BACKGROUND: Staged treatment of small bowel diseases involves the formation of an enterostomy. BishopKoop T-anastomosis and Mikulicz double-barreled enterostomy with compression clamp are widely applied. The disadvantages of Mikuliczs can be eliminated using a clip of titanium nickelide with shape memory instead of a clamp. AIM: This study aimed to evaluate the efficacy and safety of a titanium nickelide device in double-barreled enterostomy and compare the results of treatment with a T-anastomosis. MATERIALS AND METHODS: The study included newborns and infants. The clip was applied on 958 days postoperatively. Differences were accepted as significant at p 0.05. RESULTS: Since 2000, enterostomy was performed in 79 children: 12 (15.2%) had T-anastomoses, 44 (55.7%) had double-barreled stomas, and 18 (40.9%) had a titanium nickelide clip. In the study groups, stomas were applied for ileus, atresia, and aganglionosis. In the group of double-barreled enterostomies with a clip, the stoma was closed later (p = 0.027) and the operation time was short (p = 0.013). In the T-anastomosis group, parenteral nutrition was required for a longer period (p = 0.018). Self-removal of the clip and appearance of the stool occurred on days 5 and 13. Compression anastomosis was obtained in 83.3% and stoma closure outside in 73.3%. With a double-barreled enterostomy, hepatic failure (p = 0.018) and anastomosis dysfunction (p = 0.046) were less common. T-anastomosis revealed an increase in the incidence of CDC II (p = 0.013) and III (p = 0.015) complications. DISCUSSION: The results reflect the safety of the presented method in comparison with the T-anastomosis, since the operation time and duration of the parenteral nutrition are reduced, invasive treatment is less often required for complications, and anastomosis dysfunction rarely occurs. CONCLUSIONS: Double-barreled enterostomy with a compression clip is an effective and safe alternative to T-anastomosis in children aged 1 year. The formed compression anastomosis allows closure of the stoma by suturing its outer part. The conditions for the formation of the anastomosis are the patency of the distal sections and bowel diameter 1 cm.

Material and methods. A retrospective analysis of medical records of two children. Anamnestic, clinical, diagnostic and intraoperative findings were analyzed.Purpose. To describe cases of trichobezoars in children : occurrence, diagnostics and treatment.Results. In the first case, a girl, aged 5, often swallowed her own hair after a psychological trauma; and at the age of 15 she complained of hair loss and anemia. In the second case, a boy was chewing and swallowing his own hair for 6 months under the emotional stress. Two weeks before hospitalization he complained of abdominal pain. In both cases, there were no history of intestinal obstruction. At the fibroesophagogastroduodenoscopy, foreign bodies were visualized which were diagnosed as trichobezoars. X-ray diagnostics confirmed foreign bodies in both patients. Those bodies had the shape of the stomach and had an inhomogeneous porous structure. The patients were operated: laparotomy, gastrotomy with removal of dense hair formation. Postoperative course was uneventful.Conclusion. Psychological situations provoked in children the obsessive trichotillomania and trichophagia due to which large trichobezoars were formed in the stomach.

Введение Дети нередко проглатывают случайно или преднамеренно предметы, становящиеся затем инородными телами желудочно-кишечного тракта (ЖКТ). В последние 15 лет возросло число случаев, когда инородными телами являются металлические изделия, обладающие большим магнитным полем [1-5]. Актуально то, что проглоченные магнитные тела в количестве двух и более активно взаимодействуют между собой и с объектами внешней среды, мигрируют с различной скоростью по отделам ЖКТ и вызывают разного рода осложнения (перфорацию кишечной стенки, инвагинацию, непроходимость кишечника, кровотечение, перитонит), которые могут привести к фатальному исходу [5-9]. Цель исследования-проанализировать варианты прохождения магнитных инородных тел

Treatment of deep chemical burns of the esophagus in children remains an urgent problem. The formation of pronounced cicatricial strictures leads to a significant narrowing of the esophagus, the inability to eat, and a violation of the trophic status. The main method of treatment of victims with cicatricial narrowing is bougienage of the esophagus. A special device - bougie - is inserted either “blindly” or along a thread, or along a metal conductor string. However, when performing this manipulation, there is a high probability of traumatic injury up to rupture of the esophageal wall. In the presented clinical case observation, a 1.5 y/o pediatric patient received treatment for esophageal stricture by dilatation. After performing blind forced bougienage without anesthesia and endoscopic support, there were signs of increasing acute respiratory failure. Plain radiography of the chest organs visualized the picture of pneumohydrothorax on the right. The tactics of conservative therapy of this complication was chosen, which led to a positive outcome of the treatment. Therefore, bougienage of esophageal strictures after chemical burns can be safely performed using a guide wire under general anesthesia and endoscopic control in infants.

Aim. The goal of this study is to describe the clinical observations of acute appendicitis in two newborn infants. This study was a retrospective analysis performed using data obtained from medical records. Two preterm infants had a gestational age of 33 weeks, a threat of pregnancy termination, rapid childbirth in one case, and a cesarean section in another. At birth, their body weights were low, 2340 and 2420 g, respectively. The condition of the babies was evaluated on the Apgar scale, and both scored 7/8 points. We studied the data of clinical, laboratory, and instrumental study data and surgical intervention protocols. In the presented newborns, neonatal jaundice, respiratory failure of the III degree, and hypoxic perinatal damage to the central nervous system occurred from birth. On the first childs twelfth day and the second childs ninth day, they experienced a clinically acute inflammatory process in the abdominal cavity, confirmed by inflammation markers (high white blood cell counts and levels of C-reactive protein). According to the sonography of the abdominal organs, the absence of intestinal motility in the right abdominal cavity, the presence of intestinal wall pneumatosis, signs of conglomerate formation from the intestinal loops were revealed. The surgical interventions performed were a laparoscopy and a conversion to laparotomy. In both cases, inflammatory bowel changes corresponded to the course of necrotic enterocolitis, diagnosed with gangrenous-perforated appendicitis and purulent-fibrinous peritonitis. In the section, the mucous appendix was not changed. Conclusion. The aggravated premorbid background in premature infants predisposes them to necrotic enterocolitis, which can occur in children of this age with isolated perforation of the appendix. The course of necrotic enterocolitis is complicated by the formation of purulent-fibrinous peritonitis due to the destruction of the appendix with minimal changes in its walls.