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Clinical features and early diagnosis of benign mediastinal formations in children 

SOVREMENNAYA PEDIATRIYA.2014.1(57):132-137; doi 10.15574/SP.2014.57.132 

Clinical features and early diagnosis of benign mediastinal formations in children 

Kravchuk B. О., Sokur P. P.

National Medical Academy of Postgraduate Education. P. L. Shupyk Ministry of Healthcare of Ukraine 

There were more than 690 patients aged 3 months to 18 years with formations of the mediastinum, treated in Pediatric Clinic of Thoracic Surgery NMAPE P.L.Shupyk during the period from 1985 to 2013. The main group with benign tumors consisted of 294 patients. Complaints, life history of the disease, and clinical symptoms were studied, systematized and analyzed. Two varieties of the clinical course of mediastinal structures: asymptomatic and typical were identified. Asymptomatic was recorded in 39 (13.3%) patients. Typical course of mediastinal structures was clinically manifested by mediastinal compression syndrome of varying severity. Analysis of clinical data in a typical course of the disease allowed us to distinguish two periods: indistinct (limited) and organspecific manifestal symptoms. In conditions of preferential organs or structures of the corresponding system compression, the top five organspecific symptoms were defined: aerogenic (respiratory), hemodynamic, dysphagy, neurogenic, osteogenic. Entities, transformed into malignant forms or complicated by suppuration, except compression, are characterized by: total intoxication and pain symptom. In case of primary airways (trachea, bronchs) compression, in limited organ specific symptoms pathogenesis period, the «local immobilization» link is indicated respectively to localization of patologic entity, as the first level of airways compression and as a trigger mechanism of aerogenic (respiratory) symptom in this group of patients. Possible signs and risk group of children to have mediastinum entity was identified. Early WGC radiography survey in two projections is the main objectifying method, and computer, magnetic-resonance imaging and ultrasound scanning are the main diagnostic methods. Infrared thermography is highly informative and easy-going method for diagnosis of mediastinal structures. Surgical removal of mediastinal structures is the only radical method of treatment. 

Key words: children, mediastinum, mediastinal compression syndrome, clinical symptoms, diagnosis. 

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