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The aim of the work is to study demographic and clinical features of intussusception in children. Material and methods. A retrospective analysis of all intussusception patients, who received treatment at the “Ivano-Matreninskaya Children’s Clinical Hospital” in Irkutsk over the period from 2006 to 2016. The age, gender of patients, the prescription of the disease, seasonality, diagnostic methods, treatment methods and outcomes (recovery, relapse of intussusception) were taken into account. Results. Over the past 10 years, there were observed 268 intussusception children patients. The number of cases per year varied from 11 to 41 with an annual increase in the last 5 years. At the age of 1 year there were 44 (16.4%) patients, over the year - 224 (83.6%). Boys are more often ill (191 (71.3%)) in comparison with girls (77 (28.7%)). There was no regular correlation between the frequency of the intussusception and the time of year. The peak incidence was observed in the summer (29.5%) with the fall in autumn (22.7%) and approximately the same ratio in winter and spring (23.4% and 24.4%, respectively). 204 (76.1%) patients entered up to 12 hours from the onset of the disease, 35 cases (13.1%) - from 12 to 24 hours, 29 patients (10.8%) entered after 24 hours. A clinical feature of intussusception was an increase in the number of cases of recurrent forms, whose frequency accounted of 14.5%. After conservative treatment, the relapse rate was 17.8%, after surgery - 2.5% (p <0.05). Pathological formations of the intestine were revealed in 3 (7.7%) out of 39 patients with the recurrence of intussusception in comparison with 3 (1.3%) of 229 children without relapses (p <0.05). Treatment of recurrences of intussusception: conservative - 59.0%, laparoscopic disinvagination - 38.5%, laparotomy and disinvagination - 2.5%. Conclusion. There is observed an increase in the number of intussusception children patients, especially cases over the age of one year. Boys are sick 2.5 times more often than girls. The frequency of recurrences of intussusception is 14.5%. Repeated intussusception is associated with pathological intestinal formations and age over one year.

Medical news of north caucasus 2016. Vоl. 11. iss. 3 В структуре закрытой травмы живота у детей повреждение селезенки занимает первое место, составляя от 47,8 до 79,7 % [7, 12, 13]. частота хирургического лечения травмы селезенки колеблется от 45 до 66 %, а количество спленэктомий-от 37 до 69 % [3, 7]. Суждение о том, что «селезенка не является необходимым для жизни органом» [5], не может быть верным с позиций современных знаний о структуре и функции органа. по определению W. L. Buntain, спленэктомия относится к операциям, которые вызывают ятрогенные заболевания [14]. В частности, послеоперационный гипоспленизм-патологи-ческое состояние, которое развивается после хирургических вмешательств на селезенке, достигает максимальной степени выраженности после полного удаления ее ткани (аспленизация) и имеет в своей основе снижение неспецифической резистентности организма [2]. Риск развития генерализованного постспленэктомического сепсиса у детей возрастает в 50-200 раз с летальностью 40-70 % [14]. Страх перед продолженным кровотечением при чрескапсульном повреждении селезенки, передающийся из поколения в поколение хирургов, является одним из основных факторов высокой частоты спленэктомии у детей [25].

The results of treatment of 75 children with spleen damage were studied. The conservative treatment was applied in 69 (92%) cases. A restoration of spleen structure was noted in case of spleen injury on 3-4 weeks. The complete normalization of the spleen structure occurred in terms of 3-4 months after trauma. Posttraumatic cysts appeared in case of large defects and hematomas after 2-3 weeks and disappeared by 5-6 months. The regenerative process of shallow ruptures was registered after 3-10 weeks, but the deep ruptures were healed after 6-30 weeks. The preservation of the spleen after trauma have led to structure and function recovery and could be considered as primary prevention of asplenism.

It was established that thanatogenetic feature of spleen injury in children is moderate blood loss (89.6% of victims), incidence of large and massive blood loss was 6.8% and 3.4% respectively. In unoperated children blood loss did not exceed 15% of blood volume. In group of operated children (n=6; 8%) incidence of large blood loss was 4% (n=3) and did not exceed 28% of blood volume. Prevalence of moderate blood loss in case of spleen trauma due to anatomic and physiological features and mechanisms of spleen injury is theoretically justified.