Children swallow coins, beads, badges

Collection of the head of the children's thoracic branch of the Kiev Clinical Hospital No. 17 Peter Pavlovich Sokura Reminds the contents of the handmathetic box. With the difference that these, at first glance, innocuous items passed through the operating room, where their unlucky owners «delivered» in their own respiratory or esophagus. Telling about his work, Peter Pavlovich notes that there are no simple cases in their clinic. Extraction of foreign objects – Only a small product work of surgeons. If the patient was brought here from another Kiev hospital or from the distant region of Ukraine, it means that they could not help him, and now it all depends on the specialists, whose account thousands of complex operations and almost as much saved people. The branch is equipped with modern equipment, allowing urgent help with multiple chest injuries, put an accurate diagnosis with severe pathologies of respiratory, esophagus and diaphragms, eliminate them and appoint adequate treatment.

Question number 1. Peter Pavlovich, what problems the pulmonologists and thoracic surgeons are worried today?

Already in 1975, when a pulmonological center was created (his founder's world-famous Thoracleal surgeon was established, Professor Olga Matveevna Avilova), it was clear: the need for specialists of this profile will grow. Currently, in our country, respiratory diseases, alas, lead in their prevalence. It consotes only that with timely diagnosis, they are not bad for treatment. Our department headed by Professor Anatoly Vasilyevich Makarov, is preparing children's and adult thoracic surgeons and pulmonologists for all Ukraine. This is the direction of medicine, especially the operations on the lungs, interested me back in student years. Since then, I do a favorite thing.

Question # 2. You won't call your patients…

Children with severe congenital diseases of respiratory, esophagus and diaphragms that need a qualified examination are falling to. Not in all areas there are necessary conditions for this and specialists. If there are easy pathology, it is necessary to conduct fibrobronchoscopy, x-ray, bronchography and computed tomography. Comprehensive child examination, as a rule, lasts a week. It is important that this happens in a hospital, under the supervision of medical staff. If necessary, we immediately carry out operation. True, instead of 60 beds in the department, only 40 remained, which significantly complicated our work, because patients did not become less – Rather, on the contrary. And complex patients from all over Ukraine are still guided to us.

Question number 3. What are the following pathologies and how often they are found in our country?

First of all, their appearance has accommodation in polluted territory, in areas where enterprises of the chemical, coal industry are functioning. Plays a role and hereditary predisposition. Among all recurrent repeated chronic ailments of lung disease are 10-15%. Unlike heart defects, which are 3-5 times less often, but are diagnosed almost immediately, they are compensated by healthy parts of the lungs and, therefore, are revealed relatively late. There are diaphragmal hernias that cause violations of the functions of the gastrointestinal tract, lung compression and t.D.

Question number 4. What are your forecasts in such patients?

Usually favorable. For example, with a congenital cyst, we remove the purulent focus, after which the damaged cloth is gradually restored and the patient recovers. Need to remember: congenital pathologies are not amenable to conservative treatment – They always require surgical intervention!

In this regard, I want to give an example. Relatively recently we did a patient from Uman. The girl was constantly sick, but parents asked doctors not to do x-ray to avoid exposure. As a result, a gigantic tumor formed in the child for eight years, which pressed on the heart, lung, pushed the diaphragm and even started moving on the neck. The girl literally suffocated. When doctors finally made X-ray, they were shocked.

The operation was very difficult. When I revealed the chest, part of the tumor literally slipped-zero. For eight years, congenital neoplasm has reached the size of the children's head. Fortunately, the tumor turned out to be a kindness, and the child managed to save. Discharged a little patient home in satisfactory condition. But she could die!

Question number 5. How can I warn the vices of the lungs in newborns?

I will not say anything fundamentally new: a pregnant woman in no way smoke (this applies to the so-called passive smoking, when husband or other family members smoke). It is necessary to completely eliminate alcohol, work in harmful production (even with a raw construction). Make sure that there is no dust or dampness in the housing of the future mother. All these factors become decisive in those weeks when the embryo is formed by respiratory authorities.

Question number 6. In which cases it can be assumed that the child has congenital pathology of the chest bodies?

When we are trained by children's pulmonologists, pediatricians, we teach them to recognize such pathology. First of all, frequent pneumonia should be alarmed, exacerbations of chronic respiratory diseases. If the child complains of pain, discomfort in the chest, parents should not tighten with a visit to the doctor and x-ray examination, regardless of the age of the baby. Here, from two evils (irradiation or development of the disease), you need to choose a smaller. With a later identification of pathology and operations, and the period of rehabilitation is much more difficult.

Question number 7. Is it possible to cure pneumonia without antibiotics?

No. When inflammation of a light degree in the initial stage, it is possible to use tablets, and in more complex cases are intramuscular or intravenous injections. It is important not only correctly and in time to diagnose the disease, but also to carry out a full course of treatment. Otherwise, the disease is rapidly progressing: severe abscessive pneumonia develop, irreversible processes begin in the lungs, and the patient may die. It is important not only to appeal to the doctor in time, but also clearly fulfill all its appointments.

Question number 8. How often you have to extract foreign bodies from respiratory tract and esophagus?

Only in Kiev there are from 80 to 100 such cases per year. And they bring children from the Kiev region and from all over Ukraine. Nuts, seeds, beans, beads, buttons, bones, buttons, buttons, lids fall into the respiratory tract… In my collection there is even a rusty nail curve – his «inhaled» prisoner specifically to get to the hospital. We deleted «souvenir» under anesthesia, and the patient was taken to the place of conclusion. Separate collection – Objects extracted from the esophagus: large coins, badges, fishing washers, brooch, mosaic elements, alarm clock key. But this loop, together with sharp spread, I learned from the esophagus of a one-year-old kid, who left the parents for several minutes unattended. Especially often children (and often adults) hide behind the cheek of the coin, and then they swallow them. Many are taken in her mouth needles, studs, pins. I want to warn adult men and women: it's not so harmless, as it seems at first glance!

Question number 9. Can I independently help the victim – shake it, knock on the back?

If it is a small rounded subject, say, a bead, a pea, then you can turn the victim, make dump. Although, unfortunately, it helps extremely rarely. In the first few minutes it becomes clear that without the help of the doctor can not do, so it is impossible to slow! When the foreign object enters the respiratory tract and the patient does not receive timely assistance, it is fraught with the development of very difficult complications, up to death. In the esophagus, due to the presence of an extraneous item in a few days, breakdowns may form and cause gunpowder that is life threatening. Of course, there is a chance that a small subject passing through the esophagus will be released naturally. But if such a trouble happened to a small child, wait or start experimenting criminally!

Question number 10. What the team of your hospital is experiencing the most acute need today?

I have been sore for us – overpopulation. Six years ago, we began to provide assistance to adult patients with polytrams, because of what the children's office had to be compacted, and now in the same chamber, it is adjacent to 5-6 seriously ill children. In general resuscitation, 8-10 people are at the same time (these are adults, and children), not counting planned patients.

We once asked the local government to convey to us the next two-storey building, freed after moving the 7th Children's Hospital to accommodate there children's resuscitation and «Unload» Department. It seems to us directly refuse, but official consent does not give. In addition, there are stubborn rumors that in this place it is planned to build a residential building. If this happens, not only the team that has to work in very tense mode will suffer. First of all it will affect our patients. If we were going to meet in this matter, we could assist much more people from all over Ukraine.

Houses, in the Luhansk region, three-year-old Alena have long treated pneumonia, then 1.5 months – Tuberculosis, which was not! In Kiev, the girl successfully removed the congenital ventilated eight cyst.

In my collection – Objects extracted from the esophagus: large coins, badges, fishing washers, buttons, elements of mosaic, key of alarm clock, decoration, studs and pins...