Acute gynecological abdomen in children

Abstract

Acute abdomen is acutely emerging pathological processes in the abdominal cavity of different etiology and clinical course. Among the reasons causing the acute abdomen in children is the torsion ovarian formations in about 15%. Causes of acute abdomen in gynaecology can be divided into 3 groups: acute intra-bleeding (ectopic pregnancy, ovarian apoplexy - poor circulation in the internal reproductive organs (the torsion stem tumors and tumor formations ovarian torsion and / or necrosis of myoma node); acute inflammatory diseases of internal genital organs with involvement in the process of the peritoneum. The aim of the work was to demonstrate the frequency of gynecological diseases in girls occurring in the clinic of an acute abdomen. In the National Center of Pediatric Surgery |N. Georgiou" from 2004 to 2009 were operated on 126 children with pathology of the internal female genital organs, hospitalized with clinical acute abdomen. Among them are marked 59 (47%) children with apoplexy of the ovary, 52 (41%) with ovarian cysts, 21 (16,6%) with a uterin tube chists and only 2 (1.6%) with parovarian cyst. Also, among the children with ovarian cysts in 14 (27%) is recorded torsion, in 2 (3,8%) - necrosis in 3 (5.8%) - rupture and in one (1.9%) - infecting. It is also important to note that there were encountered combinations of gynecological pathologies, such as ovarian apoplexy with cyst of the uterin tube 6 (4.5%), paraovarian cyst torsion on the right ovary with the right ovary cyst 1 (0.7%), ovarian cyst with a cyst in the uterine tube 2 (1,5%) cases. But it also noted the combination of gynecological pathology with secondary appendicitis in 27 (21,4%) children and in one case (0, 8%) with gangrenous appendicitis. The distribution by age as follows: 6­ 10 years - 6 (5%) children, 11-13 years old - 15 (12%) children, ages 14 - 17 - 105 (83%) children. The most common gynecological pathology causing acute abdominal clinic in our hospital was ovarian cyst, and the age of most of the patients was from 14 to 17 years, while children 6 to 10 years with gynecological pathology clinic that simulates an acute abdomen is largely an inflammatory and does not require surgical treatment. In view of the anatomic-topographic and anatomic and physiological features of a child's body, high mobility of neoplasms in female internal genital organs in girls clinic usually simulates acute appendicitis. Ovarian Neoplasms and the leasure of the right ovary occur in puberty more often confirming the theory of genetic determination of an earlier and higher functional activity of the right ovary.