DUNBAR SYNDROME: CLINICAL MANIFESTATION IN ADULTS, DIAGNOSTIC PROBLEMS (CASE REPORT).

In this case we used CBC and biochemical tests, ECG, ultrasound of the abdominal cavity and heart, CT scan with and without IV contrast. Women with complains on recurrent severe abdominal pain in epigastric region and right part of the abdomen radiating to the back, nausea, vomiting. Making laboratory and instrumental tests for confirmation of the diagnosis. Surgical treatment of DS was performed and after one year of the follow up there were no complications. DS may mimic other medical conditions such as gallbladder diseases, gastritis/peptic ulcer, appendicitis, colorectal malignancy, hepatitis, atherosclerotic diseases etc. That is why DS is a diagnosis of exclusion. This case illustrates pathway to find correct diagnosis and improve management tactic.

CONGENITAL HEMOLYTIC ANEMIA IN CHILDREN, FEATURES OF THE COURSE AND DIAGNOSIS. THE CLINICAL CASE.

We've reported a clinical case of congenital hemolytic anemia which was treated in Vinnitsa Regional Children's Hospital from newborn period until now. We've used complete blood count, biochemichal blood investigation, ultrasound investigation of the abdominal cavity in every hospitalization. Also IFA for TOXO IgG, IgM and G CMV, IgG HSV-6 IgG EBV (EBNA) and IgM EBV, study to hepatitis B and C viruses and HIV were made. There were checked levels of serum iron, ferritin, vitamin B 12 and folic acid in blood serum.

Choice of surgical tactics at the stage of preoperative preparation of patients with biliary sepsis.

OBJECTIVE: Introduction: There is a problem of choosing the optimal method for eliminating choledocholithiasis in accordance with one The lack of satisfactory results from the use of existing methods of surgical correction explains the constant interest of specialists to this problem, requires the improvement of the commonly accepted and the search for new approaches to the treatment of this concomitant disease. The aim: To substantiate the use of individual assessment at the stage of preoperative preparation for the purposeful differential tactic of surgical treatment of the biliary sepsis. PATIENTS AND METHODS: Materials and methods: The basis of our research was the results of the analysis of treatment of 112 patients with biliary sepsis who were on treatment from 2010 to 2017 in the surgical clinic № 2. An assessment of systemic inflammation performed according to the recommended criteria of the Chicago Interventional Conference on Intensive Care (USA, 1992). The systemic inflammatory response syndrome (SIRS) was determined in the presence of 2 or more symptoms: 1) t body> 38 ° C or <36 ° C, 2) heart rate> 90 / min; 3) breathing frequency> 20 / min; 4) white blood cell count> 12 × 109 / l or <4 × 109 / l; or> 10% immature forms (SOFA score 4, 27 ± 0.6 points). RESULTS: Results: Based on the received pre-operative score, we proposed to optimize the differentiated selection of individualized surgical tactics, taking into account the available baseline conditions, to radically eliminate the cause of biliary sepsis and evaluate the measures of initial conservative therapy. In the course of work, anamnestic unit, clinical unit, laboratory-instrumental block used. The initial severity of the condition of each particular patient is calculate according to the received sum of points for each information block, which allows at the stage of preoperative preparation to standardize all patients in accordance with their score. CONCLUSION: Conclusion: Thus, the ball assessment of the severity of the condition of patients allows us to determine not only the optimal tactics, the size and type of surgical correction, but also to determine the effectiveness of the selected composition of preoperative preparation and postoperative treatment, carrying out its dynamic assessment.

Trombosis of mesenterial vessels in acute lymphoblastic leukemia (case report).

The article presents data on classification, diagnostic problems, treatment of acute lymphoblastic leukemia in children. Remaining unresolved problems of protocol chemotherapy complications of acute lymphoblastic leukemia. The presented clinical case of successful treatment of thrombosis of mesenteric vessels in a child with acute lymphoblastic leukemia, which included the stages of thrombolytic therapy and surgical treatment for resection of necrotized part of the ileum.