Abstract: This article deals with the role of arterio-venous conflicts in case of varicocele development in children. As varicocele is a widespread disease, it is important to investigate the etiology of hemodynamic disturbances in renotesticular (RTT) and ileotesticular (ITT) fields in patients with varicocele. The number of procedures registered in Russian State Pediatric Hospital (Moscow) is more than 1600 including primary and recurrent cases. Pathophisiology of the disease is not quite clear, but hemodynamic changes in RTT and ITT were thoroughly investigated. Left renal vein compression between upper mesenterial vein and aorta causes renal venous hypertension in 24% of cases. In most cases etiology of varicocele was primary valve insufficiency. Ileofemoral vericocele is rare and occurs as a result of common iliac vein flow disturbance. Endovascular procedures should be performed only after diagnostic hemodynamic study, and should not be used in pediatric practice. References 1. May R., Thurner J. The cause of the predominately sinistral occurrence of thrombosis of the pelvic veins. Angiology. 1957; 8: 419-427. 2. De Schepper A. Nutcracker phenomenon of the renal vein causing left renal vein pathology.J. Belg. Rad. 1972; 55: 507-511. 3. Trambert J.J. et al. Pericaliceal varices due to the nutcracker phenomenon. AJR. 1990; 154:305-306. 4. Scholbach T. From the nutcracker-phenome non of the left renal vein to the midline congestion syndrome as a cause of migraine, headache, back and abdominal pain and functional disorders of pelvic organs. Medical. Hypotheses. 2007; 68: 1318-1327. 5. Лопаткин Н.А., Морозов А.В., Житникова Л.Н. Стеноз почечной вены. М.: Медицина.1984. 6. Страхов С.Н. Варикозное расширение вен гроздевидного сплетения и семенного канатика (варикоцеле). М. 2001. 7. Kim et al. Hemodynamic Investigation of the Left Renal Vein in Pediatric Varicocele. Doppler US, Venography and Pressure Measurements. Radiology. 2006; 241. 8. Coolsaet l.E. The varicocele syndrome: Venography determining tin' optimal level for surgical management.J. Urol. 1980; 124: 833-839. 9. Ерохин А.П. Варикоцеле у детей (клинико-экспериментальное исследование). Дис. д-ра мед. наук. М. 1979. 10. Neglén А. et al. Stenting of the venous outflow in chronic venous disease. Long-term stent-related outcome, clinical and hemodynamic result.J. Vasc. Surg. 2007; 46: 979-990. 11. Гарбузов Р.В. Ретроградная эндоваскулярная окклюзия при варикоцеле у детей и подростков. Дис. канд. мед. наук. М. 2007
Article exists only in Russian.
Abstract: In the treatment of macro-cystic forms of lymphangiomas, puncture methods have great value. Relapses occure in 50% of cases. The cause of lymphangiomas is the accumulation of liquid and spreading of cystic walls. Aim. Was to develop and propose methods of interventional radiology in the diagnosis and treatment of macro-cystic lymphangiomas. Materials and methods. In 2007-2011, in the radiological department of our hospital were examined and treated 31 children with macro-cystic forms of lymphangiomas. The proposed method of treatment was: puncture, catheterization of cyst, aspiration, performance of cystography and then sclerotherapy with 3% solute of Fibro-Vein or ethoxysclerol.Then - inserting active aspiration system into cyst. The system operated for 3-5 days, during which carried constant active aspiration with sclerotherapy sessions. The indications for catheter removal was the end of cyst liquid secretion. In 20 children we performed a single-stage treatment. In 6 - two-staged, and only in 5 cases, after the second phase of treatment, we observed a relapse of the disease, which leaded for the third phase of treatment. Results. Good results were achieved in 15 of 19 children with lymphangioma of the head and neck, satisfactory - in 4 children. Unsatisfactory results were not noticed. In children with lymphangioma of internal organs a good result was achieved in 11 cases of 12. Only in 1 case remained a small residual cavity Conclusion. The method of active aspiration of macro-cystic lymphangiomas showed very good results. The use of techniques of interventional radiology in the diagnosis of macro-cystic forms of lymphangiomas can assess the condition, shape and size of the cyst, and spend the most effective treatment. The use of interventional techniques as an alternative to surgical excision of the lymphangioma can significantly improve the quality of life. References 1. Schwartz R.A., Fern6ndez G. Lymphangioma. Medicine Dermatology [Journal serial online]. 2009. November 13 [cited 2009 Dec 9]. Available at ttp://emedicine.medscape.com/article/1086806-overview. 2. Eijun Itakura & Hidetaka Yamamoto & Yoshinao Oda & Masutaka Furue & Masazumi Tsuneyoshi. VEGF-C and VEGFR- 3. Flanagan B.P., Helwig E.B. Cutaneous lymphangioma. Arch. Dermatol. 1977;113:24-30. 4. Bond J., Basheer M.H., Gordon D. Lymphangioma circumscriptum: pitfalls and problems in definitive management. Dermatol. Surg. 2008;34:271-5. 5. Khan Z.A., Melero-Martin J.M., Wu X. et al Endothelial progenitor cells from infantile hemangioma and umbilical cord blood display unique cellular responses to endostatin. Blood. 2006;108:915-921. 6. Weiss S.W., Goldblum J.R. Enzinger and Weiss’s soft tissue tumors, 4th edn. Mosby. St. Louis, MO. 2001.
