Інвагінація кишечника в дітей: навчання та практика

Abstract

Intestinal invagination is a mixed form of intestinal obstruction that occurs when one section of the intestine is telescopically immersed in the lumen of another and occurs mainly at the age of 3 months to 1 year, which is 90%, and mortality, according to the literature, ranges from 6 to 14.5%. Despite a sufficient number of scientific and clinical publications on the pages of medical journals regarding the diagnosis and treatment of intestinal intussusception, there are no fake simulators in the training of students and interns, which determines the relevance of this publication. Purpose - to improve the results of diagnosis and treatment of children with intestinal intussusception by analyzing domestic developments and visually studying the mechanism of its development with the help of a simulator both for the purpose of diagnosis and treatment - conservative disinvagination. Results. In today’s conditions, general practitioners and pediatricians are not trained to diagnose intussusception in children, that is, they do not have simple methods of examination. Hospitals usually do not have the equipment to examine and diagnose acute intussusception. In order to eliminate the gaps at the Department of Pediatric Surgery of the Bukovinian State Medical University, a dummy-simulator of intestinal intussusception «Garant» was developed and introduced into the educational process. Training on a simulator allows you to master the practical skills of diagnostics in the conditions of an X-ray room and conservative disinvagination followed by X-ray control. In turn, the development of skills by primary care physicians and pediatric surgeons in diagnosis and treatment will primarily improve the understanding of the onset of the disease and treatment methods. Conclusions. With certain and significant developments regarding the diagnosis and treatment of intestinal intussusception in children, the problem has not been solved, since some children seek help at the wrong time, and as a result of complications - necrosis, peritonitis with organ and multiple organ failure. The use of a scoring system for assessing the stage of invagination makes it possible to systematize the main prognostic indicators of sonographic and dopplerographic studies in order to determine an adequate method of treatment. Practicing the skills of diagnosis and treatment on the self-developed dummy «Garant» allows you to clearly understand the essence and purpose of the measures taken to establish and confirm the diagnosis of intestinal intussusception, evaluate the possibilities of various methods of conservative and surgical treatment and indications for them. No conflict of interests was declared by the authors.