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The article deals with 5-year (1986-1992) experience in the diagnosis and treatment of duodenal atresia in 26 infants. Timely diagnosis of this developmental anomaly, the variants of operative treatment, and the principles of postoperative management are discussed. The necessity of antenatal ultrasonic examination and the high diagnostic value of radiological and endoscopic methods of diagnosis are emphasized. Operations were conducted on 25 children for total high intestinal obstruction, on 23 infants in the neonatal period. The continuity of the intestinal tube was restored by duodenoduodenostomy (12), duodenojejunostomy (3), gastroduodenostomy (1), excision of the membrane (4), and dissection of the membrane (5). The latter is technically the simplest and is the operation of choice. Preliminary jejunostomy for adequate preparation for the radical operation is recommended in profoundly preterm infants with as serious premorbid background. Of high importance is postoperative enteral catheteral feeding which is begun from the first day after the operation. Seven out of the 26 patients died from severe combined developmental anomalies and infection. The mortality was 26.9%.

The paper presents the analysis of hydronephrosis treatment performed within 1987-1993 in 76 children. Special attention is paid to surgical techniques, methods of drainage with regard to hydronephrosis degree and pelvic contractility. The drainage system of the renal calicopelvic system using double-opening tube with continuous drop lavage is designed, the scheme of the patients' postoperative management is described. Good outcomes of pelvic electrostimulation are reported.

In the recent 9 years 39 girls aged from 2 to 10 years were treated at the clinic for prolapse of the urethral mucosa. Among them 24 had circular and 15 had segmental prolapse. The disease was encountered most frequently between 6 and 10 years of age, predominantly in the summer. Complex treatment was started with nonoperative measures which were followed by operation if the prolapse persisted or recurred. Spontaneous reduction of the mucosa occurred in 6 of 22 children who were treated by nonoperative measures, in 3 cases the effect was temporary and a recurrence developed. Operative excision of the mucosa was carried out in 36 girls. The results were good. The article discusses the etiopathogenesis of the disease and analyses the morphological changes in the removed urethral mucosa.

There were 849 children with various forms of acute appendicitis under observation in 1988. Generalized and circumscribed peritonitis was found in 44.2% of cases. The new clinical approach-based introduction of a previously elaborated surgical tactics showed it to be rational. The changing conditions led to a wider use of diagnostic laparoscopy, rejection of the "lavage" system in the postoperative period, and introduction of the method of laparostomy which is simpler and more effective.

Anatomo-topographic features of the kidneys in children mostly condition a great incidence of its damage, compared with adults. One hundred and fifty children with renal injuries were observed, 147 of them with closed injuries and 3 -- with open ones. In 10 cases a trauma of anomalously developed kidneys was noted. 124 children were treated conservatively, 26 children were operated upon, in 16 of them organ-preserving operations were performed, in 10 children -- nephrectomay. Late results were followed up in 51 children in terms from 6 months to 10 years (40 patients were treated conservatively and 11 -- were operated upon). As a result of the conducted control investigation all patients were subdivided into three groups: practically healthy children (25), children with roentgenoradiological changes on the part of the injured kidney but without signs of clinico-laboratory symptomatics (11) children with posttraumatic complications (15). An analysis of late results enabled to revise indications to surgery in an acute period of trauma in behalf of their extension.

Iatrogenic disease is considered as an unintentional or occasionally inevitable damage to the patient which is caused by the medical personnel during the patient management or at examinations, diagnostic and therapeutic procedures. Iatrogenesis, being the reverse side of medicine, is an essential part of medical progress. Any therapeutic exposures, especially to invasive techniques, are prone to both positive and negative effects. The development of the physician's skill, cultural standard, refinement, continuing self-education and analysis of errors in line with governmental program to improve public health are to warrant iatrogenic disease control.

The surgery in children should take into consideration 6 steps of diagnosing: initial, exact, subnarcotic, intraoperative, immediate postoperative and late postoperative steps when the growth of the child's organs and systems enable the final diagnosis to be established. Close attention to physically revealed symptoms of the disease may restrict the application of special methods and shows the skill of the physician.

Iatrogenesis, earlier considered to be an unfavorable effect of the word on the patient has acquired a new essence. Iatrogenesis means an unintentional and often inevitable complication resulting from contact with the patients, the influence upon him or due to inaction of medical personnel during prophylactic, diagnostic and curative procedures. An analysis of clinical and social sources of iatrogenesis gives grounds to find out ways to make it less.

The development of protein insufficiency in children with surgical diseases is considered by the authors to be an important problem. Even good appetite does not always meet the protein requirements of the organism. An additional probe feeding is indicated for the reestalishment of passage along the intestine if the natural supply by food products fails to meet the needs of the organism.

Inadequately utilized reserves of rendering surgical aid to children are analysed. The author discusses particular problems linked with prevention, diagnosis, tactics, treatment, and research in the field of pediatric surgery. The prospects of the specialty are intimately connected with general surgery and public health care as a whole and are caused by social reconstructions and stage-by-stage organizational decisions.