Congenital malformation of the gastrointestinal tract in a rare case can cause partial obstruction and masquerade as functional disorders of the intestine for a long time. Atypical clinic of membranous gastric obstruction causes difficulties in diagnosis and determination of treatment tactics. The aim to determine and present to the surgical community the features of diagnosis, surgical treatment, possible complications of a rare malformation of the stomach in children in the form of a stomach membrane. The paper presents a clinical case of the stomach membrane in a child 1 year 10 months old with complaints of vomiting after each meal, bloating, lethargy for one month. The results of ultrasonography, X-ray examination with the passage of a contrast agent through the gastrointestinal tract, fibrogastroduodenoscopy established anatomical changes in the stomach in the form of pyloric stenosis up to 0.40.5 cm in diameter. Intraoperative revision of the stomach, supplemented by intraluminal endoscopic support, made it possible to reliably establish the presence of a perforated pyloric membrane. The membrane is radically cut along the entire circumference at the level of its base. The next postoperative period was uneventful. After 1.5 months, the child was again admitted to the pediatric surgical department on an emergency basis with a clinic of intestinal obstruction, including the childs anxiety, repeated vomiting, and bloating. X-ray and endoscopic picture corresponded to the diagnosis of cicatricial stenosis of the pyloric part of the stomach. Taking into account the presence of cicatricial deformity, due to the high risk of complications during resection of the stenotic part of the stomach and the imposition of gastroduodenoanastomosis, a bypass retrocolic gastrojejunoanastomosis with Brown fistula was formed. When examining a child of a child in the late postoperative period, no complications were identified. The presented clinical case confirms that congenital malformations of the gastrointestinal tract in the form of stenoses and membranes can have a long stage of compensation, their diagnosis is based on a comprehensive examination of the child using radiopaque and endoscopic studies.

Objective. The differential diagnostics of gynecological diseases with a picture of acute abdomen and acute appendicitis may be challenging and can cause a variety of complications, impaired reproductive function and infertility.Purpose. To assess outcomes after diagnosing and treating girls with the syndrome of “acute abdomen” in whom an acute gynecological pathology was revealed.Material and methods. Case histories of 85 girls with gynecological diseases who were hospitalized to the emergency surgical department of Children City Clinical Hospital No 9 in Yekaterinburg are analyzed. All children were admitted to the emergency department with a picture of “acute abdomen”.Results. All children were operated on laparoscopically, and the cause of their acute abdominal syndrome was clarified. Acute inflammatory diseases of the uterine adnexa prevailed in the structure of causes (59%). In 21% of cases, there was uterine adnexa torsion . The rest of children had apoplexy (11%) and ovarian cysts (9%).Conclusion. The differential diagnostics of acute appendicitis and acute gynecological pathologies is difficult due to various and similar clinical symptoms. Laparoscopy can not only identify the cause of pain syndrome, but also can help to chose a future curative tactics .