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CLINICAL CASES

    1. Republican State Budgetary Medical and Preventive Institution “Republican Children’s Multidisciplinary Hospital”, 369010, Russia, Cherkessk, Griboedova str. 77A.

    Keywords: ntussusception, Peutz — Jeghers syndrome, polyps, pediatric surgery, intestinal obstruction

    Abstract:Introduction. Intestinal intussusception is the most common type of non-congenital intestinal obstruction and one of the most common nosologies in emergency pediatric surgery. This disease occurs mainly in children of the fi rst year of life and is extremely rare in older age. In children over 3 years of age, intussusception usually has leading points in the form of organic causes: diverticulum, doubling of the intestinal tube, polyps, tumors and others. Material and methods. A child of 7 years old, entered the department of pediatric surgery with acute abdominal pain syndrome, repeated vomiting, the duration of the disease is about 20 hours. The child was operated on urgently basis with a preliminary diagnosis of acute appendicitis. Results. Intraoperative ileocecal invagination with necrosis of the ileum was detected, about which a resection with an anastomosis of the intestine was performed. Histological examination of a remote small intestine revealed the presence of Peutz-Jeghers polyps. After discharge from the surgical department, the child was sent under the supervision of an oncologist and a gastroenterologist. Conclusion This clinical case demonstrates one of the possible causes of intestinal invagination in children older than 1 year. Peutze — Jeghers syndrome is an autosomal dominant condition defined by the development of characteristic polyps throughout the gastrointestinal tract and mucocutaneous pigmentation. Invagination of the intestine is one of the frequent complications of this disease and occurs, as a rule, in older children.

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    Full text is published :
    Shidakov I. H., Kalniyazov B. M. A rare form of intestinal invagination in a child. Experimental and Clinical Gastroenterology. 2019;162(2): 173–177. (In Russ.) DOI: 10.31146/1682-8658-ecg-162-2-173-177
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    1. Moscow state medical and dental University named after A. I. Evdokimov (Moscow, Russia)
    2. Central research Institute of gastroenterology (Moscow clinical research center) Moscow Healthcare Department (Moscow, Russia)

    Keywords: polycythemia, erythremia, destructive cholangitis, the hepatitis induced by drug intake

    Abstract:The article presents a clinical case of combined liver damage in an elderly patient. On the one hand, monochemotherapy with cytostatics for true polycythemia (erythremia) became a probable cause of liver damage by the type of destructive cholangitis, and possibly provoked the development of AMAM2-positive primary biliary cirrhosis. On the other hand, on the background of subcompensation of the underlying disease, diffi culties arose with verifi cation of the Genesis of rapidly developed portal hypertension.

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    Full text is published :
    Golovanova E. V., Khomeriki S. G., Konev Yu. V., Kolechkina I. A. Diffi cult diff erential diagnosis of liver damage in an elderly patient with true polycythemia (erythremia). Experimental and Clinical Gastroenterology. 2019;162(2): 178–182. (In Russ.) DOI: 10.31146/1682-8658-ecg-162-2-178-182
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