Acquired internal inter-intestinal fistulas in children are rare. Their cause may be acute intestinal perforation after surgery, or covered (not diagnosed) ulcer as a complication of NEC in deeply premature children. Of the 3 children with acquired internal inter-intestinal fistulas, 2 were operated on for congenital intestinal obstruction. After the operation, acute intestinal ulcers appeared. In a premature child, an inter-intestinal fistula arose against the background of NEC, which was treated conservatively. All the children were operated on, the inter-intestinal fistula was eliminated. 2 children are alive, 1 died after surgery (multiple organ failure).

Purpose - to determine the possibility of laboratory and endoscopic methods for the diagnosis of ischemic bowel disorders in children with ASIO. Material and methods. 40 children with ASIO underwent routine examinations, including ultrasound, abdominal x-rays, laparoscopy, and lactate (lactic acid). Results. It has been established that the lactate level and laparoscopic examination make it possible to diagnose ischemia with an accuracy in children with ASIO. Conclusion. Lactate levels and laparoscopy in children with ASIO are important factors in the diagnosis of intestinal ischemia.

Purpose. The purpose was to determine the depth and prevalence of pathomorphological changes in the small intestine of children at the distance from the visible border of necrosis with decompensated acute strangulated intestinal obstruction (ASIO) to determine the minimum possible length of intestinal resection.Material and methods. Morphological studies of a resected fragment of the small intestine were performed in 24 children aged 3 days to 18 years who had undergone a surgery for ASIO with intestinal necrosis. Strangulated adhesive obstruction was found in 17 children, five children had congenital intestine torsion and two children faced small intestinal strangulation in the congenital mesenteric defect. The postsurgical material was studied morphologically using histological stains with the distance of 3 cm between the section.Results. The depth, prevalence of the morphological changes in the small intestinal wall, intensity and length of morphological changes in children with decompensated ASIO were determined.Conclusion. A differentiated approach to the selection of resection scope in the proximal and distal directions from the visible border of ASIO-related necrosis is necessary. The distances are twice shorter in children as compared to adults. Refusal from extensive resections will enable to reduce the rate of short bowel syndrome in children.