In 2018, at the annual congress of the European Society of Hypertension and European Society of Cardiology the updated guidelines on the diagnostics, management and prevention of arterial hypertension (AH) were announced. On October 8, 2018 the Ministry of Health of the Republic of Belarus issued order № 1000 “About improvement of work on delivery of health care to patients with arterial hypertension”, included all the best of the European recommendation with emphasis on assessment of efficiency of maintaining patients with AH. The article covers modern approaches to diagnostics and treatment of AH and is intended for practical doctors.

The article reflects the possibilities of applying the method of hygienic risk assessment of the development of computer dependence and the development of reasonable preventive measures for its prevention as a result of summarizing the results of implementation during 2014–2018. research work "Hygienic assessment of the health of students in the conditions of use of modern scientific and technical training tools based on the analysis of risk factors" with a survey in the dynamics of 5 years 1800 adolescents and 427 young people. The material was obtained by questioning (Phillips questionnaire, A. T. Beck scales. Unified questionnaire for monitoring behavioral risk factors, a questionnaire for analyzing computer dependence, the HornOstberg chronophysiological test, the diagnostic method of propensity for deviating behavior (SOP) A. N. Orel, SUN methodology, V. V. Markov’s questionnaire, V. V. Boyko’s test-questionnaire) and copying data on the health of students from medical records. Practical application of this method will allow to carry out rapid diagnostics of the risk of computer dependence in children, highlighting the most significant factors and risk groups of its formation, thereby justifying the tactics and amount of necessary preventive measures, both at individual and group and collective levels, aimed at prevention of addictive behaviors, preservation and strengthening of health, promotion of optimal growth and favorable development of the younger generation.

Inflammatory diseases of the external ear are common among children and adults and constitute 17 percent of the Otorhinolaryngologic Diseases. It can progress to the inflammation of the auricle, middle and inner ear, salivary gland, scalp and cause meningitis and otogenic brain abscesses if symptoms and treatment are ignored. In this article (review,) we provide an analysis of actual data about acute otitis externa and describe etiology, pathophysiology, clinical signs and symptoms, therapy. This information are important not only for otorhinolaryngologists but also for other specialists particularly pediatricians and general practitioners.

This article provides general information about the clinical manifestations, current approaches to the diagnosis and treatment of patients with facial neuropathy (NLN). The authors focus on the medico-social significance and relevance of the problem among people of working age, including military personnel. And also presented the results of their own research on the provision of medical care to servicemen hospitalized in 432 “The Main Military Clinical Medical Center of the Armed Forces of the Republic of Belarus” (432 GVKMTS) regarding the NLN. The analysis of clinical and diagnostic capabilities, tactics of treatment, prevention of possible complications, the solution of expert issues in this category of patients in the conditions of 432 GVKMTS.

Pregnant women with pre-eclampsia have a significant increase in the degree of platelet aggregation in response to ADP, in comparison with a physiologically occurring pregnancy, allowing use this criterion for diagnostic purposes. In vitro experiments revealed that diadenosine-5’,5’’’-P1,P4-tetraphosphate (Ap4A) and ATP-Mg2+ exhibited the greatest inhibitory effect on ADPinduced platelet aggregation. At the same time, a decrease in the degree of platelet aggregation in pre-eclampsia reached the level noted during physiological pregnancy. The potential advantage of Ap4A and its derivatives as therapeutic antiplatelet agents is that they have a synergistic inhibitory effect on the P2Y1 and P2Y12 platelet receptors and have a longer half-life in the bloodstream compared to ATP. The research results suggest using Ap4A as a substrate for the development of drugs aimed at reducing the increased functional activity of platelets in pre-eclampsia.

Intestinal obstruction of tumor Genesis – a syndrome that is characterized by a violation of the passage of the contents of the intestine along the digestive tract and is caused by a mechanical obstacle, which is a malignant or benign neoplasm of the intestine. Intestinal obstruction of tumor etiology refers to obturation obstruction and in the overwhelming number of cases is colonic. To the development of this syndrome, first of all, lead to malignant tumors of the intestine. Obturation may also occur due to the overlap of the lumen of the intestinal tube with the primary or recurrent tumor coming from neighboring organs and tissues.
The analysis of the results of treatment of 126 patients admitted in the 1st surgical Department of the clinical hospital 5 with referral diagnosis of "acute intestinal obstruction". In some patients the diagnosis was not confirmed, the rest were examined and operated on. Depending on the cause of intestinal obstruction, the time of receipt from the onset of the disease, concomitant pathology, patients underwent a different volume of surgery. Postoperative mortality in acute intestinal obstruction of tumor origin was 7.9%. The article analyzes the different choice of surgical benefits depending on the patient’s condition and the prevalence of the pathological process.

Hammer-like deformation of fingers is most often the result of a patient’s injury – a closed tear-off fracture of the base of the back fragment of the distal phalanx. In the treatment of this pathology since the late eighties of the twentieth century, Ishiguro blocking osteosynthesis has been successfully applied. The authors developed and applied in clinical practice a method of compression-blocking osteosynthesis. The article presents a comparative analysis of blocking and compression-blocking osteosynthesis performed in 15 patients aged from 11 to 57 years who had tear fractures of 16 fingers and applied for help to the republican center of hand surgery, operating on the basis of the 6th city clinical Minsk hospitals. Ishiguro blocking osteosynthesis was performed in eight observations (on nine fingers), compression-blocking osteosynthesis, the method of implementation of which is illustrated with diagrams and radiographs, was performed in seven cases. All patients studied using the Russian version of the DASH questionnaire received excellent and good results of surgical treatment. The best anatomical and functional results of operations (six of seven) were achieved after performing compression-blocking osteosynthesis.

The article presents an analysis of the effectiveness of the clinical use of a new method for the prevention of postoperative ventral hernias in patients with morbid obesity. It has been established that the use of the developed method of restoring the integrity of the aponeurosis of the anterior abdominal wall after performing laparotomy in patients with morbid obesity avoids the occurrence of postoperative abdominal hernias, as well as the development of local complications both in the early and distant postoperative period, leads to a decrease in the duration of inpatient treatment; significantly improves the quality of life of patients after surgery.

The article presents the results of examinations of 400 patients with pain in the cervical, thoracic and lumbar spine, the purpose of determining the relationship of visceral pathology with the occurrence and manifestation of dorsalgia. Along with the assessment of the vertebral neurological status, on the basis of clinical data and laboratory and instrumental methods of research, the diagnosis of associated diseases of internal organs was carried out. Revealed patterns in the localization and features of the manifestation of pain, depending on the associated visceral pathology. Proved the important role of visceral pathology in the formation and manifestation of pain. The data obtained significantly change the pattern of traditional dorsalgia diagnosis and allow us to approach the problem of nonspecific back pain from a new perspective.

Subpopulation composition of synovial fluid in patients with osteoarthritis joints of large and medium-sized was studied. Fibroblast-like synoviocytes were identified in the synovial fluid of 68,2% of the patients. This indicates damage to the synovial membrane.
It was found that the quantitative content of T-cells and the ratio of their subpopulations indicates the presence of immune inflammation in the affected joint.

The article provides an analysis of the monthly and seasonal dynamics of perforated ulcers (PU) over a 25 year period. The absence of an increase in incidence rates of PU in the spring and autumn has been established. It has been suggested that the frequency of the PU is related to the seasonal dynamics of the synthesis of the hormone of the pineal gland – melatonin.

Gastroesophegeal reflux, or GER, which clinical signs have more than 2/3 of newborns, in most of cases is a physiological process and determined by anatomical and physiological features of infants. During the 1st year of live number of regurgitation episodes and volume of refluxate get less. By the 12 months number of babies with reflux don’t exceed 5%. There are known factors, which predispose to GER, such as hypoxic-ischemic-traumatic nervous system damage, reduce of motor and evacuation functions of stomach, food allergy, increase of intraabdominal pressure due to infectious agents or blockage in the digestive system. Despite to well-known, it is one of the most actual problems in pediatrics. The importance of this issue is determined by the potential risk of developing lifethreatening conditions such as aspiration of regurgitated food, which can cause sudden infant death syndrome. In this article there are reviewed not only classical theoretical representations about clinical signs and symptoms of GER, but also possible factors, which can predispose to reflux. As well, the effects of anti-reflux therapy in groups of infants with different clinical pathology were analyzed.

Objective: To increase the relapse-free survival rate of patients with locally advanced cancer of the oral cavity, tongue and pharynx using concurrent chemoradiоtherapy with dynamic accelerated hyperfractionation with concomitant boost.

Materials and methods. A randomized, prospective clinical trial included 280 men with diagnosis of squamous cell carcinoma of the oral cavity, tongue and pharynx III and IVA, B stages. All patients randomized to the main and control groups. In the main group, radiation therapy was performed by dynamic accelerated hyperfractionation with concomitant boost. In the control group, the conventional chemoradiotherapy used.

Results. For a comparative analysis of the development of loco-regional relapses and relapse-free survival, we included 172 patients with a complete tumor response. In the main group, recurrences of the primary tumor developed in 8 cases, in regional lymph nodes – in 7 cases. In the control group, local recurrences detected in 16 patients, regional – in 13, and locoregional – in 16 patients. Statistically significant differences (p < 0.001) of 5-year relapse-free survival rate of patients of the main (58.2%±6) and control (21.9%±6) groups were revealed.

The conclusion. The chemoradiоtherapy with dynamic accelerated hyperfractionation with concomitant boost is an effective option for treatment of patients with locally advanced head and neck cancer. The use of this option leads to a decrease in the number of loco-regional relapses and an increase in relapse-free survival.

Patients with bicuspid aortic valve (BAV), including without hemodynamic disorders prone to the development of dilatation and dissection of the root and ascending aorta compared with patients with tricuspid aortic valve. The low prognostic value of currently used biomarkers of the risk of developing aortic dissection leads to the search for new methods for diagnosing early manifestations of BAV-associated aortopathy. The aim of the study was to evaluate the elastic properties of the aorta in patients with BAV using the method of two-dimensional speckle tracking echocardiography (first proposed in the Republic of Belarus as an instrument for assessing aortic function) in patients with BAV and aortic dilatation and without compared with patients with tricuspid aortic valve (TAV).
47 patients were examined (22 patients with BAV, mean age 44 years, 25 volunteers, mean age 44 years).
BAV-associated aortopathy was found in 100% of cases, characterized by an increase in aortic root size at all anatomical levels (mainly in the synotubular junction), accompanied in each case by dilatation of the aortic wall.
As an early marker for the development of BAV-associated aortopathy with a violation of the elastic properties of the aorta, a reduction in global circular deformation (9.8 (1.7)% vs 7.64 (3.9)%; p = 0.01) against the background of increased indicators of distensibility and stiffness of the aorta.

The article discusses the relevance of the problem, some information about approaches to the diagnosis, treatment and secondary prevention of patients with transient ischemic attacks (TIA).
This publication also presents the results of our own research on the provision of medical care to servicemen hospitalized at the State Institution “432 Orders of the Red Star, the main military clinical medical center of the Armed Forces of the Republic of Belarus” regarding TIA. The analysis of the results of clinical diagnostic studies, treatment tactics, secondary prophylaxis, and the solution of expert questions in this category of patients has been carried out.

The results of this study suggest that the cardinal violation in patients with obsessive-compulsive disorder is deviation from occurring in healthy people the evolution of their spatio-temporal model which occurs multiple daily recurrence of the individual space and time transformations. The latter manifests itself by stereotypical changes of characteristic clinical symptoms of this disorder. In patients consciousness respectively to tendency of individual spatial-temporal models symmetrization an ideal archaic sphere that defines the entire way of life of the patients and their mental functioning becomes the dominant.

Objective. Identify the clinical, laboratory, and instrumental manifestations of spondyloarthritis associated with Chlamydophila pneumoniae infection.

Materials and methods. Clinical manifestations, laboratory parameters and instrumental data of 21 patients with spondyloarthritis associated with Chlamydophila pneumoniae infection aged from 18 to 57 years. The average age of patients was 32.5±2.4 years. The average disease duration was 4,4±0,98 years. Diagnosis of Chlamydophila pneumoniae infection was carried out using 2 methods: real-time PCR in samples from the oral cavity, urethra, cervical canal, synovial fluid, as well as the detection of specific antibodies (Ig M, Ig A, Ig G) in the blood by ELISA. Data processing was carried out using MS Exel and Statistica 10 (serial number BXXR207F383402FA-V).

Conclusion. Infection Chlamydophila pneumoniae can be associated with both reactive spondyloarthritis and can be detected in patients with ankylosing spondylitis. Spondyloarthritis associated with Chlamydophila pneumoniae infection usually occurs in men (85.7%) of a young age (85.7%) and may manifest as a variant with a primary lesion of the peripheral joints, as a rule, of the lower extremities (p = 0.039). In the debut of the disease may lesion any part of the spine.

In patients with spondyloarthritis, Chlamydophila pneumoniae DNA is found in samples from the oral cavity (in 16 of 18 examined), synovial fluid (in 3 of 4 examined) and even in the genital tract (in 2 of 9 examined).

As the disease progresses, prevails the variant of spondyloarthritis with a primary lesion of the peripheral joints (p = 0.005), of which the large and medium joints of the extremities are most often involved in the inflammatory process (71.4%). Both with reactive spondyloarthritis and ankylosing spondylitis, the body can react to an infection in the form of fever, changing the color of the skin over the joints in the form of hyperemia or cyanosis, inflammation of the eye layers in the form of conjunctivitis, uveitis or iridocyclitis, periarticular tissues in the form of enthesitis, perichondritis, achilite and heel spurs.

The lesion of the small joints of the hands and feet in the debut of the disease distinguishes spondyloarthritis, associated with Chlamydophila pneumoniae infection, from spondyloarthritis, without association with infection. In general, spondyloarthritis associated with Chlamydophila pneumoniae infection, unlike spondyloarthritis, without association with infection, is characterized by recurrent febrile syndrome (p = 0.042), lesion of the metatarsophalangeal joints (p = 0.023), high laboratory activity of the disease and predominantly unilateral lesion of the sacroiliac joints (p = 0.021).

Peculiarity of the cognitive manifestations in patients with anorexia nervosa in the developed phase of the disease, as well as the dynamic variability of the anorexia syndrome within the structure of schizophrenia, determines the need for a differentiated approach to these clinical phenomena. The article presents the findings of a comparative pathopsychological study of women with anorexia nervosa and paranoid schizophrenia and highlights clinically significant characteristics of differential diagnostics. The patients, having given their informed consent, participated in a comparative cross-sectional single-step study with formation of the sampling by directional selection. The work provides a review of the literature containing peculiarities of pathopsychological studies of patients with anorexia nervosa and discusses the complexity of diagnostics of this nosology. The article argues that eating disorders often require dynamic observation and differential diagnosis with disorders of schizophrenic spectrum.

The period from 1995 to 2018 was characterized by an increase in the incidence of infectious mononucleosis in the Republic of Belarus of both the total population and individual age groups. In the groups of 0–2 years, 3–6 years and over 15 years, the perennial epidemic trends were the same in direction and similar in severity in the two analyzed periods, which indicates common factors that shape the incidence of this infection in these age groups. In the second period, the activity of factors forming the incidence of infectious mononucleosis decreased. In the group of 7–14 years in the second period (in comparison with the first), a more pronounced tendency towards an increase in the incidence was revealed, which indicates an increase in the activity of constantly acting factors and determines the need to intensify preventive measures in this age group.

Bicuspid aortic valve (BAV) is one of the most common and heterogeneous congenital heart diseases, affecting approximately 0.5–2% of the population, often manifested by associated aortopathy. Of scientific interest is the search for new biomarkers reflecting the pathophysiological process in the vascular wall as a prediction of its dilatation in order to prevent a life-threatening condition.
The aim of the study was to clarify the predictive role of galectin-3 as a potential biomarker of the aneurysmal transformation of BAV-associated aortopathy.
47 patients were examined (22 patients with BAV, mean age 44 years; 25 volunteers, mean age 44 years). The measurement of the serum level of galectin-3 was carried out using an ELISA kit (Galectin 3 ELISA Kit). It has been established that an increased serum level of galectin-3 in patients with BAV-associated aortopathy may serve as a serological marker indicating a poor prognosis, accompanied by an increase in the size of the aorta diameter.

The purpose of this work: to study the peculiarities of the neuro-reflex regulation of the morphofunctional state of the small intestine under the influence of superluminal blood laser irradiation in the complex treatment of experimental ethanol intoxication. The work is devoted to fundamental medical and biological research, which allows to understanding the importance of laser stimulation in the complex treatment of ethanol intoxication.Experimental pathogenetic reasonable application of laser stimulation initiates the activation of adaptive processes, which is expressed by the motor function of the small intestine on day 3 after treatment with ethanol intoxication. The results obtained in the course of experimental studies, according to the integrity of the pathogenetic concept of ethanol intoxication, allow a differentiated approach to the application of the supernatural laser irradiation of blood in the complex treatment of this pathology.

The article presents the results of a study of metabolic parameters in the blood of patients with primary liver cancer: aspartat aminotransferase (AsAt), alanine aminotransferase (AlAt), γ-glutamyltranspeptidase (GGT), haptoglobin, bilirubin, albumin, cholesterol, activated partial thromboplastin time (APTT), international normalized relationship (INR). Blood plasma and whole blood of patients with primary hepatocellular carcinoma (HCС), patients suffering from cholangiocellular carcinoma (CСС) and clinically healthy individuals in the control group served as the material for the study. Results were expressed as median [25%-75%].
Patients with primary HCC and CCC have signs of violation of hepatocyte integrity (increased transaminase, GGT activity) and reduced metabolic ability of these cells (increased concentration of bilirubin, haptoglobin, reduced albumin, cholesterol). These changes are more pronounced with HCC (AsAt – 48.0 [33.2–69.4] U/l, control – 20.8 [19.0–28.0] U/l; AlAt – 46.5 [24.0–76.2] U/l, control – 18.6 [13.3–22.1] U/l; GGT – 125.5 [78.7–203.1] U/l, control – 17.0 [14.0–23.3] U/l; bilirubin – 16.9 [13.5–24.1] μmol/l, control – 9.8 [7.0–14.2] μmol/l; haptoglobin – 1, 29 [0.4–1.9] g/l, control – 1.0 [0.9–1.5] g/l; albumin – 37.0 [32.2–41.0] g/l, control – 44.0 [42.0–46.0] g/l; cholesterol – 3.8 [3.1–4.7] mmol/l, control – 4.9 [4.3–5.6] mmol/l). The presence of cirrhosis in patients with HCC significantly aggravates the above-mentioned changes. This is demonstrated in the blood plasma of such patients by a higher activity of AsAt (66.8 [47–140.0] U/l) and bilirubin level (25.5 [16.7–51.1] μmol/l), and also a lower total cholesterol concentration (3.5 [3.1–4.5] mmol/l). The decrease in albumin concentration in the blood plasma of patients with primary HCC is associated with the stage of the disease (R = – 0,453). According to the ROC-analysis, its definition can be used as an auxiliary indicator for diagnosing the degree of tumor development in the liver in primary cancer. The diagnostic efficiency of the model is 72%.

The article presents the original complex method of repairing soft tissue defects in the region of the distal segment of the lower extremity (lower third of the leg, ankle joint, foot) with an anatomical rationale for the possibility of its implementation and the features of operational techniques.

A total of 364 practically healthy young people of both genders at the age 22.8±0.56 years old were investigated: medical students of the BSMU with average physical activity (220 persons) and students of the BSUFC, who regularly engaged in physical culture and sports (144 persons). The questionnaires about health conditions and blood pressure (BP) measurements during a few days were used in every person; on individual series of the BP values the hemodynamic phenotypes were defined. The analysis of the phenotypes prevalence and their characteristics was made in students with different levels of physical form, as well as in athletes involving in different groups of the sport. Harmonic phenotype (norm) was in 64.5% of BSMU students and in 74.3% of BSUFC students, others participants had borderlines phenotypes and dysfunctional ones, the most frequent of them was diastolic dysfunction type – 16.4% (BSMU) and 13.2% (BSUFC). It has been shown that regular employment by physical culture and sports have been reflected in phenotype as decrease of the indicator of heart propulsive work and an increase the of the “peripheral heart“ work in the hemodynamic process. Therefore an increasing in physical activity is the main way for correction of dysfunctional phenotypes, especially of diastolic ones which is related with “hypertrophied” heart function in the hemodynamic process.

Relevance. The issues of complex treatment of acute cholangitis are relevant for modern medical science and require further research in an experiment on laboratory animals.

Purpose. Optimization of the method of modeling acute cholangitis in experimental animals for the study of photodynamic therapy of this pathology.

Research methods. This review presents various ways to model acute cholangitis in experimental animals. Analyzed the fundamental work on experimental surgery of acute cholangitis of domestic authors.

Results and its discussion. Analyzed models of acute cholangitis allow us to study various aspects of the pathogenesis and treatment of this disease. We have developed a method for modeling cholangitis, which allows to introduce into the lumen of the bile duct drugs and optical fibers of laser devices, to simulate both internal and external drainage of the bile duct after the development of cholangitis.

Findings. The developed method of modeling acute cholangitis allows to study the effectiveness of photodynamic therapy of acute cholangitis with various photosensitizers.

Autoimmune liver diseases are characterized by immune-mediated damage to liver structures of varying severity. Conditions at which symptoms of two different autoimmune liver diseases are simultaneously detected are referred to as cross-over syndromes. Autoantibodies can be detected in serum of people with autoimmune liver diseases. The diagnostic spectrum of those diseases is reflected in the article of the same name by the authors [12].
Chronic autoimmune hepatitis can develop gradually. Clinical manifestations can be from asymptomatic to severe in combination with extrahepatic lesions. There are several subtypes of autoimmune hepatitis associated with different HLA phenotypes, which affects the clinical manifestations. The Paris criteria for the diagnosis of autoimmune hepatitis in combination with cholestatic liver damage are given. Covered issues of drug damage to the liver and induced autoimmune hepatitis, the difficulties of their differential diagnosis. Given the current understanding of autoimmune IgG4-associated cholangitis, HISORtcriteria, questions of differential diagnosis with primary sclerosing cholangitis.
The treatment tactics for autoimmune diseases of the liver is described taking into account the clinical protocol of the Ministry of Health of the Republic of Belarus and the recommendations of the European Association for the Study of the Liver.

The review presents updated Guidelines for the management of arterial hypertension, adopted at the congress of the European Society of Hypertension in June 2018, and then at the annual congress of the European Society of Cardiology in August 2018. Of particular interest are various questions about the features of the treatment of arterial hypertension in certain clinical situations. In the new version of the Recommendations, many of the positions presented in the document to the professional community are contradictory, despite the extremely high level of evidence.

Improved visualization methods provide the necessary anatomical and spatial information in patients with complex cardiac anomalies. 2-dimensional imaging may be limited in its representation of true 3-dimensional relationships. The use of 3D printing has expanded the possibilities of creating physical models that overcome the limitations of the 2D screen. Many researchers have reported on the use of 3D printing for preoperative planning in patients with different causes of heart failure. This article aims to review the innovative uses of this technology in creating individualized models to improve the quality of treatment.

Cases of tick-borne encephalitis often have atypical characteristics that make it difficult for a practitioner to make a diagnosis. The risk of misdiagnosis in such patients is obvious, given the severity and possible fatal consequences. In this case, high-tech methods of neuroimaging may be ineffective.
Meanwhile, the correct and timely clinical diagnosis based on a multidisciplinary approach to patient management tactics significantly affects the positive outcome of the disease. The authors of the article share their experience with colleagues about how they managed to arrive at a diagnosis. Clinical cases of tick-borne encephalitis occurring under the masks of acute respiratory infection, gastroenteritis and psychotic disorder are presented.

Primary hyperaldosteronism is one of the most frequent causes of symptomatic arterial hypertension. This case illustrates special features of the course and diagnostics of PHA. Early diagnosis will rid patient from hypertension or will make its course milder which will let minimize the risk of development of complications.

An original data of the some immune status indexes of patients with various stages and integral groups of COPD risk is resulted in the article.

Inflammatory diseases of the external ear are common among children and adults and constitute 17 percent of the Otorhinolaryngologic Diseases. It can progress to the inflammation of the auricle, middle and inner ear, salivary gland, scalp and cause meningitis and otogenic brain abscesses if symptoms and treatment are ignored. In this article we provide an analysis of actual data about acute otitis externa and describe etiology, pathophysiology, comparative study of the clinical signs and symptoms, therapy in adults and children. Significant seasonal variation in otitis externa was being revealed. The major causative agent this disease are Ps. Aeruginosa and Candida albicans. We analyzed specificity of therapy acute otitis externa in adults and children. This information are important not only for otorhinolaryngologists but also for other specialists particularly pediatricians and general practitioners.

Pathology of fatty suspensions of the colon, according to the literary analysis, amounts to 0.3% of all acute diseases of the abdominal cavity. The rarity of this pathology and the absence of pathognomonic signs makes diagnosis difficult. In a retrospective study of a clinical series of cases on the basis of the 1st surgical department of a public institution "432 Order of the Red Star, the main military clinical medical center of the Armed Forces of the Republic of Belarus" in the period from 2012 to 2017, we analyzed the case histories of 34 patients with the disease fatty appendages. The majority of patients treated in the 1st surgical department of “432 orders of the Red Star is the main military clinical medical center of the Armed Forces of the Republic of Belarus” were male patients (91,17%). The treated patients were of working age (the average age of the patients was 42,4 years). Most of the patients complained of pain without clear topographic localization and various complaints of a general nature, which confirms the presence of nesphyphy of the manifestation of this pathology. When studying the indicators of the constitutional status of patients, it was found that 82,4% were overweight or obesity of varying degrees. All patients underwent diagonoscopic laparoscopy for the final diagnosis and surgical treatment. 61,7% of patients did not have any abnormalities in general clinical blood analysis. The absence of signs of intoxication syndrome can also give doctors a prerequisite for a false diagnostic search and lead to a differential error. Based on the foregoing, there is a need for a thorough differential diagnosis of this pathology, which is not always successful.