Diagnosis and treatment of esophageal achalasia in children

The article shows the results of diagnosis and treatment of achalasia of the esophagus in 21 children aged from 20 months to 15 years. Radiological examination with the use of the nitroglycerin test was highly informative and authentic in all cases. To evaluate the condition of the esophagus, additional endoscopic and esophagomanometric examination is necessary. From analysis of the results of drug therapy in all patients, operative in 13, and pneumocardiodilatation in 7 children it was found that treatment of achalasia of the esophagus in children should begin with forced pneumodilatation. Modified Heller's operation with fundoplication produces good results.     

Surgical correction of intrathoracic compression of respiratory ways due to double aortal arch in children

In 1982-1999 period 49 children aged 1.5 mo-14 yrs with vascular ring anomaly were examined. In 28 of them the double aortal arch (DAA), causing intrathoracic compression of respiratory ways, was revealed. Surgical correction of DAA was done in 27 patients. Optimal surgical access is left-sided lateral thoracotomy along third or fourth intercostal space. Tactics of surgical intervention was differentiated one depending on anatomo-topographic peculiarities of aortal arch morphology, its branches and age of a child. Aortopexy was done together with vascular failure correction for concomitance with secondary tracheomalacia and Kommerel's diverticulum.     

Diagnosis and treatment of Hirschsprung disease in young children

The diagnostic value of instrumental methods of examination and the results of surgical treatment were studied in 56 patients under 3 years of age with Hirschsprung's disease. Complex examination (irrigography, anomanometry, histochemical and neurohistological studies) allows the disease to the diagnosed early and operative treatment to be undertaken in time. Colostomy is the operation of choice for infants. Operation for downward transposition of the colon with primary anastomosis produces better results in older children.