Introduction. Foreign bodies in the gastrointestinal tract are various objects of organic and inorganic origin, which are swallowed - not as food - either accidentally or intentionally. The article describes a clinical case of a 13-year-old child with multiple foreign bodies in his gastrointestinal tract which could cause serious complications, such as: perforation of hollow organs, peritonitis, intestinal obstruction, internal bleeding. By statistics, every fourth patient of the conscious age with foreign bodies in the gastrointestinal tract can potentially have problems in the neuropsychic sphere.Material and methods. A 13-year-old boy was admitted to the Clinical and Research Institute of Emergency Pediatric Surgery and Trauma (CRIEPST) with nausea, repeated vomiting after each meal and water drinking. The careful anamnesis revealed that before the boy’s state deteriorated, he had swallowed a large number of magnets and metal objects within a short period of time. X-rays examination found multiple foreign bodies in his gastrointestinal tract. They were removed during esophagogastroduodenoscopy (EGDS) and surgical intervention.Results. The plain-film X-ray examination of the abdomen in the projection of the stomach revealed a radiopaque group of foreign bodies of a rounded shape as a conglomerate. At FEGDS, 54 objects were removed: 4 metal balls up to 0.5 cm in diameter, 47 round magnets up to 1.5 cm in diameter, a metal chain and two screws. During laparotomy and gastrotomy 99 foreign bodies were removed: 82 magnet balls 0.5 cm in size, 16 metal balls 1.5 cm in size, 1 bolt. The postoperative period was uneventful. The child was discharged on the 12 th day after surgery in the satisfactory state.Conclusion. Due to timely diagnostics and proper curative tactics, multiple foreign bodies were revealed and removed from the child’s stomach endoscopically and surgically within a short period of time. A correctly chosen curative tactics resulted in a complete recovery of the patient without complications on the 12th hospitalization day.

Objektive is to identify the place of hyperbaric oxygenation (HBO) in complex therapy of children’s wounds. Materials and methods. The HBO method in complex therapy of wounds has been used for 106 children aged 9 ± 4,5. In the 1st group (n = 66) HBO was conducted at presurgery stage; in the 2nd group (n = 40) – at post-surgery stage. Therapeutic sessions were conducted in the intensive care altitude chamber Sechrist-3200 (USA), 10 (9,4 %) children were on artificial lungs ventilation. HBO sessions were carried out with pressure during the period of 1,2–1,5 АТА isopresssure, with course from 8 to 15 sessions. Findings. The use of HBO before surgery (1st group) promotes acceleration of demarcation of devitalized tissues, improvement of trophism of surviving tissues, which enables identification of surgical tactics in earlier stage and preparation for plastic closure. Use of HBO in post-surgery treatment of wounds (2nd group) increases the survival rate of mobilized and implanted tissues, stimulates marginal epithelialization, decreases soft tissues oedema, promotes formation of elastic cicatricial tissue and retention of traumatized limb function. Conclusion. Implementation of HBO sessions under conditions of reanimation altitude chamber proves to be an effective method in combination therapy of major wound defects in pre-surgery as well as post-surgery stages regardless of child’s condition and period of the wound.

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Introduction. A rare disease in pediatric population - acute hematogenous osteomyelitis of the patella - is presented in the article by the authors. Diagnostic approaches and specificity in choosing a curative modality are described as well. A purulent focus in the patella was treated arthroscopically. Satisfactory outcomes in the shortest possible period were achieved due to the combined curative modality: antibiotic therapy, flow-lavage drainage of the joint and early rehabilitative measures. Purpose. To demonstrate potentials of modern diagnostic and endosurgical techniques for treating acute hematogenous osteomyelitis of the patella of rare location. Material and methods. In February 2017, a 12-year-old boy with acute hematogenous osteomyelitis of the right patella was examined and treated at the department of purulent surgery of the Research Institute of Emergency Pediatric Surgery and Trauma (CRIEPST). A complex of diagnostic techniques included laboratory (clinical analysis of blood and urine, biochemical blood test) and instrumental (ultrasound diagnostics of knee joints, computed tomography) examinations. Conservative treatment included antibacterial, anti-inflammatory and symptomatic therapy . Surgical debridement of the osteomyelitis focus in the knee joint was made arthroscopically. Results. Given the obtained data, the diagnosis of acute hematogenous osteomyelitis of the right patella was put. Location of the process, purulent effusion in the joint cavity and damaged articular surface of the patella urged surgeons to decide on the endosurgical treatment: arthroscopic cleansing of the purulent-necrotic focus of the patella and sanitation of the knee joint cavity. In the postoperative period, the child had medicamentous therapy, apparatus therapy, hyperbaric oxygenation therapy. The right lower limb was immobilized with a posterior plaster cast for 7 days. The joint was washed with physiological saline solution for 5 days, after which the drainage was left for passive aspiration for another two days. Standing-up position with crutches and emphasis on the low legs were achieved on the 7th postoperative day. On the 14th postoperative day, the child was discharged home in a satisfactory state. Catamnestic examination 4 months later revealed that the right knee joint was not externally changed, movements in the joint were in full range. Ultrasound examination did not reveal any pathology either. MRI examination revealed an area with reparative signs at the site of operated purulent focus which looked like a partial replacement of the bone defect. Conclusions. The arthroscopy is a minimally invasive and effective technique for surgical treatment of intra-articular purulent foci in acute hematogenous osteomyelitis of the patella.

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