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The pancreas is an organ that plays a key role in the digestive process, preparing food ingredients such as proteins, fats and carbohydrates for adequate absorption in the small intestine. Today, a wide range of pathological conditions is known in which the tissue of the pancreas is affected and its functions are lost. The literature review examined various diseases that phenotypically manifest as pancreatitis, as well as various diagnostic and therapeutic strategies.

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Introduction. Duplications of the digestive tract (DDT) are a rare congenital pathology. They have a close anatomical connection with any part of the gastrointestinal tract, are lined with a mucosa and have a fair developed layer of smooth muscles. The DDT prevalence rate amounts of 1:4,500 newborns. According to the literature, in most cases, DDT is diagnosed before the age of two years, being found in both girls and boys with little prevalence in boys. Duplication of the stomach makes up about 4-8% of the duplication of the gastrointestinal tract. Unlike other types of duplication, duplication of the stomach is more often found in girls. Material and methods. There was made a retrospective analysis of the examination and surgical treatment of 13 stomach duplication children which were on treatment at N.F. Filatov Children’s Municipal Clinical Hospital No 13 during the period of from 2011 to 2015. The diagnostic significance of such instrumental methods of research as ultrasound diagnosis, computed tomography (CT), radiopaque examination and fibro-esophagogastroduodenoscopy was analyzed. Minimally invasive interventions were performed in 11 (84.6%) cases. Results. In the diagnosis, ultrasound (ultrasound), CT, esophagogastroduodenoscopy and radiopaque examination were used according to the indications. We consider the ultrasound method to be the most accessible, non-invasive and informative method for diagnosing of DDT. In our series of patients in 8 (61.5%) cases of ultrasound was informative and the echo-picture corresponded to the duplicative cyst of the stomach. Multislice CT was performed in 5 children, out of which in 2 cases the picture corresponded to the duplicating cyst of the stomach, in 3 patients the small omentum cyst, lymphangioma of the small intestine mesentery and pancreas cyst were suspected. Surgical interventions in the vast majority of cases were performed by means of a laparoscopic mode, in 2 cases an open intervention was performed in a 5-month-old child due to the presence of a combined pathology of the pancreatic tumor and also in a 4-month-old child who had undergone a laparotomy in connection with intestinal obstruction. Discussion. Duplications of the stomach make up about 4-8% of the DDT cases. The comparative rarity of this pathology and the absence of reliable pathognomonic signs of the disease make it difficult to establish the correct preoperative diagnosis, despite numerous imaging methods. Clinical manifestations are variable and depend on the location of the mass, its size, the presence of an ectopic mucosa and communication with the lumen of the stomach. To diagnose gastric duplication, various imaging methods are used. We consider the ultrasound method to be the most accessible, non-invasive and informative method for diagnosing the gastric duplication. We consider the ultrasound method to be the most accessible, non-invasive and informative method for diagnosing of DDT duplications. Currently, in all types of DDT, the methods of minimally invasive surgery are tried: thoraco- and laparoscopic, laparoscopic-assisted and intraluminal interventions. Such surgical interventions should comply with the principles of radical surgery: the duplication should be removed completely, and if this is not possible it is necessary to completely remove the mucous membrane. In our study, in all cases, the radical surgical intervention was achieved, while the share of minimally invasive operations was 84.6%.

Early restoration of anatomical and functional structures of the anterior abdominal wall is necessary for good cosmetic result and prevention of recurrent ventral hernia. We presented three clinical examples of commonly used surgical procedures in children including anterior abdominal wall repair using biological material 'Permacol'.

Introduction. Despite the good long-term results of duodenal atresia correction in the long term, about 10% of patients have severe upper gastrointestinal motility disorders: GERD, gastroduodenitis, and megaduodenum, which requires re-reconstruction of the duodenal anastomosis. Materials and methods. For the period from 2010 to 2021 in the clinic of the FGBUZ DGKB them. N. F. Filatov DZM Moscow 7 patients was treated with megaduodenum, operated on for duodenal atresia. The average age of the patients was 5.4 ± 3.9, boys predominated (6/7). All children underwent a standardized examination: ultrasound, barium fluoroscopy, FGEDS and laboratory research methods. MRCP and abdominal CT were performed as indicated (3/7). All patients were operated on, depending on the cause of obstruction and the degree of its compensation. Reconstruction of the previously applied anastomosis (4/7) or resection of the duodenum (3/7) was performed. Results. Main patient complaints: abdominal pain 7/7 (100%), vomiting 7/7 (100%), abdominal distention 4/7 (57.1%), poor weight loss 3/7 (42.8%), constipation 3/7 (42.8%). 5 out of 7 had multiple congenital malformations (MCDs). Mechanical causes of chronic renal failure were detected in 4 out of 7 children: stenosis of the duodeno-duodenoanastomosis (2), “blind loop” syndrome (infringement of the Roux loop in the form of a “double-barrel” in the window of the mesentery of the transverse colon) (1), stenosis of the duodeno-duodenoanastomosis in in combination with fibrosis of the head of the pancreas (1). In the remaining 3 cases a secondary megaduodenum was detected with good obstruction of the previously imposed anastomosis. Hiowever, it was noted that the diameter of the anastomosis was definitely less than the diameter of the duodenum above its level. In 6 out of 7 patients chronic renal failure was complicated by secondary gastroesophageal reflux disease (GERD), which required surgical correction in only one patient after 6 months. In other cases, the dynamics of reflux spontaneously decreased to 1 degree and was intermittent, the patients had no complaints. All children were examined in follow-up after 1, 3, 6 and 12 months. All of them showed positive dynamics in the form of weight gain, absence of complaints and signs of protein-energy insufficiency. Conclusion. Children operated on for duodenal atresia need long-term careful dispensary observation. Since in the presence of pronounced motor-evacuation disorders of the duodenum, repeated interventions are necessary. Surgical tactics should be strictly differentiated. Resection of the duodenum improves passage through the upper gastrointestinal tract and is well tolerated by patients.

Introduction. Colon atresia is a rare form of congenital bowel obstruction. In scientific literature, there are isolated publications devoted to colon atresia, and only some authors discuss the membranous form of atresia.Material and methods. The article describes a rare clinical case of an incomplete colon membrane in an infant. At the age of 11 months, the child developed symptoms of acute intestinal obstruction. Irrigography was performed; Hirschsprung’s disease was suspected. At the first stage, the child was taken a floor-by-floor biopsy of the colon, and an ileostomy was put. Visually, Hirschsprung’s disease seemed to be present; however, histological examination turned aside this diagnosis. Given this, the colon membrane was suspected. Partial resection of the altered part of the sigmoid colon was performed with good clinical effect. Histological examination revealed an incomplete serous-muscular membrane of the colon.Conclusion. Colon atresia is a rare disease that presents a serious problem for diagnosis and treatment. Preoperative morphological verification of the diagnosis is important, even in case when Hirschsprung’s disease seems obvious. Preoperative diagnostics is important because surgical tactics may be considerably different in colon local lesions.