The wide antibiotics use in different areas of medicine has significantly increased the incidence of pseudomembranous colitis caused by Clostridium difficile. Strong necessity of antibacterial therapy in hematological patients is the reason of a higher frequency of this complication after programmed chemotherapy and hematopoietic stem cell transplantation. The atypical course of clostridial colitis makes it difficult to diagnose, leads to delay of treatment and fatal complications. We presented the case of clostridial colitis with atypical clinical manifestations in the 8-year-old child with Hodgkin’s lymphoma. Disease was complicated by colon perforation and fecal peritonitis, which required surgery and long-term rehabilitation. The analysis of publications devoted to clostridial colitis in patients with hematological malignancies was carried out and possible reasons of its atypical course was reviewed. The ways to improve the diagnosis, treatment and prevention of this serious complication are presented.

Relevance.Reliable and long-term venous access is one of the most important condition for a successful leukemia therapy in children. Safe and convenient access to a central vein allows to provide chemotherapy, adjuvant treatment, parenteral nutrition and blood transfusion. It decreases the likelihood of phlebitis development and reduction of the peripheral venous network in comparison with peripheral venous access. The use of totally implantable venous port systems reduces risks of severe complications associated with re-catheterization of the central vein thus it improves patient’s quality of life.The purpose of the studyis a retrospective assessment of the experience of use and analysis of the complications of totally implantable venous port systems in children with diseases of the blood system.Materials and methods.The data of 61 patients of the pediatric hematology clinic with venous port systems have been analyzed.Results.Perioperative complications developed in 3 (4.9 %) patients Median time of using of port systems was 679 catheter-days. Delayed complications requiring removal of the device developed in 8 (13.1 %) patients. Infectious complications were the reason for device removal in 3 (2.9 %) patients, mechanical complications in 5 (8.2 %) patients. No thrombotic complications were found.Conclusions.The use of venous port systems in children with hematologic diseases for a long period of time is an effective and safe way for central venous access providing.