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The article presents an analysis of the features of primary peritonitis in children. Medical reports of 182 patients with primary and appendicular peritonitis were analyzed. It was significant, that the sick girls aged 4-7 years often had the primary peritonitis after acute inflammatory processes, which took place a month earlier. Chronic infection foci were noted in these patients. The age-specific features of maturation of the immune and reproductive systems predisposed the disease.

A retrospective analysis of 854 case histories of patients who died in surgical hospitals of Orenburg Province from 1996 till 1998 has shown that 67% of the patients had infectious complications including 32.5% of suppurations of the postoperative wounds. Other causes of complications and lethality were established. Main ways to reduce their amount are determined.

Under analysis there were 4227 case histories of patients operated upon in 1978-1987 for acute surgical diseases of the abdominal organs. It was found that diagnostic, tactical and technical medical errors had taken place in 24.8% of the cases at the hospital stage. In 113 dead patients errors responsible for the lethal outcome were found in 30% of the cases. For the period from 1987 to 1997 postoperative lethality from acute surgical diseases was substantially decreased due to the improvement of professional training of the surgeons, less amount of errors, using the present-day methods of treatment and surgery.

The article analyzes results of treatment of 900 thousands patients with acute surgical diseases of organs of the abdominal cavity. Factors responsible for unfavorable results are shown. The authors consider that reduced lethality depends on strict observation of the main principle of the medical doctrine in emergency surgery and on wider introduction of endovideosurgical technologies into practice.

Under analysis was the material of the department of urgent and consultation medical aid (sanitary aviation) for the last 20 years. It was found that under conditions of surgical departments of central regional hospitals multiple relaparotomies made up 12.5% of all reoperations. It was shown that results of the multiple relaparotomies were dependent on urgent coming of a consultant and active surgical treatment on the spot. Reconstructive operations for intestinal fistulas must be performed under conditions of a specialized proctological department.

Complex research made it possible to reveal factors influencing timely hospitalization of patients by studying the causes of timely and late hospitalization, medical erudition of the urban and rural population, as well as the organization of emergency medical service in the prehospital stage. New methodical approaches to health education among the population as well as measures for raising the confidence of the sick in doctors of emergency aid service and surgeons are suggested. From the example of urban health service the authors emphasize the importance of the principle of necessary hospitalization of patients for profound examination in all cases of a doubtful diagnosis of an acute surgical disease.

Insufficiently studied problems of late hospitalization of patients with acute surgical diseases of the abdominal organs are discussed from the standpoint of a systemic approach. The mean annual (1982-1986) index of late hospitalization was 1.8 times lower in rural districts of the Rostov region than in urban ones. The level of late hospitalization decreased significantly in towns with a 100,000-150,000 population. The index of late hospitalization was found to increase with the age of the patients. A seasonal pattern of the indices of late hospitalization and a high level of late hospitalization among medical workers were revealed. Study of the patient's medical histories showed factors causing delayed hospitalization. Information collected among the population by means of a questionnaire confirmed insufficient qualification and accessibility of the medical service, which influences essentially the tendency of most of the interrogated persons to temporize or resort to self-treatment when acute, growing pain appears in the abdomen.

Within a five-year period in a special room intended for endoscopy 1934 investigations were performed, including 1318-on urgent indications. 77 esophago-gastroduodenoscopies were performed elsewhere-in the operating room, in the intensive care unit; 35 investigations were carried out under general anesthesia with the use of myorelaxants of a short effect. In 256 cases the neccesity of active infusion therapy and reanimation arose. In the paper, the authors' considerations concerning the need of organization, in large cities, of a mobile endoscopic team attached to the emergency medical aid are given with special reference to some features of the organization of endoscopy room in the clinic of emergency abdominal surgery.