The aim of study: To evaluate the results of endoscopic diagnostics and treatment of pediatric patients with respiratory tract foreign bodies (FB). Materials and methods. From 2001 to June 2024, 248 patients with suspected FBs aged 7 months to 15 years (average age 2.5 years) were examined and treated. The highest number of aspirated FBs occurred in patients under five years of age, with the peak incidence occurring between the ages of 1 and 2 years. Boys predominated in a ratio of 1.98:1. The duration of suspected FB aspiration ranged from 1 hour to 1.5 years. Results. Pathological changes according to X-ray were detected in more than 50% of patients. Among them, the prevalence of pulmonary tissue swelling and atelectasis (78 - 31.45%), which is an indirect sign of the presence of FB in the respiratory tract. X-ray contrast FB were detected in 14 (5.64%) patients. FB of organic origin were detected in more than 80% of patients. In 145 (60.92%) cases, these were sunflower peel and seeds, peanuts, and legume seeds. X-ray contrast FB (14 - 5.88%) were metal objects. An attempt at FB extraction was performed in all patients. The technical success of the intervention was 98.73% (235 patients). In most cases - 186 (78.15%) aspirated FB (especially in young children) were extracted by using rigid tracheobronchoscopy. The technique of combined tracheobronchoscopy for FB extraction (used in 49 (20.58%) patients) was optimal for this category of patients: a flexible bronchoscope was inserted through the rigid bronchoscope tube, which made it possible to combine the advantages of both methods. FBs from the lower respiratory tract were successfully extracted by using flexible bronchoscopy in 52 (21.84%) patients. Conclusions. The frequency of FB detection in pediatric patients admitted to hospital is very high. Most foreign bodies in pediatric patients are of organic origin. Endoscopic methods are the main ones in the diagnosis and treatment of pediatric patients with foreign bodies in the respiratory tract, allowing for foreign body extraction in more than 98.9% of cases. Flexible endoscopes can be used at the diagnostic stage. The choice of equipment at the FB removal stage depends on the specialist’s experience (flexible endoscope only, rigid endoscope, combination of flexible and rigid bronchoscope).

Relevance. Bleeding from varicose veins of the esophagus ranks second among the causes of gastrointestinal bleeding. In patients with cirrhosis of the liver and portal hypertension, bleeding from varicose veins of the esophagus and stomach leads to death in 20% of cases within six weeks. Primary and secondary prevention should be carried out to avoid bleeding. This literature review will present the causes of portal hypertension and methods of preventing bleeding from varicose veins of the esophagus. The purpose of this study is to identify global trends in the prevention of bleeding from varicose veins of the esophagus in portal hypertension. Conclusion: During the analysis of the literature, we came to the conclusion that the advantage should be given to combined methods of prevention. Most of the available data is extrapolated from adult studies. Currently, there is no single developed strategy for the prevention of bleeding from varicose veins of the esophagus in children.

Hamartoma polyps are benign epithelial formations that primarily form in the gastrointestinal tract. Currently, many syndromes that are united by the formation of hamartomas have been described and studied. The term «hamartoma» itself describes neoplasms formed due to a violation of the quantitative ratio of tissue elements and their hyperplasia. The clinical presentation of most gastrointestinal polyps is very similar, while each hamartomatous polyposis syndrome has its own clinical features and unique presentations. This group of diseases is diverse; the most important aspect of this problem is that most of the diseases described in this literature review are associated with cancer. In the vast majority of cases, endoscopists are the first to see hamartomatous polyps in the gastrointestinal tract. Modern technologies make it possible to perform minimally invasive removal not only in the upper sections and large intestine, but also in the small intestine. However, the endoscopic picture of different syndromes is practically the same.Thus, timely detection, differential diagnosis, correct diagnosis and selection of optimal tactics for dynamic observation and adequate treatment is an important task that requires a multidisciplinary approach. This paper presents the characteristics of rare syndromes of hamartomatous polyposis, namely juvenile polyposis syndrome, Peutz-Jeghers, hereditary mixed polyposis, Cowden, Bannayan-Riley-Ruvalcaba, as well as acquired juvenile polyposis syndrome - Cronchite-Canada. A brief historical background is presented, clinical manifestations, etiology, pathogenesis, microscopic differences and features are described.

In modern conditions, bronchoscopy is one of the important endoscopic methods, without which the treatment and diagnostic process in pediatrics is indispensable. When treating children with respiratory pathology, bronchoscopy not only complements the data of radiation diagnostic methods, allowing for visualization and various diagnostic manipulations during examination, but can also be the main method for diagnosing pathological changes. In addition, in some cases, bronchoscopy is an indispensable treatment method. Thanks to the active development of technologies and the availability of a range of endoscope diameters, it is now possible to perform bronchoscopic manipulations in young children, newborns and premature babies with low body weight. Like any invasive technique, bronchoscopy has its risks and when performing an examination in children, especially in the neonatal and early age periods, it requires certain conditions (examination of children only in a hospital setting) and the level of training of the endoscopist.

In this review article briefly described history, principles, technique and clinical applications of confocal laser endomicroscopy. This technology allows to expand the diagnostic ability of traditional white light endoscopy and to assess effectiveness of therapeutic procedures in different gastrointestinal diseases. New experimental and clinical data in assessing inflammatory changes of the digestive tract, small bowel barrier dysfunction as a predictor of relapse for inflammatory bowel disease, applying of the technology in irritable bowel syndrome and Hirschsprung disease is presented. Examples of reports in adult patients are given, which can potentially be extremely useful in pediatric patients. Problems and perspectives regarding application of optical biopsy for gastrointestinal tract in pediatric practice are discussed.

Eosinophilic esophagitis (EoE) is characterized by endoscopic signs and detection of more than 15 eosinophils per high-power field of view in biopsies of the esophageal mucosa. Due to deep chronic eosinophilic inflammation, it can cause complications: esophageal stenosis, rarely perforation. Intramural esophageal dissection (IED) is a previously undescribed complication of EoE in children. We present a case of IED in a 15-year-old boy, which clinically manifested itself as sudden epigastric pain radiating to the back and nausea against the background of acute respiratory viral infection. According to the endoscopy, CT and X-ray contrast study, a double-barreled esophagus with two cavities was found - the esophagus itself and a blind «pocket», histologically in which granulation tissue and active inflammation with a large number of neutrophils were found. The initial histological examination did not reveal significant eosinophilic infiltration in the esophagus. The boy received a course of esomeprazole, was re-examined after 6 months. The radiographic picture was the same, and endoscopically characteristic signs of EoE were detected: longitudinal grooves and erosions, transverse rings, narrowing of the esophageal lumen. In the middle third, the picture of a double-barreled esophagus was still preserved, but without signs of acute detachment, but with a dense septum between the two cavities of the esophagus. Histologically, the infiltrate contained more than 50 eosinophils in the field of view. The diagnosis was: eosinophilic esophagitis complicated by RTI. A strict hypoallergenic diet was prescribed, excluding obligate allergens, budesonide 1 mg 2 times a day in the form of a gel. Endoscopic dissection of the esophageal septum was performed, its patency was restored. After 2 months, against the background of ongoing drug therapy and diet, the boy was examined again. He had no complaints, radiological patency of the esophagus was not impaired. Endoscopically, the esophagus is freely passable, there is only a small fold at the site of the operation, longitudinal grooves and small erosions in the lower third remain. Histologically, the number of eosinophils has significantly decreased. Therapy was continued. This clinical case demonstrates the possibility of developing RDI as a complication of Eo E. The course of EoE can be asymptomatic, and RDI is the first manifestation of the disease. The endoscopic picture of a double-barreled esophagus is a consequence of dissection. The combination of a hypoallergenic diet, topical steroids and endoscopic septectomy is effective in the treatment of EoE with RDI. Eosinophilic esophagitis (EoE) is characterized by endoscopic signs and detection of more than 15 eosinophils per high-power field of view in biopsies of the esophageal mucosa. Due to deep chronic eosinophilic inflammation, it can cause complications: esophageal stenosis, rarely perforation. Intramural esophageal dissection (IED) is a previously undescribed complication of EoE in children. We present a case of IED in a 15-year-old boy, which clinically manifested itself as sudden epigastric pain radiating to the back and nausea against the background of acute respiratory viral infection. According to the endoscopy, CT and X-ray contrast study, a double-barreled esophagus with two cavities was found - the esophagus itself and a blind «pocket», histologically in which granulation tissue and active inflammation with a large number of neutrophils were found. The initial histological examination did not reveal significant eosinophilic infiltration in the esophagus. The boy received a course of esomeprazole, was re-examined after 6 months. The radiographic picture was the same, and endoscopically characteristic signs of EoE were detected: longitudinal grooves and erosions, transverse rings, narrowing of the esophageal lumen. In the middle third, the picture of a double-barreled esophagus was still preserved, but without signs of acute detachment, but with a dense septum between the two cavities of the esophagus. Histologically, the infiltrate contained more than 50 eosinophils in the field of view. The diagnosis was: eosinophilic esophagitis complicated by RTI. A strict hypoallergenic diet was prescribed, excluding obligate allergens, budesonide 1 mg 2 times a day in the form of a gel. Endoscopic dissection of the esophageal septum was performed, its patency was restored. After 2 months, against the background of ongoing drug therapy and diet, the boy was examined again. He had no complaints, radiological patency of the esophagus was not impaired. Endoscopically, the esophagus is freely passable, there is only a small fold at the site of the operation, longitudinal grooves and small erosions in the lower third remain. Histologically, the number of eosinophils has significantly decreased. Therapy was continued. This clinical case demonstrates the possibility of developing RDI as a complication of Eo E. The course of EoE can be asymptomatic, and RDI is the first manifestation of the disease. The endoscopic picture of a double-barreled esophagus is a consequence of dissection. The combination of a hypoallergenic diet, topical steroids and endoscopic septectomy is effective in the treatment of EoE with RDI.

Esophageal leukoplakia is an extremely rare pathological condition of the esophageal mucosa and, at the same time, a lesion that has a high potential for malignization. Currently, there are no generally accepted recommendations for the treatment of patients diagnosed with leukoplakia. However, modern endoscopic techniques allows not only to diagnose this pathology with high accuracy, but also is one of the methods of radical treatment. This clinical observation demonstrates the results of endoscopic diagnosis of esophageal leukoplakia and the option of surgical treatment by argon-plasma coagulation.

Quality control of endoscope processing is carried out in accordance with the requirements of the current sanitary legislation (1,2) within the framework of industrial control by instrumental and laboratory methods. The results of instrumental control entirely depend on the quality of the final cleaning of the endoscope by hand. The results of laboratory control are determined not only by the efficiency of the entire processing cycle, but also by the correctness of sampling and delivery to the microbiological laboratory. Interpretation of unsatisfactory results of microbiological control is very important. It includes searching for technical malfunctions, biological films and system errors in processing, if there are indications for this.

Among the critical conditions, the most threatening is an acute violation of cerebral circulation (ONMC, stroke). When conducting endoscopic examinations for such patients, the principle of observing the “golden hour” is extremely important, when the reverse development of the pathological process is possible. Practical application of the Endomed videobronchoscope according to the 26.60.12-005-44302848-2022, model VB52 (ENDOMED, Russia) was held as part of the testing of equipment of domestic production in the period from 09/22/2024 to 09/10/24. Both endoscopists and anesthesiologists-intensive care specialists took part in the testing of the equipment, During the testing, the endoscope was used: in conditions of difficult intubation in 4 patients; during 20 planned rehabilitation tracheobronchoscopies and in 2 emergency situations. As a result of the testing, it was noted: the high mobility of the presented equipment, simplicity and ease of operation, a high level of image on a 3.5-inch screen with an endoscope mount on the handle, a small diameter of the distal end and a sufficient level of bending.

The article is dedicated to the VIII Eurasian Forum UralEndo, which took place on September 26-27, 2024 in the city of Orenburg, where live broadcasts from operating rooms were conducted in an interdisciplinary and international format and the following topics were discussed: Endoscopy and ultrasound techniques in clinical practice. Endoscopy and laser techniques in the clinical practice of urologists, abdominal surgeons, endoscopists (for the first time at the forum). X-ray endoscopic techniques in the practice of surgeons and endoscopists. Issues of procedural sedation during endoscopic interventions (draft of Russian methodological recommendations). Possibilities and prospects of capsule endoscopy. Issues of safety and quality of endoscopic equipment processing. Issues of the earliest possible implementation of the best endoscopic and radiation techniques in clinical practice.