Possibilities of Ultrasonic Differential Diagnosis Communicative Pyocele and Haematocele in Newborns
Communication haematocele and pyocele in newborns, despite the casuistic rarity, are manifestations of life-threatening conditions: damage to the abdominal organs, and inflammatory changes in the last generalized. These changes are clinically characterized by edema syndrome of scrotum (SES) and integrate a large number of clinical entities. Ultrasonography (US) is the only safe, non-invasive and highly effectiveness diagnostic method in the SES in newborns. Purpose. Determination of the diagnostic value of ultrasound examination and improvement of the algorithm examination in the communication haematocele and pyocele in newborns. Materials and methods. 244 male newborns admitted to neonatal surgery department with the preliminary diagnosis of SES were treated in the St. Vladimir Moscow clinical municipal children hospital in the period from 2002 to 2014. To accomplish this goal were selected and analyzed the results of ultrasonography performed at admission and in dynamics during the treatment (surgical and conservative) neonates with communication haematocele and pyocele, extravaginal deep hematomas (14 (5.7%) patients). Communication pyocele found in 3 patients (with perforated peritonitis on the background of necrotizing enterocolitis); communicative haematocele occurred in 8 cases (rupture of the liver - 5, if damaged umbilical vein - 1 at postoperative hemoperitoneum - 2); extravaginal deep hematomas - 3 cases at break adrenal gland. Results. Based on the analysis of own observations the most representative sonographic manifestations of communication haematocele and pyocele are highlighted. Conclusions. Communication haematocele and pyocele not accompanied by structural changes in the testis and epididymis, do not lead to disruption of blood flow in the data structures in the newborn. Given the mechanism of development, communication haematocele and pyocele may be bilateral as opposed to unilateral obligate extravaginal deep hematomas. Sonographic characteristics of pathological changes in communication haematocele and pyocele is not specific, therefore, these states can not be differentiated with absolute certanly by US, in this connection, emphasizes the need to expand areas of research in the identification of these symptoms.