The purpose of the study. Obtaining a set of new data, identifying patterns in the endoscopic anatomy of the ileocecal intestine and, on this basis, improving the diagnosis of its pathology.

Materials and methods. The present study was conducted in 182 patients (men — 84, women — 98) who were examined and treated in the polyclinic and in the hospital of the Orenburg Regional Clinical Hospital. The age of all the examined patients is from 18 to 75 years. A set of methods was used: endoscopic (videocolonoscopy, videoileoscopy, examination of the mucous membrane in white light and in the NBI mode, the method of taking material for morphological examination), morphometric, morphological examination of biopsies, X-ray (irrigoscopy, irrigography), variational and statistical data processing.

Results. In this work, a set of new data was obtained and patterns of the in vivo anatomy of the ileocecal department were revealed based on the results of colonoscopies. It was found that the endoscopic anatomy of the ileocecal region consists of individually variable parameters determined during intravital endoscopy: the shape, external structure and direction of the ileocecal valve, the internal relief and shape of the cecum, the projection and width of the tapes, the intraluminal morphometric parameters of the elements of the ileocecal valve and the cecum. Changes in the endoscopic anatomy of the ileocecal region in ulcerative colitis and Crohn’s disease were quantifi ed and presented. A rational set of studies based on endoscopic and X-ray anatomy is presented, which is necessary for improving the methods of colonoscopy, diagnosis of ulcerative colitis and Crohn’s disease, and various types of surgical treatment of pathology of this department.

Conclusion. The new set of data obtained and the revealed regularities of the endoscopic anatomy of the ileocecal region expand the understanding of its clinical anatomy and the possibilities of in vivo study.

The aim of the study. Determining the dependence of the bile microstructure degree of destabilization of bile and on the age of patients with the I (pre-stone) stage of the cholelitiasis.

Material and methods. About 396 patients with stage I of cholelitiasis. 1 group consisted of 125 young patients (25–44 years), 2 groups — 164 middle-aged patients (45–59 years), 3 group — 107 elderly patients (60–74 years). In verifi cation of the diagnosis, in addition to anamnestic and general clinical data, the results of ultrasound examination (ultrasound) of the gallbladder, the study of the physical and chemical properties of bile are used. Crystallography was used to study the morphological pattern of the gallbladder.

Results. In the evaluation of the bladder bile of patients with stage I gallstone disease, there is a decrease in the angle of the tilt of the liquid crystal lines, as well as the appearance of optically active inclusions, such as branched dendrites with plate branches, matted- fi ber aggregates, shield- shaped units and short- branched dendrites.

Conclusion. Crystallography is highly sensitive, but at the same time an easy-to-perform method and can be widely used in early diagnosis of gallstone disease.

The aim of this work is to study the features of the electrical and viscoelastic parameters of erythrocytes in patients with inflammatory bowel diseases (ulcerative colitis, Crohn’s disease, unclassified colitis), taking into account the stage of the disease for possible use in differential diagnosis.

The electrical and viscoelastic parameters of erythrocytes were studied using dielectrophoresis in 109 patients with IBD, mean age 37,7 + 11,7 years (50 patients with ulcerative colitis (UC), 41 with Crohn’s disease (CD), 18 with unclassified colitis (UCC) and 53 conditionally healthy, comparable in age and sex with the main groups.

Red blood cells of individuals with IBD differed from those in the comparison group by a smaller average diameter, an increased proportion of deformed, spherocytic cells with a changed surface character with a reduced ability to deform, a lower level of surface charge of cells, an altered membrane structure with an increased ability to conduct electric current, prone to destruction and the formation of aggregates (p <0,0001–0,05).

Analysis in individual groups with IBD in the acute stage, taking into account the therapy, revealed significant differences between the forms of IBD: in patients with Crohn’s disease, in contrast to patients with UC, red blood cells had lower values of the amplitude of deformation, capacity, dipole moment, and velocity of movement of cells towards electrodes, the proportion of discocytes, polarizability at most of the frequencies of the electric field (p <0,00001–0,05). On the contrary, the summarized indicators of rigidity, viscosity, electrical conductivity, aggregation and destruction indices were higher in CD than in UC (p <0,0001–0,05). CD patients had a greater number of deformed cells with altered surface character (p <0,00001).

The features of the electrical and viscoelastic parameters of erythrocytes in patients with differentnosological forms of IBD can be used for the differential diagnosis of ulcerative colitis and Crohn’s disease in case of colon lesions, in the long term — for verification of the diagnosis in unclassified colitis.

Purpose of the study. To analyze retrospectively our own experience of using intramural dexamethasone injections during endoscopic bougienage of recurrent or very tight (refractory) benign cicatricial strictures of the esophagus and esophageal anastomoses.

Materials and methods. From 2013 to March 2021, this method was applied in 43 patients (26 — men, 17 — women) with peptic (11), cicatricial (8), burn (6) esophageal strictures and strictures of anastomoses (18) prone to restenosis. Dexamethasone was injected into the constricted area with a needle passed through the endoscope biopsy channel as an addition to supportive bougienage.

Results. After dexamethasone injections, 41 (95.3%) of 43 patients achieved a satisfactory lumen diameter, at which the symptoms of dysphagia disappeared for a long time without relapse. In most patients, the lumen in the stricture zone stabilized at a diameter of 8–18 mm (average 13 mm). With strictures of the esophagus, it was possible to achieve a diameter of 8–14 mm (average 11 mm), and with strictures of the anastomoses — 10–18 mm (average 14 mm).

Conclusion. With the tendency of stricture to restenosis, the standard algorithm for endoscopic bougienage, developed in the endoscopy department of the “Petrovsky National Research Center of Surgery”, was supplemented with intramural injections of dexamethasone. This combined endoscopic treatment made it possible to increase the diameter of the bougie and the intervals between bougienage due to the stabilization of the scar frame and to complete the endoscopic treatment with a satisfactory result in 95.3% of patients.

Goal. To evaluate the genetic profi le of patients with chronic hepatitis C (CHC) by the CAT gene polymorphism in the region-262G/A (rs1001179), GPX4 in the region-718C/T (rs713041), IL28B in the region C/T (rs12979860) and VEGFA in the region- 634G/C (rs2010963) to analyze the association of the rate of progression of liver fi brosis with polymorphic genetic markers.

Materials and methods. We examined 36 patients with CHC with a rapidly progressive rate of fi brosis (up to 10 years) and 56 patients with a slowly progressive course of the disease (more than 10 years). The study of single- nucleotide polymorphisms of genes was carried out by the method of polymerase chain reaction.

Results. In the group with rapid progression of liver fi brosis, individuals with multiple risk alleles for the studied polymorphisms were more common, which confi rms the association of the risk of liver fi brosis progression with the genetic markers CAT in the region-262G/A (rs1001179) and GPX4 in the region-718C/T (rs713041) with their combined carrier. Among patients with rapid progression of fi brosis, a greater number of individuals had simultaneously 4–6 risk alleles in 27.5%, while patients with slow progression of the process only in 11% of cases.

Conclusion. This set of genetic markers can be used as genetic testing of patients with liver fibrosis to determine the prognosis of the disease.

The article highlights the results of a study of a new method for diagnosing non-alcoholic fatty liver disease in a living organism by determining the serum level of the marker Secreted frizzled related protein-4 (SFRP4) with histological confirmation of the results. In a chronic experiment, the parameters of two groups of experimental animals were studied: control and experimental, 15 rats each. The control (reference) group of animals was in the usual feed and drinking mode, the experimental received food with a high content of carbohydrates and fats. The results of biochemical blood tests and autopsy biomaterials on day 180 of the experiment indicated the presence of fatty changes in the liver in the experimental group of animals. The importance of circulating adipokine SFRP4 in the diagnosis of non-alcoholic fatty liver disease (NAFLD) has been confirmed. A histologically confirmed direct correlation of SFRP4 with the degree of liver fibrosis in NAFLD was revealed. The place of SFRP4 in the pathogenesis of non-alcoholic fatty liver damage is explained. It is noted that in case of successful extrapolation of the results of the study on the human body, information will become a successful solution to one of the most pressing problems of modern hepatology.

Сholelithiasis ranks third in terms of the prevalence of diseases among the adult population. A complication such as choledocholithiasis occurs in up to 33% of patients with gallstone disease. Despite the improvement in treatment methods and the use of “gold” standards, the number of complicated forms of cholelithiasis has no tendency to decrease. Timely resolution of choledocholithiasis by a correctly chosen technique helps to reduce complications and increases the frequency of favorable outcomes of the disease, returning patients to social activity.

That is why it is important to know and, if possible, to use various methods of rehabilitation of the common bile duct when performing modern endoscopic transpapillary interventions.

The pulmonary function which determines the prognosis of the disease in patients with cystic fibrosis (CF) depends directly on their nutritional status. Normal body mass index (BMI) for a given age/sex of the patient is considered to correspond with normal nutritional status. However, it is known that in CF patients only lean body mass (musculoskeletal and visceral) correlates directly with lung function. Bioimpedansometry, as the he method for assessing body composition in children with cystic fibrosis is actual, informative and available in pediatric practice. Body composition indicators can be used in these patients not only for diagnostic and prognostic purposes, but also for monitoring the course of the disease in a particular patient and correction of nutrition.

The estimation of body composition with bioimpedance method in children with CF, carried out in this study, shows that in children with normal and even low BMI, the percentage of lean body mass is low, which requires measures to increase muscle/bone mass, the strength of the respiratory muscles especially, both by correcting the protein component of the diet, and by increasing physical / sports activity, in addition to compulsory respiratory physiotherapy.

In the article they are determined peculiarities, principles and possibilities of using capsule endoscopy as the method for intravital anatomical investigation of gastrointestinal tract on the basis of resalts capsule endoscopy by 170 patients without pathology of digestive canal and received experience. They are showed its connections with other methods of intravital visualization.

The aim: to focus on the possibilities of modern endoscopy in the diagnosis of laterally spreading (creeping) tumors — LST (laterally spreading tumor) of the colon.

Materials and methods: description and comparison, based on data available in the literature, of modern endoscopic techniques for the diagnosis and differential diagnosis of LST.

Results: the analysis and systematization of the obtained data revealed the advantages of modern endoscopic diagnostic methods not only in detecting LST, but also in predicting their morphological structure.

Conclusion: the use of modern endoscopic diagnostic methods allows not only to improve the detection of neoplasms, but also to choose the best options for further treatment based on the information received.

Clinical relevance. Duodenal MALT-lymphoma, a rare disease of the duodenum with a blurred clinical picture, frequently is an incidental finding at esophagogastroduodenoscopy. Therefore, the authors presented a clinical observation of a 59-yearold patient, whose diagnosis was established on the basis of endoscopic imaging, morphological and immunohistochemical investigations of biopsy material.

The purpose of the study was to demonstrate clinical observation of MALT-lymphoma of duodenum

Materials and methods: The case history of a 59-year-old patient diagnosed with duodenal MALT-lymphoma is presented.

The article presents some information about xanthomatosis, as well as about xanthomas of the stomach, which are benign formations, but their etiopathogenesis is unknown. Some believe that there is a relationship between xanthomas of the stomach and hyperlipidymia, diabetes, preneoplastic changes in the mucous membrane, age-related features of the gastric mucosa.

The clinical case described in this report confi rms the existing point of view about xanthomas as markers of preneopastic changes in the gastric mucosa and its precancerous diseases.

A 26-year-old patient with no symptoms of gastroesophageal reflux disease developed complaints of dysphagia. Endoscopic examination revealed a short grade 3 cicatricial stricture in the upper third of the oesophagus, and in the lower parts of the oesophagus mucosa was represented by a columnar epithelium for 16 cm. Histological examination verified the long segmental Barrett’ oesophagus. Above the stricture large areas of heterotopia of the gastric mucosa were determined among the regular oesophageal squamous epithelium. While taking proton pump inhibitors, the patient underwent a long course of endoscopic bougienage with intramural dexamethasone injections, which made it possible to stabilize the lumen in the stricture zone at a level of 12 mm. A precise examination of all parts of the oesophagus with the use of modern clarifying imaging techniques allows to correctly interpret the endoscopic picture and determine the further tactics of treatment and follow-up, taking into account the possible risks of neoplasia in the heterotoped area of the mucosa of the upper third of the oesophagus.

The aim of the investigation was to demonstrate the possibility of modern technology of endoscopic drainage of difficultly accessible pancreatic pseudocyst of complex configuration using endosonography.

Material and methods: a patient with a long history of recurrent chronic pancreatitis and a pseudocyst of complex configuration and anatomical location formed on this background was subjected to internal drainage of postnecrotic cyst under the control of endosonography in November 2020.

Result: The surgical intervention and postoperative period were without complications. Control CT scan of the abdominal cavity organs after 3 months showed complete reduction and disappearance of the cyst. The follow-up period up to the present time is 5 months. The patient had no complaints at the moment.

Conclusion: this clinical observation demonstrates the advantages of minimally invasive intraluminal transduodenal access. The used access permitted to perform surgery in maximum organ preserving variant with the best functional result.

Clinical relevance: Colon lipomas are not rare tumors, but they occur with blurred clinical features and patients arrive with complications- obstructive intestinal obstruction or bleeding. In this regard, the authors presented a clinical case of a 57-yearold patient whose diagnosis was established only by morphological examination of the surgical material.

The purpose of the study was to demonstrate clinical observation of colon lipoma.

Materials and methods: The case history of a 57-year-old patient diagnosed with colonic lipoma is presented.

Pancreatic tumors are very rare problem in children that mostly in literature presented just with case reports. Solid-pseudopapillary tumors of the pancreas are a little part, just about 1–2%, from all nonendocrine tumors of the pancreas. About 90% of all patients with this tumor are female teenagers and young women. Solid-pseudopapillary tumors of the pancreas are innocent, and mostly all of them are incidental findings. However, we can see clinical findings if patient has big size of such tumor, which compress nearest anatomical structures. In this article we present a case of incidental finding of solid- pseudopapillary tumor of body and tale of the pancreas in 11 years old girl, who was treated with distal resection of pancreas.

The article provides an anatomical description of the eight most common eponyms in the anatomy of the small intestine, describes the history of discovery of these anatomical formations, gives brief biographical information about the scientists after whom these or those structures are named, and describes their contribution to the medicine.

The article is dedicated to the V International Congress UralEndo “Endoscopy: different views, a common language” held in Yekaterinburg on February 12, 2021. The review of the congress examines the main events of the congress concerning the direction of development of modern endoscopy in both scientific and practical orientation. The immediate tasks include the improvement and standardization of endoscopic terminology in order to develop a unified understanding of the definitions of modern endoscopy by doctors of different specialties. The key event of the congress is an online round table with international experts-endоleaders, during which the issues of terms and definitions, their correct use, both in English and in Russian, were also considered.