scholarly journals Changes in the filtration function of the spleen after surgery following traumatic organ injuries

2021 ◽  
Author(s):  
I. V. Kolosovуch ◽  
I. V. Hanol
Keyword(s):  
Peripheral Blood ◽  
Abdominal Cavity ◽  
Traumatic Injury ◽  
Pathological Process ◽  
Splenic Tissue ◽  
Subtotal Resection ◽  
Target Cells ◽  
Sonographic Examination ◽  
Surgical Interventions ◽  
Splenic Parenchyma

The incidence of splenic injuries among all closed injuries of the abdominal cavity is from 15.5 to 30.0 %, and a mortality rate is between 7 % and 26 %. The tactics in the treatment of splenic injuries is determined by the degree of traumatic injury, the patient's condition during the operation, and a concomitant pathology. Studies of tissue regeneration of the operated spleen allow identifying two main options for its regeneration, associated with the nature of blood circulation in the preserved part. Objective — to study the regeneration and filtration function of the spleen after various types of surgery for the management of traumatic spleen injuries. Materials and methods. The results of treatment of 85 patients in the period 2015 — 2020 were analyzed. To investigate the changes in the filtration function of the spleen, a study of the peripheral blood (general blood test) was performed to assess the shape of erythrocytes. In order to determine the size of the residual splenic parenchyma, its structure and regenerative processes were evaluated and sonographic examination was carried out. Results. The average increase in the size of the residual splenic tissue after subtotal resection of the organ with the formation of couplings of the parenchyma averages 40.2 ± 3.4 % one year after surgery, and in patients who underwent subtotal resection of the spleen with covering the cut plane with adhesive hemostatic plate 70 % — 49.14 ± 6.77 %. The study of changes in the filtration function of the spleen in patients, who underwent subtotal resection of the spleen, showed the appearance of target cells, acanthocytes and halocytes in the peripheral blood, but their number was insignificant and did not exceed normal (not more than 3 %). Any destroyed and pathologically altered erythrocytes were not visualized in patients, who underwent atypical resection of the spleen (mass deficit less than 30 %). Conclusions. Spleen regeneration is determined both by the nature of blood supply to the residual splenic tissue and its size, and does not depend on the nature of the pathological process. Organ‑preserving surgical interventions on the spleen allow maintaining the filtration function of the spleen.  

scholarly journals PUNCTIONAL DRAINAGES UNDER ULTRASOUND CONTROL IN ABDOMINAL SURGERY

2018 ◽  
Vol 14 (1-2) ◽  
pp. 49-53
Author(s):  
R.A. Sydorenko
Keyword(s):  
Abdominal Cavity ◽  
Surgical Care ◽  
Operative Management ◽  
Pathological Process ◽  
Term Treatment ◽  
Main Task ◽  
Complex Treatment ◽  
Surgical Interventions ◽  
Endogenous Factors ◽  
Abdominal Organs

Relevance. Punctic-drainage interventions under the control of ultrasound have become an effective help in complex treatment. But some technological aspects in the procedure and post-operative management of patients remain the subject of discussion. Objective: to improve the results of the use of punctional drainages under ultrasound control in abdominal and retroperitoneal pathology. Materials and methods. Echo-controlled puncture-drainage interventions are used in 89 patients: with pancreatogenic fluid concentrations in the stuffing box, parapancreatic cellular spaces (34); with intra-abdominal complications following operations on the abdominal organs (18), inflammatory processes in the gall bladder (15), tumor obstruction of the bile ducts (12), and with liver abscesses (10). Depending on the nature of the contents of the "target", its localization for puncture drainage was used by trokars of various modifications and diameters, as well as stylet-catheters of the type "PIGTAIL". Manipulation was carried out using ultrasonic devices with convection (frequency 3.5 MHz) and linear (frequency 7-12 MHz) sensors. In 68 patients, the display for intervention was infected fluid formation. In 12 – jaundice syndrome and 9 patients – sterile clusters of enzymatically active content. The main task of puncture-drainage procedures was the evacuation of the content of pathological or anatomical fluid formations to reduce intoxication and (or) their decompression. In assessing the effectiveness of minimally invasive techniques, account was taken of the effectiveness of the operation, that is, the target effect for which the intervention was performed, and the number of complications. Results. Puncture-drainage interventions have become independent and end-of-term treatment in 68 out of 85 cases (with the exception of 4 patients who, due to complications during the procedure, used other methods). The reasons for the reduced effectiveness of echo-controlled puncture-drainage interventions in 9 patients were: the predominance of the tissue component (large sequester) in the cavity, the presence of multiple isolated gates, the use of drainage structures with insufficient drainage properties. Fatal consequences in 5 patients are caused both by the above reasons, and by endogenous factors (a significant prevalence of the pathological process, decompensated background pathology, reduction of internal reserves of the organism). Conclusions. Puncture-draining interventions under ultrasound control are an alternative to open surgical interventions, especially in patients with severe concomitant pathology, severe general condition. In this case, they can be as element (stage) of complex treatment and an independent, final method of surgical care. The choice of echo-controlled interventional technologies as a method of operational correction should be carried out with understanding their capabilities. The effectiveness of such mini-invasive methods allows us to recommend their acceptance in surgical hospitals for diseases of the abdominal cavity organs and retroperitoneal space.

scholarly journals The protective effect of intraperitoneal splenic autotransplants in mice exposed to an aerosolized suspension of type III Streptococcus pneumoniae

Blood ◽  
1979 ◽  
Vol 54 (2) ◽  
pp. 354-358
Author(s):  
JD Dickerman ◽  
SR Horner ◽  
JA Coil ◽  
DW Gump
Keyword(s):  
Streptococcus Pneumoniae ◽  
Bacterial Infection ◽  
Abdominal Cavity ◽  
Traumatic Injury ◽  
Splenic Tissue ◽  
Control Group ◽  
Mortality Experience ◽  
Type Iii ◽  
Sham Control Group ◽  
Low Incidence

Splenosis has been shown to occur after traumatic injury to the spleen. It is postulated that this is the mechanism for the low incidence of bacterial infection in this group of patients when compared to those who undergo splenectomy for other reasons. Therefore, we studied the effect of exposure to an aerosolized suspension of type III Streptococcus pneumoniae on splenectomized mice who had either all or half of their splenic tissue cut up and reimplanted into the abdominal cavity 8 wk prior to bacterial exposure. It was determined that the mortality experience of these two groups of mice was similar to each other and no different from the sham control group, although all three groups had a statistically significant lower mortality experience than the splenectomized control group. This study demonstrates that splenosis in mice can protect against aerosolized bacterial infection.

scholarly journals PUNCTIONAL DRAINAGES UNDER ULTRASOUND CONTROL IN ABDOMINAL SURGERY

2018 ◽  
Vol 14 (1-2) ◽  
pp. 49-53
Author(s):  
R.A. Sydorenko
Keyword(s):  
Abdominal Cavity ◽  
Surgical Care ◽  
Operative Management ◽  
Pathological Process ◽  
Term Treatment ◽  
Main Task ◽  
Complex Treatment ◽  
Surgical Interventions ◽  
Endogenous Factors ◽  
Abdominal Organs

Relevance. Punctic-drainage interventions under the control of ultrasound have become an effective help in complex treatment. But some technological aspects in the procedure and post-operative management of patients remain the subject of discussion. Objective: to improve the results of the use of punctional drainages under ultrasound control in abdominal and retroperitoneal pathology. Materials and methods. Echo-controlled puncture-drainage interventions are used in 89 patients: with pancreatogenic fluid concentrations in the stuffing box, parapancreatic cellular spaces (34); with intra-abdominal complications following operations on the abdominal organs (18), inflammatory processes in the gall bladder (15), tumor obstruction of the bile ducts (12), and with liver abscesses (10). Depending on the nature of the contents of the "target", its localization for puncture drainage was used by trokars of various modifications and diameters, as well as stylet-catheters of the type "PIGTAIL". Manipulation was carried out using ultrasonic devices with convection (frequency 3.5 MHz) and linear (frequency 7-12 MHz) sensors. In 68 patients, the display for intervention was infected fluid formation. In 12 – jaundice syndrome and 9 patients – sterile clusters of enzymatically active content. The main task of puncture-drainage procedures was the evacuation of the content of pathological or anatomical fluid formations to reduce intoxication and (or) their decompression. In assessing the effectiveness of minimally invasive techniques, account was taken of the effectiveness of the operation, that is, the target effect for which the intervention was performed, and the number of complications. Results. Puncture-drainage interventions have become independent and end-of-term treatment in 68 out of 85 cases (with the exception of 4 patients who, due to complications during the procedure, used other methods). The reasons for the reduced effectiveness of echo-controlled puncture-drainage interventions in 9 patients were: the predominance of the tissue component (large sequester) in the cavity, the presence of multiple isolated gates, the use of drainage structures with insufficient drainage properties. Fatal consequences in 5 patients are caused both by the above reasons, and by endogenous factors (a significant prevalence of the pathological process, decompensated background pathology, reduction of internal reserves of the organism). Conclusions. Puncture-draining interventions under ultrasound control are an alternative to open surgical interventions, especially in patients with severe concomitant pathology, severe general condition. In this case, they can be as element (stage) of complex treatment and an independent, final method of surgical care. The choice of echo-controlled interventional technologies as a method of operational correction should be carried out with understanding their capabilities. The effectiveness of such mini-invasive methods allows us to recommend their acceptance in surgical hospitals for diseases of the abdominal cavity organs and retroperitoneal space.

scholarly journals NECROTIZING PANCREATITIS: THE WAYS OF IMPROVEMENT OF SURGICAL TREATMENT

2020 ◽  
Vol 6 (1) ◽  
pp. 43-49
Author(s):  
O.V. Rozenko
Keyword(s):  
Mortality Rate ◽  
Abdominal Cavity ◽  
Necrotizing Pancreatitis ◽  
Pathological Process ◽  
Steady Increase ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Wide Range ◽  
Surgical Tactics ◽  
Omental Bursa

Background. In connection with a steady increase of patients with destructive forms of acute pancreatitis, the proportion of which takes from 10-15 to 20-30%, despite of the wide range of treatments for non-biliary necrotizing pancreatitis, the rate of mortality reaches 80-90% in case of infected forms and needs further improvement of therapies. Objective. The purpose of this study is to improve the results of treatment of patients with nonbiliary necrotizing pancreatitis, by optimizing surgical tactics. Methods. The study examined the cases of 120 patients, whose age ranged from 22 to 83 years, including patients under the age of 50 years old who accounted for 60.0%. There were 80 males (66.7%) and 40 females (33.3%). Disease duration up to 24 hours was found in 36 (30.0%) patients, from 25 to 72 hours - in 25 (20.8%) individuals, more than 72 hours - in 49 (49.2%) patients. Results. The research claims in non-necrotizing pancreatitis, left-sided retroperitoneal phlegmon often develops in 64.2% (mortality rate 26.0%) of patients, right-sided in 24.2% (mortality rate 6.8%) of patients, and bilateral - in 11, 6% (mortality rate 64.2%) individuals. Moreover, the highest mortality was observed with a combination of retroperitoneal phlegmon cellulose and abscess of the pancreas and/or omental bursa - 39.1%. Conclusions. The use of various surgical interventions depending on the involvement in the pathological process of various sections of the abdominal cavity/ retroperitoneal space, which made it possible to reduce mortality and hospitalization time of patients in the hospital by 1.5-2 times is proposed.

scholarly journals The protective effect of intraperitoneal splenic autotransplants in mice exposed to an aerosolized suspension of type III Streptococcus pneumoniae

Blood ◽  
1979 ◽  
Vol 54 (2) ◽  
pp. 354-358 ◽  
Author(s):  
JD Dickerman ◽  
SR Horner ◽  
JA Coil ◽  
DW Gump
Keyword(s):  
Streptococcus Pneumoniae ◽  
Bacterial Infection ◽  
Abdominal Cavity ◽  
Traumatic Injury ◽  
Splenic Tissue ◽  
Control Group ◽  
Mortality Experience ◽  
Type Iii ◽  
Sham Control Group ◽  
Low Incidence

Abstract Splenosis has been shown to occur after traumatic injury to the spleen. It is postulated that this is the mechanism for the low incidence of bacterial infection in this group of patients when compared to those who undergo splenectomy for other reasons. Therefore, we studied the effect of exposure to an aerosolized suspension of type III Streptococcus pneumoniae on splenectomized mice who had either all or half of their splenic tissue cut up and reimplanted into the abdominal cavity 8 wk prior to bacterial exposure. It was determined that the mortality experience of these two groups of mice was similar to each other and no different from the sham control group, although all three groups had a statistically significant lower mortality experience than the splenectomized control group. This study demonstrates that splenosis in mice can protect against aerosolized bacterial infection.

scholarly journals Coincidence of Intra-Abdominal Splenosis in a Patient with Advanced Ovarian Cancer: Case Report and Review of the Literature

2021 ◽  
Vol 07 (02) ◽  
pp. e116-e120
Author(s):  
Tatjana Braun ◽  
Amelie De Gregorio ◽  
Lisa Baumann ◽  
Jochen Steinacker ◽  
Wolfgang Janni ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Case Report ◽  
Diagnostic Imaging ◽  
Medical History ◽  
Rare Disease ◽  
Metastatic Cancer ◽  
Abdominal Cavity ◽  
Advanced Ovarian Cancer ◽  
Splenic Tissue ◽  
Tumor Spread

AbstractSplenosis is a rare disease, which is often discovered incidentally years after surgical procedures on the spleen or traumatic splenic lesions. Through injury of the splenic capsule, splenic cells are able to spread and autoimplant in a fashion similar to the process of metastatic cancer. Here we present the case of a 62-year-old female patient with a palpable tumor of the lower abdomen. Her medical history was unremarkable, except for splenectomy after traumatic splenic lesion in her childhood. Clinical examination and diagnostic imaging raised the suspicion of advanced ovarian cancer, which was further substantiated by the typical presentation of adnexal masses and disseminated peritoneal metastases during the following staging laparotomy. Surprisingly, we also found peritoneal implants macroscopically similar to splenic tissue. Microscopic examination of tissue specimens by intrasurgical frozen section confirmed the diagnosis of intra-abdominal splenosis. The patient then underwent cytoreductive surgery with complete resection of all cancer manifestations, sparing the remaining foci of splenosis to avoid further morbidity. This case demonstrates the rare coincidence of intra-abdominal carcinoma and splenosis, which could lead to intraoperative difficulties by misinterpreting benign splenic tissue. Therefore, splenosis should be considered in patients with medical history of splenic lesions and further diagnostic imaging like Tc-99m-tagged heat-damaged RBC scan could be used for presurgical distinguishing between tumor spread in the abdominal cavity and disseminated splenosis. The presented case report should not only raise awareness for the rare disease splenosis, but also emphasize the need to consider the possibility of simultaneous incidence of benign and malignant intra-abdominal lesions, as to our knowledge this is the first published case of simultaneous peritoneal carcinomatosis and splenosis.

Abstract 51: Peripheral Regulatory T cells and Th17 Cells Is Associated With Pathogenesis of Moyamoya Disease

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Leihua Weng ◽  
Xiang Chen ◽  
Yun Xu
Keyword(s):  
Healthy Volunteers ◽  
Moyamoya Disease ◽  
Peripheral Blood ◽  
Th17 Cells ◽  
Treg Cells ◽  
Peripheral Blood Lymphocytes ◽  
Pathological Process ◽  
Medium Term ◽  
Significant Difference ◽  
And Gender

Background: Despite unclear pathogenesis, previous studies have suggested immune responses may play a pivotal role in the process of Moyamoya disease (MMD), a rare cerebrovascular occlusive disorder. The objective of this study is aimed to explore the change of peripheral Treg/Th17 in MMDpatients and whether the change is associated with pathogenesis of MMD. Methods: In the present study, we collected 26 MMD patients diagnosed by angiography according to the diagnostic criteria of definitive MMD and recruited 32 healthy volunteers. To explore the balance of peripheral Treg/Th17 in MMD patients, lymphocytes in peripheral blood were harvested and flow cytometry was used to measure the percentage of Treg and Th17in CD4+ Tcells, respectively. Meanwhile, relevant cytokines in serum were measured to evaluate the function of Treg and Th17 cells. Results: According to Suzuki’s angiographic staging of moyamoya disease, patients were divided into subgroups of the preliminary-term, medium-term and late-term. Cerebral hemorrhage is thefirstsymptom of onset occuringin half of patients, followed bycerebral ischemia.Our data revealed that both the percentage of Treg and Th17 cells in peripheral blood lymphocytes was increased in MMD patients compared with volunteer group. Meanwhile, the levels of IL-6, IL-10,IL-12, IL-17, TNF-α, VEGF and TGF-β in serum were significantly increased in MMD patients. In this study, the level of HMGB-1, a middle-late period inflammation biomarker, in serum of MMD patients is obviously elevated compared with volunteers. However, the ratio of Treg/Th17 had no significant difference in MMD patients compared to healthy volunteers. Intriguingly, our data revealed that ratio of Treg/Th17 was significantly increased in late-term MMD patients compared with medium-term patients as evidenced by elevated percentage of Treg cells.. In addition, TGF-β level in later-term MMD patients was significantly higher than this in medium-term MMD patients. No difference was observed in the way of onset and gender between two groups. Conclusion: Enhanced peripheral Treg and Th17 in MMD patients suggested that there may be an immunological component in the pathogenesis of MMD. Peripheral Treg may be associated with pathological process of MMD.

scholarly journals 151 Potentiating the Large-Scale Expansion and Engineering of Peripheral Blood-Derived CAR NK Cells for Off-the-Shelf Application

2021 ◽  
Vol 9 (Suppl 3) ◽  
pp. A159-A159
Author(s):  
Michael Whang ◽  
Ming-Hong Xie ◽  
Kate Jamboretz ◽  
Hadia Lemar ◽  
Chao Guo ◽  
...  
Keyword(s):  
T Cells ◽  
Cell Therapy ◽  
Nk Cells ◽  
Peripheral Blood ◽  
Nk Cell ◽  
Adoptive Cell Therapy ◽  
Therapeutic Window ◽  
Target Cells ◽  
Healthy Donors ◽  
Custom Made

BackgroundPeripheral blood natural killer (NK) cells are mature cytotoxic innate lymphocytes possessing an inherent capacity for tumor cell killing, thus making them attractive candidates for adoptive cell therapy. These NK cells are also amenable to CRISPR and chimeric antigen receptor (CAR) genomic engineering for enhanced functions. Moreover, NK cells possess an inherent capacity for off-the-shelf therapy since they are not known to cause graft-versus-host disease, unlike T cells. Presently, approved CAR cell therapy is custom-made from each patient‘s own T cells, a process that can limit patient pool, narrow therapeutic window, and contribute to product variability. In this study, we investigate whether peripheral blood NK cells from a selected donor can be edited, engineered, and expanded sufficiently for off-the-shelf use in a wide patient population.MethodsUsing the CRISPR/Cas9 system, we knocked out CISH expression in isolated peripheral blood NK cells from 3 healthy donors. Subsequently, we expanded edited NK cells by using IL-2 and sequential stimulations using NKSTIM, a modified K562 stimulatory cell line expressing membrane-bound form of IL-15 (mbIL-15) and 4-1BBL. IL-12 and IL-18 were added twice during expansion to drive memory-like NK cell differentiation. We transduced the expanded NK cells to express engineered CD19-targeted CAR and mbIL-15 during an interval between the first and second NKSTIM pulses. We assessed NK cell cytotoxicity against Nalm6 target cells by IncuCyte.ResultsIsolated peripheral blood NK cells from 3 healthy donors were successfully edited using CRISPR/Cas9, engineered to express high levels of CAR, extensively expanded using a series of NKSTIM pulses in the presence of IL-2, and differentiated into memory-like NK cells using IL-12 and IL-18. Interestingly, NK cells from the 3 donors exhibited distinct outcomes. NK cells from one donor reached a peak expansion limit of approximately 7-million-fold before undergoing contraction whereas NK cells from two donors continued to expand over the length of the study surpassing 100-million-fold expansion, without appearing to have reached a terminal expansion limit. At the end of the study, NK cells from one donor exceeded 1-billion-fold expansion and maintained 88% cytolytic activity compared to Nkarta’s standard process control in a 72-hour IncuCyte assay.ConclusionsIn this study, we demonstrate that healthy donor-derived peripheral blood NK cells are capable of expanding over billion-fold while maintaining potency. These results provide a rationale for the development of off-the-shelf CAR NK cell therapies using NK cells from donors selected to provide optimal product characteristics.Ethics ApprovalHuman samples were collected with written informed consent by an approved vendor.

scholarly journals Human bone marrow and peripheral blood T lymphocyte depletion: efficacy and effects of both T cells and monocytes on growth of hematopoietic progenitors

Blood ◽  
1985 ◽  
Vol 65 (3) ◽  
pp. 663-679
Author(s):  
L Levitt ◽  
TJ Kipps ◽  
EG Engleman ◽  
PL Greenberg
Keyword(s):  
T Cells ◽  
T Cell ◽  
T Lymphocyte ◽  
Peripheral Blood ◽  
Cell Depletion ◽  
Target Cells ◽  
Facs Analysis ◽  
Hematopoietic Progenitors ◽  
T Cell Depletion

The efficacy of four separate methods of human bone marrow T lymphocyte depletion was assessed, and the effect of T cells and monocytes on in vitro growth of marrow (CFU-GEMM, BFU-E, and CFU-GM) and peripheral blood (BFU-E) hematopoietic progenitors was determined. Extent of T cell depletion was assessed by multiparameter fluorescent cell sorter (FACS) analysis and by functional studies. Cells staining positively by FACS analysis for one or more of three separate fluorescent pan-T cell monoclonal antibodies (MCAbs) comprised 8.4% to 9.5% of control marrow mononuclear cells (MNCs). T cells constituted 3.2% to 5.1% of marrow following single, sequential, or combination treatment with two different pan-T cell MCAbs (Leu 1 and TM1) plus complement, 1.5% to 2.2% of marrow following solid-phase immunoabsorption (“panning”), 0.2% of marrow after sheep cell rosetting, and only 0.05% of marrow after FACS selective cell sorting and gated separation. T cells made up 59% to 73% of control peripheral blood MNCs and 0.8% to 2.8% of peripheral MNCs following sheep cell rosetting plus treatment with Leu 1 MCAb and complement. Mitogen (PHA, Con A) and allogeneic MLC-induced blastogenic responses (stimulation indices, experimental/control or E/C) revealed a concordant decrement in marrow T cell function after MCAb plus complement (E/C of 3.9 to 9.0), after panning (E/C of 1.6 to 3.5) and after sheep cell rosetting (E/C of 0.7 to 1.3), compared with control marrow (E/C of 5.3 to 15.7). After T cell depletion, marrow BFU-E growth was 95% to 120% of control, CFU-GM growth was 90% to 108% of control, and CFU-GEMM growth was 89% to 111% of control. Marrow T cell and/or monocyte depletion did not alter erythropoietin-dependent BFU-E growth in the absence of Mo-conditioned medium (81% to 95% of control), and the addition of as many as 50 to 100 X 10(3) purified marrow monocytes or T cells to 10(5) autologous nonadherent T cell-depleted marrow target cells had a negligible (P greater than .1) effect on marrow BFU-E growth in vitro. Peripheral blood (PB) BFU-E/10(5) T- depleted target cells were 106% +/- 19% of expected; PB BFU-E growth was significantly diminished after monocyte depletion alone (7% +/- 6% of expected) or after monocyte plus T cell depletion (8% +/- 4% of expected).(ABSTRACT TRUNCATED AT 400 WORDS)

scholarly journals Shunting of congenital hydrocephalus in children

2019 ◽  
Vol 5 (2) ◽  
pp. 103-108
Author(s):  
S. Abdykerimov ◽  
D. Kochkunov
Keyword(s):  
Conservative Treatment ◽  
Computerized Tomography ◽  
Early Treatment ◽  
Abdominal Cavity ◽  
Drainage System ◽  
Subsequent Treatment ◽  
Congenital Hydrocephalus ◽  
Surgical Interventions ◽  
Ventriculoperitoneal Shunting ◽  
Tomography Scan

The paper analyzes the results of ventriculoperitoneal shunting operations in the treatment of congenital hydrocephalus in 55 patients aged 3 months up to 3 years. There were 37 boys and 18 girls who underwent various types of shunting operations after the failure of conservative treatment. Retrospectively, by the nature of the performed surgical interventions, the patients were divided into two groups: the first group included 25 children with congenital forms of cerebral dropsy, where ventriculoperitoneal shunting is performed with fixation of the distal shunt by separate sutures into the abdominal cavity; the second group included 30 children of similar ages, who underwent ventriculoperitoneal shunting without fixation by creating a tunnel and two, three holes fixing it. By studying the nature and causes of occlusive syndromes, the authors modified the method of shunting operations, which proved its rationality and effectiveness. In the scientific–grounded causes of occlusion of shunt catheters and methods for their correction. Dynamics with the use of neurosonography and MRI are recommended for detection and early treatment of disturbed shunt conditions. The most dangerous complication hyperdrainage detected during the operation was the formation of hydromas. To prevent the development of this pathology, it is enough to put the patient on the bed with the lowered head end. For the detection and subsequent treatment of conditions associated with dysfunction of the shunt required regular re not, with the spuriousness of this method is the computerized tomography scan or MRI. It is very important to have a conversation with the parents of the child who underwent shunting operations about the properties of the drainage system, the nature of possible complications and tactics of behaviour that allows you to timely provide the necessary assistance to patients.

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