Hypertrophic pylorostenosis is one of the most frequent causes of vomiting in newborns requiring surgical intervention. While the intraoperative complications and immediate results of pyloromyotomy are widely reported in the literature, the remote consequences of this intervention, especially depending on the method of correction, are not well understood and contain contradictory results. Purpose - to study the remote consequences of pyloromyotomy depending on the method of surgical correction - open (OMPT) or laparoscopic pyloromyotomy (LMPT). Materials and methods. The primary assessment of long-term outcomes was performed by analysing the answers to the questions of the Diagnostic Questionnaire for Paediatric Functional Gastrointestinal Disorders, which was sent to 246 patients and their parents; responses were received from 169 (68.7%) respondents, who were included in the study. Re-hospitalisation was required in 57 (33.7%) children who underwent X-ray examination, fibrogastroscopy and ultrasonography. Statistical processing of the study results was performed using the software StatPlus: mac, AnalystSoft Inc. (version v8). Results. The average age of patients involved in the study was 8.5±0.3 years (range of fluctuations - from 2 to 18 years old). Among the respondents, 132 (78.1%) children underwent OPMT, and 37 (21.9%) children underwent LPMT. No complaints were expressed by 102 (60.4%) children, including 81 (61.4%) children after OPMT and 21 (56.8%) after LPMT (p=0.6152). The main complaint in children after pyloromyotomy, which required re-hospitalisation, was chronic abdominal pain, as indicated by 38 (22.5%) of the respondents. There was no correlation between the occurrence of chronic abdominal pain and the age at which hypertrophic pylorostenosis was diagnosed (R=0.183, p=0.2588), the duration of the disease (R=0.079, p=0.6275) and the child's body weight at the time of the intervention (R=0.048, p=0.768). Functional disorders of the digestive tract were diagnosed in 15 (8.9%) children. In 24 (14.2%) children, a slowdown in barium passage through the intestine was detected, which, in combination with periodic pain, indicated chronic adhesive disease. Fibrogastroscopy revealed duodenogastric reflux in 18 (10.7%) children, which in 5 (2.96%) patients was combined with pylorus insufficiency and in 12 (7.1%) with gastritis, and in 17 (10.1%) children gastroesophageal reflux was diagnosed. Conclusions. Thus, in the long term after pyloromyotomy, 33.7% of children required re-hospitalisation due to various pathologies of the gastrointestinal tract. Duodenogastric and gastroesophageal reflux and chronic adhesive disease were most often detected in the long term after pyloromyotomy, and the frequency of their occurrence did not depend on the method of surgical intervention. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the institution mentioned in the paper. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Hypertrophic pyloric stenosis (HPS) in newborns is the one of the most frequent causes of vomiting that required surgery. During long period of time, X-ray was the main method for the confirming diagnosis of HPS, however after first reports about possibilities of ultrasonography (US), this method was widely applied in clinical practice. Purpose - to summarize own experience of US applying for the diagnostic of HPS; determining advantages and disadvantages of this method of examination. Materials and methods. This study based on the US results of 93 patients with HPS and 27 children with pylorospasm that were observed and treated in Lviv regional children’s clinical hospital for 2009-2020 years. By US measured the thickness of pyloric muscle, length, front-posterior (transverse) size, and diameter of orifice of pyloric canal. Results of the study were evaluated by the statistical program StatPlus: mac, AnalystSoft Inc. (version v8). Results. The thickness of pyloric muscle and pyloric canal length are the major criteria of confirming/excluding HPS diagnosis. By the measurement of pyloric muscle thickness, it is necessary to remember that tangential position of transducer and muscles’ contraction can cause pseudo-thickening. According to the results of the study, the thickness of pyloric muscle in case of HPS was 6.4±0.3 mm (a range - 3-10 mm) and was no correlation nor with duration of illness (p=0.364) nor with age of child (p=0.534). In pylorospasm, which clinically can simulate HPS, the thickness of the pyloric muscle was 3.02±0.1 mm, what is significantly less compared to infants with HPS (Student’s t-test - 1.983; p=0.0000). Pyloric canal length in case of HPS was 22.9±0.6 mm (a range - 16-32 mm), what also was significantly differed than in case of pylorospasm - 15.8±0.5 mm (Student’s t-test - 1.998; p=0.0000). This was only indicator that clear correlated with child’s age (p=0.004) and duration of illness (p=0.006). Diameter of pyloric canal orifice and front-posterior size differed from indices in children with pylorospasm also. According to the results of ROC analysis, the best markers for the confirming diagnosis of HPS was thickness of pyloric muscle, its length, and front-posterior size, while the diameter of pyloric canal orifice shows the moderate prognostic significance. Conclusions. Ultrasonographic examination makes it possible to establish the diagnosis of HPS in newborns with a high degree of reliability. A doctor, who performs US in a child with suspected pylorostenosis, should be guided by the size of the unchanged pyloric canal and in case of its hypertrophy remember the «pitfalls» in the examination and know the ways to overcome them. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Sirenomelia is extremely rare congenital malformation that characterized by the complete or incomplete fusion of the low extremities and associated by the various organs’ disorders, such as urinary system, which determined the poor outcome in these infants that died during antenatal or early neonatal period. Prenatal ultrasonography, especially during first-second trimester, permits to establish the presence of sirenomelia. Due to the rarity of this malformation, the own observation of first case of sirenomelia in one infant from twins is presented, which borne in Ukraine. Diagnosis of sirenomelia was established at the planned ultrasonographic screening of multigravida mother. After the birth, neonate with sirenomelia was transferred at the intensive care unit of Lviv regional children’s clinical hospital «OXMATDYT». At the first examination, the throughout fusion of lower extremities, the absent of one kidney, bladder, and external genitalia was revealed. With increasing signs of renal and respiratory failure baby died at 9 days after birth. Conclusions. Sirenomelia is extremely rare congenital malformation that associated with the high mortality during early neonatal period due to the presence of underlying congenital malformations, such as urinary system. Ultrasonography during the prenatal period is the screening methods for the diagnosis of this malformation. No conflict of interest was declared by the authors. Key words: sirenomelia, diagnostic, twins.