Necrotizing enterocolitis (NEC) is a major cause of the morbidity and high mortality in preterm infants. With the ELISA method there were determined cytokine concentrations of the transforming growth factor-β (TGF-β), macrophage inflammatory protein1β (MIP-1β), matrix metalloproteinases (MMP-2, -3, -8, -9) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) in low birthweight (LBW) premature infants with NEC. There were examined 68 infants at the conservative and surgical stages of NEC. In all patients on admission at 3rd and 7th day of the treatment the concentration of these compounds was determined in blood serum and tissues from damaged ileum and colon. There were established divergent differences in TGF-β content (reduction by 1,9-3 times) and MIP-1β (1.3-1.5 fold increase) in serum as compared with the control. More pronounced changes in the blood concentrations of these biomarkers in patients at the surgical stage of the NEC due to a decrease in TGF-β content, a significant increase in MIP-1β concentrations, MMP-8, TIMP-1 and the lack of the decrease in their content in the course of treatment, are associated with the severe course of NEC in LBW premature infants and prove to be indices of the unfavorable course of NEC, which requires to revise and optimize the therapeutic approach timely in such patients.

The article describes clinical observation of treatment of a premature infant with chyloperitoneum. Accumulation of fluid in the abdominal cavity was diagnosed prenatally at 31–32 weeks of gestation. Premature surgical delivery was performed at 34– 35 weeks due to the high risk of antenatal fetal death. Paracentesis with fluid analysis was done; chylous exudate was confirmed. Total parenteral nutrition, octreotide and drainage of the abdominal cavity were used during conservative treatment. It was decided to perform a surgery as the therapy was ineffective. At the age of 2 months and 7 days laparotomy was conducted, abdominal organs were revised, lymph ducts were ligated, and abdominal cavity was drained producing a positive effect. The fluid outflow was terminated and the child was discharged in a satisfactory condition.

The article describes two cases of children operated on for the biliary atresia (BA) on days 56 and 33 of their life. One child after the Kasai surgery had liver transplantation at the age of 1 year and 2 months because of the deterioration of his liver synthetic function which was manifested by the clotting factor deficiency. Another child (5-month old) does not need any transplantation at present. The article defines “red trackers” for the immediate examination of a child for biliary atresia.

Necrotizing enterocolitis (NEC) is a major cause of morbidity and mortality in preterm infants. The development of NEC is associated with changes in the expression of a number of acute phase proteins and cytokines, such as C-reactive protein (CRP), procalcitonin (PCT), calprotectin (CP). To determine their diagnostic and prognostic significance there were performed studies of the dynamics of the blood levels of CRP, PCT and CP in preterm infants with NEC. A total of 68 premature infants with conservative and surgical stages of the NEC were examined. In all patients at admission, 3rd and 7th day of the treatment there was determined the serum concentration of CRP, PCT and CP. The gradual significant decline in CRP, PCT and CP. Blood concentrations was established at the 7th day of the observation ofpatients with conservative stage of NEC, which was associated with a favorable outcome of the treatment of NEC in this group of preterm infants. More pronounced changes in these markers in the blood of patients with surgical stage of the SEC due to a sharp increase in concentration and a lack of the decline in their content in the course of treatment, are associated with severe NEC and are a formidable sign of unfavorable course of the NEC, which requires timely revision and optimization of the treatment of such patients.

Necrotizing enterocolitis of newborns (NEC) is a severe intestinal disease that occurs against the background of acute hypoxia, violations of normal colonization of the intestine by microflora, leading to necrosis and perforation of the intestinal wall, peritonitis. Frequency of occurrence of 1-5 cases per 1000 live-born children. Most often, premature babies and children with low birth weight get sick. The development of NEC in a child significantly worsens the prognosis and increases mortality. Modern development of medical technology has made it possible to provide assistance to extremely premature newborns, which has led to an increase in the number of patients with NEC who are in a critical condition due to the course of multi-organ failure, including kidney failure, which requires renal replacement therapy (RRT). The main method of RRT used in newborns and young children is peritoneal dialysis (PD). NEC in the initial stages is considered an absolute contraindication for performing invasive manipulations on the abdominal cavity, since the risk of disease progression with the development of complications requiring surgical intervention increases at times. Recently, peritoneal dialysis has also become widespread in deeply premature newborns, who are the main risk group for developing NEC. Peritoneal dialysis in the continuous flow modification eliminates high intra-abdominal tension, one of the provoking factors for the progression of NEC, and in foreign expert studies, there are reports that the dialysis solution improves the intestinal wall trophism. This article presents a clinical case of peritoneal dialysis in flow modification in a 1-month-old child with acute renal damage and necrotizing enterocolitis.