Congenital esophageal stenosis is a rare developmental anomaly. It occurs with a frequency of about 1 case per 20-50 thousand newborns and accounts for about 3-5% of the total number of congenital malformations. In the initial diagnosis, it is difficult to differentiate it from other stenoses caused by inflammatory changes in the mucous membrane of the esophagus, the final diagnosis becomes clear only after treatment and dilation.Treatment of congenital esophageal stenosis can be carried out in various ways. Endoscopic dilation is an effective and safe method of treatment, while surgical intervention is intended only for stenoses that do not respond to dilation.

Aim. The paper presents the experience of treatment of echinococcal cysts in children, which reflects most of the existing methods of treatment.Materials and methods. From 2010 to 2021, 81 patients with hepatic echinococcosis aged from 3 to 17 years (average 14.3 ± 1.3) were treated at the bases of the Department of Pediatric Surgeons of the Pirogov Russian State Medical University. All patients were examined according to the standard procedure, including: general clinical examination, examination of liver function, ultrasonography, chest X-ray, CT scan, blood test for IgG to echinococcus antigens. All children were divided into 2 groups according to the type of the surgery: in the group 1, 27 (33.3%) children underwent laparoscopic surgery; in the group 2, 54 (66.7%) children – laparotomy.Results. The treatment duration accounted 12.5 ± 3.1 days in group 1 and 9.2 ± 1.3 days in group 2 (p < 0.0067). In the group 1 the drainage duration was higher (6.8 ± 0.6) than in the group 2 (4.1 ± 0.3) (p < 0.03). Complications occurred in 7 patients, relapse of cysts – in 2 patients.Conclusion. Children with echinococcal cysts in Central Russia occur with a constant frequency and require to apply modern approaches in diagnosis and treatment. The classification and treatment protocol of echinococcosis, adopted by WHO, are easy-to-use and proves its effectiveness. There is no significant difference in germicidal agents’ effect on echinococcus and the effect on the development of relapse. The method of selection in the treatment of solitary and superficial cysts is laparoscopic interference with the mandatory application of a PAIR and a high-power aspirator. An important stage of the interference is the treatment of the fibrous capsule of the cyst, if it is impossible to completely remove it, with an argon-plasma coagulator.

BACKGROUND: In recent years, there has been marked a tendency to a sharp increase in the number of children with complaints of pectus carinatum. The literature describes only a few cases report of a combination of keeled chest deformity with a more serious pathology of the spine - Scheuermann-Mau disease.AIMS: The aim of the work is to study the frequency, clinical manifestations and methods of timely diagnosis of combined structural lesions of the thoracic spine in children with keeled chest deformity.MATERIALS AND METHODS: The observational single-center cross-sectional study included patients from 5 to 176 years old with pectus carinatum. Categorical values ​​were described by indicating absolute values ​​and percentages in the sample, quantitative indicators corresponding to the criteria of normal distribution were described by using arithmetic means (M) and standard deviations (SD), boundaries of the 95% confidence interval; quantitative indicators not meeting the criteria for a normal distribution were descrided by using the median and interquartile range (Me, Q1Q3).RESULTS: Scheuermann-Mau disease was detected in 11 (9.3%) of 118 children with pectus carinatum. Pterygoid scapulae noted in 97 (82.2%) children with pectus carinatum, increased cervical lordosis in 93 (79.7%) children, and sloping, anteriorly adducted shoulders in 99 (83.9%) children significantly hampered the clinical assessment of the magnitude of thoracic kyphosis. Rigid thoracic kyphosis at the time of examination was formed in 1 16-year-old boy. In children of the younger age group (514 years old), Scheuermann-Mau disease had no clinical manifestations and was detected only during screening X-ray examination, while in the older age group (1516 years old), 3 out of 4 adolescents complained on the back pain. CONCLUSIONS: The frequency of occurrence of Scheuermann-Mau disease in children with pectus carinatum exceeds the average prevalence in the population. In patients with keeled chest pterygoid scapulae, excess cervical lordosis, and rounded shoulders sloping shoulders are associated with the difficulty of assessment the magnitude of thoracic kyphosis. Asymptomatic progression of Scheuermann-Mau disease is typical for younger children with pectus carinatum, and the complaints of pain syndrome and clinical picture of the disease develop only by the age of 15-16.Thus, all patients with pectus carinatum and posture disturbance should undergo a screening X-ray examination of the thoracic and lumbar spine in order to detect Scheuermann-Mau disease and start treatment in time.

In children with extrahepatic portal hypertension (HSV), the most frequent and life-threatening complication is bleeding from varicose veins of the esophagus and stomach. Therefore, the main task of HSV treatment is to prevent bleeding from the veins of the upper gastrointestinal tract. The most effective treatment is portosystem bypass surgery (PSS), the effectiveness of which reaches 94-97%. However, the use of these operations is limited precisely because of a decrease in portal liver perfusion (PPP) and the development of portosystemic encephalopathy (PSE). The aim is to analyze domestic and foreign publications devoted to the surgical treatment of portal hypertension and the development of portosystemic encephalopathy in the postoperative period. A systematic search was carried out in the databases PubMed, Web of Science, Scopus, MEDLINE, eLibrary, RSCI, Cyberleninka. 345 references were analyzed, 110 articles were reviewed, 97 publications on surgical treatment of portal hypertension were selected for the review. The development of PSE in the postoperative period often occurs after the imposition of total PSS. To reduce the risk of developing PSE, selective shunts have been developed, which to some extent preserve the PPP. With distal splenorenal anastomosis (DSRA), the frequency of PE is less than 10-15%. An intermediate position is occupied by a side-to-side splenorenal anastomosis, which has signs of selective surgery. The results of the analysis of literature sources showed that discussions are still underway regarding the choice of the optimal treatment strategy for patients with HSV, the place and role of endoscopic methods for the prevention of gastrointestinal bleeding, as well as mesoportal shunt (MPSH) in the treatment of patients with extrahepatic PG. Nevertheless, the majority of world experts consider MPSH to be the most optimal operation for primary and secondary prevention of varicose bleeding and other complications of HSV. And if it is impossible to perform it, the operation of selective bypass surgery of the DSRA can serve as an alternative to performing MPSH.