sick person with bagatoraz blues;
• abdominal muscles tension;
• at once with pain the tachycardia and the arterial grip decrease;
• a sick turbulent fever, which is unclear;
• obsyag abdomen strongly zbіlshuєtsya, suprovodzhuyuchis swinging pain;
• gases do not come in, but peristaltic noises in the daytime;
• women have a clear vision or bleeding.

Kozhen z tsikh is a sign (and more than one day) of a general consultation of a fahivtsya, so that I can appear as a manifestation of a life that is not safe for life.

Abdominal pain syndrome in children

Children are a special group behind the development of abdominal syndrome. It is tied to the child's body in a mind-boggling manner to react to whatever factor is in order to ear.

So, in the early name of the name, the syndrome can appear to provoke supramundane gas solutions, to wick the intestines of a baby. And the disease in the form of a cause can be a disease and inflammation (type of obstruction) of the intestine, as a result of a negligent hospitalization, or even in the presence of anomalies of organs in the black waste.

Abdominal syndrome in children of schoolchildren is most often known to be familiar with chronic gastroduodenitis or impaired functions of the fatigue. It is not common for the syndrome to develop on aphids or chronic pathologies of any type of abnormality. In children-pidlіtkіv wіn can be manifested during the formation of the menstrual cycle. Before the speech, in such a kind of pain I can see the familiarity of the cysts of yachniks.

Difficult diagnosis for abdominal syndrome in children

Abdominal syndrome in children with severe illness in the diagnosis of pathology, which became the cause of the onset of pain. It’s tied together, but a child is most often not in a snake to accurately characterize its perception, its localization, strength and manifestation of its radiance.

Mіzh іnshim, pedіatri sturdzhuyut, how babies often endure, whether it’s unsuccessful and because of discomfort they describe how much in the belly. We give a description of those who want to navigate in quiet vipads, if the child is clearly seeming to be spoiled, pains in vuhah, or a head or nudotu.

Ways to fight the abdominal syndrome in children, so that in older adults, it’s easy to stay out of the main anxiety, but we strongly recommend that fathers don’t take self-reliance on children who don’t antibiotic drugs. On the right, in the case of some kind of child, you can create a picture of how to see a child, to develop even more importance and without that it is important to diagnose and by yourself to diagnose serious inheritances.

And that means, when your child has a scarg for a little in the stomach, and they are signs of an abdominal syndrome, it is necessary to turn to a doctor. In the whole vipadku it is more beautiful to play it safe!

Manifesting the syndrome with GDVI

Frequently pediatric patients develop GDVI with abdominal syndrome. In children, the process is also tied to the special reaction of the body to the factor that makes us feel better.

In such cases, to the extreme symptoms of viral infection - a sore throat, undead, cough, weakness and fever - in a small patient, you may feel positive for blues and pain in the abdomen. Alle the name, it can manifest itself as a special reaction to the child's organism to infection, so, for example, I became aware of the chronic pathology of the organs of the black waste.

That is why the diagnosis "GDVI with abdominal syndrome" in medical stakes is imprecise and routine. Vin does not give a specific explanation, but to be seen in the body of a sick person at a given moment, but the patient with manifestations is a sign of the guessed syndrome of a vimag of obovazkovy additional obstruction for the prevention of surgical reasons for the diagnosis of pain in the animal.

Like abdominal syndrome

At the point of time, we will describe the camp є we will not condemn the ailments, but deprive them of a complex of symptoms, struggling with the abdominal syndrome of slid, assimilating, in the first place, the cause of the disease. Chimalu has a role in the general development of also the reduction of motor dislocations of the intestinal tract and the normalization of pain relief in the patient.

For usunennya discomfort, scho appearing on a number of problems with the shlunkovo-intestinal tract, as a rule, it means myotropic antispasmodics. The most popular among them is the drug "Drotaverin", which volodya is very vibrant and not negatively infused on the nerve and heart-vascular system. Daniy didn’t just have spasmolytic activity, but also help to reduce the viscosity of the blood, as well as allowing the stasis of this not only in case of dyskinesia of the gallbladder, intestinal ailments of the intestine, and intestinal diseases

There are no less drugs that appear to be used to blockers of muscarinic receptors (you can smell the smell for muscle relaxation and heart spasms) or to selective and nonselective cholinoblockers. ...

Also abdominal ischemic syndrome

From the described disease of abdominal pain in the abdomen in medicine, the syndrome of abdominal chronic ischemia is accepted. Wine is to develop for a trivial hour, the lack of blood flow in the small aorta as a result of:

• important heart-vindicators;
• arteries;
• vasculitis;
• anomalies in the development and health of the vessels;
• as well as the appearance of cicatricial stenosis due to injuries and operations.

Such a camp is littered with deaths (necrotization) of dalyanoks, or organs that do not fit in a sufficient world of water and do not produce a drop.

Cycavo, abdominal ischemic syndrome most often occurs in people aged 45 years. I manifest guilt, as a rule, a triadic sign - oppressive, uneasy, attack-like pain in the abdomen, intestinal dysfunction, and also progressive decrease in mass.

Yak struggling with abdominal ischemic syndrome

Bіl bezvichey to appear approximately in the first year of the year, and maybe even more until the next year. Innocent vona irradiation in the back or in the left part of the breast cage and superfluous flatulence, swelling, boredom, blues, right as a result of the accepted health.

You may not be able to get away with it, but it’s not just physical stress, but it’s easy to walk, but to buy it in a calm self-paced state, however, only for some people who need to take an anti-stress risk.

When diagnosing "abdominal ischemic syndrome", treatment, such as in some types of diseases, is directed to the main disease. It is important for a sick person to polish the process of blood circulation, anticoagulation, and in case of intestinal dysbacteriosis - to get rid of it, to polish its microflora.

We are sick to recommend you to use shotguns with other portions for rough ones and in case of severe interruption of the disease, it may be shown promptly for the restoration of blood circulation in the abdominal aortic tubes.

Compartment syndrome

If the patient, as a result of the acceleration, suffering from injuries or surgical entrapments, the internal vise is moving, then such a standard is diagnosed as an abdominal compartment syndrome. It’s not safe to eat, and also to have pain in the abdomen of great strength and localization, as to lie down at the age of painful threshold at the patient, and as soon as I’m going out of bed.

Before speech, specific symptoms, such as talking about internal hypertension, it is not necessary for the formulation of the named diagnosis of the lack of a physical way of obesity of the abdomen, or the introduction of a backward cliché picture of entrapment. In a more precise way to identify hypertension in a given context, as to maintain a fakhivtsi, є vimіryuvannya vise in a slash, as і can serve as a point of reference for the designation of a term adequate lyuvannya.

As you already spoke, the compartment syndrome is not a safe camp. Without a special treatment, it can lead not only to serious damage to the functions of organs of a black empty, but it can lead to a lethal result. As a rule, by finding the best way to deal with the predicted abdominal syndrome surgical involvement - this is the name of the decompression, as a result of which the level of the internal vascular clamp is reduced and the blood circulation in the cranium is introduced.

Functional abdominal bill (R10.4) - not associated with abdominal pain, not associated with organ pathology, overwhelming triviality for 3 months for 6 months afterwards.

One of the most frequent skargs in children is pain in the abdomen. The diagnosis of pain in the abdomen of a functional nature may have dyskinetic discord of unreported genesis, albeit without an organic basis.

Symptoms of Child Functional Abdominal Pain

The main symptom is bіl, which is localized in the peri-umbilical region, or even in other areas of the abdomen. At the same frequency, the nature and intensity of abdominal pain can be debilitating. Clinical signs of guilt do not occur more than 1 time per week spanning 3 months. A typical feature of functional abdominal pain є marriage is a viral connection with a loss of life and defecation. The out-of-the-box children with abdominal pain syndrome are insignificant, physical development shows up, they get out-of-the-box activity, normal appetite and sleep. Often, children experience psychomotional damage.

Diagnostics of child functional abdominal pain

To prevent the functional nature of pain in the abdomen, it is necessary to exclude the organic cause of the abdominal syndrome and the functional dislocation of the intestinal tract, with similar symptoms. Evidence of the organic nature of the abdominal syndrome є the occurrence of recurrent pain in the abdomen with fever, intoxication, bloating, home blood in feces, diarrhea, constipation and unmotivated contractions) (.

For all children with abdominal pain, it is indicated that there is a laboratory and instrumental treatment, including the back analysis of blood, slaughter, feces for egg worms and cyst lamblia, coproscopy, abdominal ultrasound and ultrasound examination. Endoscopic and radiological preliminaries of the slunk-intestinal tract and other diagnostic methods, clarifying the diagnosis, are carried out according to the transmission pathology.

Likuvannya childish functional abdominal pain

Includes a set of therapeutic approaches that are focused on the elimination of pain syndrome. The child's eating habits have products that increase motor activity and gas production in the intestines. There are food fats, chocolate, peas, kvass, sauerkraut, cabbage, milk, grapes, sauerkraut, kvass, black bread, gas drinks, rods. Surrounded by fresh vegetables and fruits.

To relieve pain syndrome, heat treatment is performed on the abdominal area (warmth, warmth, or sedative baths). When out of sight, the effect is recognized as spasmolytic drugs. For myotropic spasmolitics, “Papaverine” stagnates in the fallowness as a result of 0.005-0.06 2 times per dose; "Drotaverin" ("No-shpa", "spazmol") for children up to 6 rocks at 0.01-0.02 times, from 6 to 12 rocks at 0.02 1-2 times for dobu; "Mebeverin" ("Duspatalin") in a dose of 2.5 mg / kg in 2 doses for 20 minutes before їzhі (from 6 years); "Dicitel" 50-100 mg 3 times a day for children of school. In case of flatulence, preparations are used to change the gas solution ("Plantex", "Espumizan"). For normalization of intestinal microflora, vikoristovuyut pro and prebiotics ("Linex", "Acitpol", "Bifiform", "Khilak-forte"). We are important directly in the process of correcting the psychomotional camp, consulting a psychotherapist.

Basic drugs

Є contraindication. Consultation of a specialist is required.

1. (Papaverine) - myotropic spasmolytic. Dosing regimen: vseredinu 0.005-0.06 2 times for dobu. For children from 1 to 12 years, the maximum single dose is 200-300 mg / kg.
2. () - myotropic spasmolytic. Dose regimen: for children up to 6 days, with a dose of 0.01-0.02, from 6 to 12 times, 0.02 1-2 times per dose. The maximum additional dose when taking the median for children from 6 to 12 years is 80 mg, for those older than 12 years - 160 mg.
3. Simethicone () is a drug that reduces flatulence, intrusion. Dose regimen: for scargs, tied with overwhelming gas solutions, we will grow up and children over 6 years old should take 2 capsules. 3-5 times / day. The triviality of the course of treatment is due to the manifestation of symptoms of altered gas. If necessary, the drug Espumizan can be stored for a trivial period of an hour.
4. (A drug that regulates the intestinal microfloria). Dose regimen: children priznachayut drug 20-40 drops 3 times / dobu; nemovlyats - 15-30 drops each 3 times / add. If the dose is reduced, the dose of Hilak forte can be reduced by half. The drug should be taken all the way to the middle until the hour is taken, diluted in a small amount of ridini, milk is included.