[Neurofibroma of the small intestine as a cause of massive bleeding from the gastrointestinal tract]. / Neurofibroma jelita cienkiego przyczyna masywnego krwawienia z przewodu pokarmowego.

Two cases of neoplastic tumors of small intestine, operated on because of acute abdominal signs, were described. In both cases, before ultimate surgical treatment, chronic gastro-intestinal bleeding and ileus were observed. None of routine diagnostic procedures (endoscopy and angiography) diagnosed the disease. It was the radiological contrast examination of small bowel, that solved the problem. For the reason, that neoplastic tumors of small intestine are extremely rare and symptoms are not specific, results of treatment were described. Also the mistakes in diagnostic process were analysed. Malignant lesions are very rare and they are not symptomatic, those are the reasons of delayed surgical treatment. Moreover, they are more common in older age (over 60), that makes the invasive diagnostics even more difficult because of general condition and additional loads, e.g. atherosclerosis or circulatory and respiratory failure. Literature survey underlines the fact, that difficulties in the diagnostics process lead to developing of advanced stages of neoplastics disease, which are treated because of massive bleeding ileus. Often patients are hospitalized many times before the ultimate surgery, but are discharged without right diagnosis. Therefore the retrospective analysis of our cases can be useful in future for the proper interpretation of clinical signs.

[Abrikosov's tumor of the esophagus]. / Guz abrikosowa przelyku.

The authors are reporting a case of Abrikosov's tumor of the oesophagus (myoblastoma granulocellulare, granular cell tumor, GCT). Due to the rare incidence of these lesions, they are also presenting general state of knowledge on these particular tumors based on the literature, diagnostic methods and treatment.

[Glutamine--its metabolic role and possibilities for clinical use]. / Glutamina--rola w ustroju i mozliwosci zastosowania klinicznego.

Glutamine has been the point of interest of many nutritional studies concerning parenteral and enteral nutrition. Advantages from glutamine support have been observed previously in animal models. It was shown that glutamine is the energy source for rapidly dividing cells e.g. immune cells, gut mucosa. Recent molecular and protein chemistry studies have begun to define metabolic mechanism of glutamine action, and clinical trials suggest its safe and positive influence on catabolic patients. Parenteral and enteral nutrition enriched with glutamine improves gut integrity and function, decreases infection rate and improves function of immune cells. However, the indications for glutamine enriched nutrition and appropriate protocol of administration need determination. Taken together the data suggest that this amino-acid is an important dietary nutrient and is probably conditionally essential in certain catabolic conditions.