Omental torsion as a possible cause of acute abdomen.

Primary torsion of large omentum is a rare cause of abdominal pain. The knowledge of this disease is essential for surgeons. It plays an important role in differential diagnosis of acute abdomen. The authors present two cases of primary omental torsion. They describe the diagnostic and therapeutic process. Diagnosis of omental torsion is difficult. Frequently, it presents with abdominal pain and imitates other acute abdominal diseases such as acute appendicitis in most cases. It is difficult to diagnose before surgical revision is approached. Laboratory and paraclinical examinations may not provide any clear findings. Laparoscopic revision is the method of choice, with confirmation of the diagnosis and laparoscopic resection of the ischemic part of omentum.

[Mechanical ileus as a result of scar tissue stenosis of the small intestine]. / Mechanický ileus jako následek jizevnaté stenózy tenkého streva.

INTRODUCTION: Ileus accounts for about 20% of all acute abdomen onsets. Etiologically and clinically, it is a very heterogeneous group of diseases. The presented case report shows other possible causes of ileus. CASE REPORT: The authors present a case of mechanical ileus in a 40 years old female admitted and operated due to mechanical ileus. Preoperative imaging methods and the postoperative finding showed stenosis of the small intestine. This finding was resolved by resection of the stenotic part of the intestine. Chronic inflammation, heterotopic gastric mucosa and mucosal ulceration were described based on histology. DISCUSSION: In the presented case, the authors discuss the etiology of intestinal stenosis. The authors consider as a possible cause blunt abdominal trauma or an ulcerogenic lesion in the terrain of heterotopic gastric mucosa. CONCLUSION: The diagnosis and treatment of ileus conditions are well known to all surgeons. The presented case report discusses other possible causes of mechanical ileus.

[Large intestine bleeding caused by the lienal artery pseudoaneurysm rupture complicating a pancreatic pseudocyst]. / Krvácanie do hrubého creva spôsobené ruptúrou pseudoaneuryzmy arterie lienalis komplikujúcej pankreatickú pseudocystu.

Bleeding pseudoaneurysm of a peripancreatic artery is a rare cause of gastrointestinal haemorrhage. Arterial pseudoaneurysm develops as a result of partial enzymatic damage of arterial wall in acute or chronic pancreatitis. The authors report the case of a 60-years old man with bleeding into the lienal flexure of the colon due to the erosion of the pseudoaneurysm of a branch of splenic artery into the pancreatic pseudocyst in the tail region of the pancreas communicating with the colon. The diagnosis was established by CT-scan and angiography. The patient underwent surgery with the ligation of the bleeding vessel and the resection of the part of the colon.