Primary retroperitoneal mucinous cystadenocarcinoma in pregnancy - case report.

INTRODUCTION: Primary retroperitoneal mucinous cystadenoma (PRMC) and its malignant variant - cystadenocarcinoma are extremely rare tumors known only from case studies and reviews. PRMC is a cystic tumor of the retroperitoneum, which remains asymptomatic for a long time and can reach significant proportions. It occurs mainly in women. CASE REPORT: We present the case of a 38-year-old healthy woman with diagnosed resistance in the right mesogastrium during a c-section. The delivery was terminated without a surgical intervention. The above mentioned resistance was examined further by ultrasound, computed tomography and magnetic resonance imaging. All imaging examinations showed a solid - cystic bilocular expansion, which looked like a mesenteric cyst in the right paracolic area. The patient was asymptomatic at all times, with only a palpable resistance of the abdominal wall. In November 2020, the patient underwent an elective surgery - extirpation of the cystic tumor and prophylactic appendectomy. The operation was performed classically, via midline laparotomy without perioperative perforation of the cystic tumor and without complications in the postoperative period. The histopathological examination showed a malignant variant of PRMC. So far, the patient remains free of any problems and is followed at the department of oncology. CONCLUSION: The goal of treatment is to achieve complete surgical removal of the tumor without its perioperative perforation. Due to the rare occurrence of the disease, there are no guidelines for the diagnosis and treatment of PRMC. Precisely because PRMC is a rare tumor, it should be part of the differential diagnosis of cystic tumors of the retroperitoneum, especially when young women are concerned.

Perforation of descending colon diverticulum by swallowed rabbit bone - a case report.

Authors present a case of a 58-year old pacient that underwent acute surgery for perforation of descending colon diverticulum by swallowed rabbit bone. The thesis focuses only on foreign bodies swallowed by adult patients. Comprehensive spectrum of foreign bodies that have entered the digestive tract in another way is omitted.

[Invagination in an adult as a rare cause of acute abdomen - 2 case reports]. / Invaginace u dospelého jako vzácná prícina náhlé príhody brisní - 2 kazuistiky.

The authors present two cases of intestinal invagination in adult patients. The first case is an 84-year-old polymorbid female patient indicated for acute surgical revision due to ileus with a finding of invagination in the sigmoid area, with no evidence of an organic cause. The second case, an 80-year-old polymorbid female patient, was indicated for acute surgical revision also due to ileus with a finding of invagination on the small intestine and with a proven neuroendocrine tumor. Unlike invagination in childhood where its cause is usually unknown[1,7], intestinal invagination is relatively rare in adults and it is mostly due to an organic cause, most frequently a benign tumor of the small intestine[2]. This study focuses on invagination as a rare cause of acute abdomen in adult patients.Key words: invagination - ileus - idiopathic.

[Abdominal actinomycosis - 3 case reports and literature overview]. / Brisní aktinomykóza - 3 kazuistiky a prehled literatury.

The authors present three cases of abdominal actinomycosis that were initially diagnosed as acute appendicitis, an abscess in the left groin and pelvic tumour, probably of gynaecological origin. Definitive diagnosis of abdominal actinomycosis was established as late as postoperatively. Abdominal actinomycosis is a chronic, infectious disease characterized most frequently by non-specific symptoms such as abdominal pain, fever, vomiting, bowel obstruction, weight loss, sometimes palpable resistance, and leukocytosis [1-9]. Diagnosis may be difficult and needs to be taken into account, especially in patients with risk factors.

[Laparoscopic appendectomy in pregnancy - a case report]. / Laparoskopická apendektomie u tehotných - kazuistika a prehled literatury.

The authors present a case of a 25- year- old pregnant patient diagnosed with acute appendicitis, indicated for laparoscopic appendectomy based on a consultation with gynecologists. No complications occurred during postoperative recovery and the patient was discharged on the fifth postoperative day, vital fetus with normal development. This case review points out a rarely discussed topic of laparoscopic appendectomy in pregnant women as a safe alternative to open surgery. Appendicitis is one of the most common indications for surgery during pregnancy. Appendicitis in pregnancy represents a challenge for a surgeon, both in terms of diagnosis as well as treatment and choice of surgical approach.

[Pain following laparoscopic inguinal hernioplastics using the TAPP technique]. / Bolesti po laparoskopické inguinální hernioplastice technikou TAPP.

INTRODUCTION: Postoperative inguinodynia belongs among referred complications of laparoscopic hernioplasty. Its frequency varies from 0.2% to 4.4% according to the literature. METHODS AND CLINICAL MATERIAL: 223 Laparoscopic operations of groin hernias in 201 patients were performed on the surgical department in Chrudim since the 1st January 2003 to the 31st December 2004. All patients were treated by TAPP technique. RESULTS: All patients with laparoscopic hernioplasty were checked the first day after the laparoscopic procedure, and on the day of dimissal. They were then invited to follow-up examination in the interval of 10-14 months. They filled up the questionnaire. 174 Patients were checked, (i.e. 86%) and 4 of them suffered from inguinodynia which represented 2%. DISCUSSION: The authors focus on causes, diagnostic and treatment possibilities of postoperative inguinodynia after laparoscopic groin hernioplasty. CONCLUSION: The possibilities of prevention of postoperative inguinodynia after laparoscopic groin hernioplasty are listed in the conclusion.

[Laparoscopic cholecystectomy using the ultrasonic scalpel versus standard coagulation]. / Laparoskopická cholecystektomie s ultrazvukovým skalpelem versus s pouzitím klasické koagulace.

The authors compare the results of using classical monopolar electrocoagulation with ultracision during laparooscopic cholecystectomy. The results from the 5 surgery departments in the Czech Republic are elaborated.

[Preemptive antimycotic therapy in critically ill patients]. / Preemptivní antimykotická terapie kriticky nemocných.

This article presents the results of the first year of the grant study that deal with preemptive treatment of yeast infection in surgical ICU. This research included patients with a large number of risk factors (ten and more). These risk factors indicated in the chart. 147 patients reached a score of ten and more points. This number was divided in two groups. In the first group there were 87 patients who received treatment of itraconazol by prescribed scheme. They were hospitalized in ICU for 11.6 days, on average. The first group did not display any positive hemoculture and also other microbial culture from intravenous cannula. No patients fell from ill candida sepsis. Itraconazol was not administered to the 60 patients, who were hospitalizated 11.8 days, on average. Positive hemoculture or yeast sepsis with connection invasive yeast infection was proven in six cases (10%). No patient died in direct connection with yeast infection in either groups. The presented results show a reduction in the number of developing yeast infections and mainly yeast sepsis in patients undergoing preemptive treatment with itraconazol.

[Antibiotic therapy in surgical intensive care units]. / Lécba antibiotiky na chirurgické JIP.

The authors describe contemporary therapeutic procedures of ATB treatment at surgical ICUs. In conjunction with prophylactic administration they describe its indications, selection of ATB and period of administration. They discuss the necessity to start antibiotic treatment which is at first empirical and aimed after the results of cultivation examinations are available.

[Quality of implants for correction of hernia defects]. / Kvalita implantátu pouzívaných ke korekci defektu pri resení kýl.

The use of implants in the correction of defects of the abdominal wall is not new in surgery. At present in conjunction with the development of the surgical technique and the development of new materials their use is even more frequent. The properties of implants differ, therefore the selection of suitable material is important.

[Classical versus laparoscopic plasty of inguinal hernias]. / Klasická versus laparoskopická plastika kýly v oblasti trísla.

Operations of hernias in groin area are frequent. They account for 7-10% of all operations in surgical departments. The surgical solution of inguinal hernias is not simple. There exist many correction techniques. At present there is moreover a laparoscopic approach. The aim of the present study was to compare the results of inguinal hernias operated using conventional and laparoscopic techniques on the surgical department of the Pardubice Hospital during 1997-1998. We focused attention on the incidence of peroperative and postoperative complications and reconvalescence period.

[Testing of implants used in the correction of abdominal wall defects in hernia surgery]. / Testování implantátu vyuzívaných ke korekci defektu brisní steny pri operacích kýl.

The aim of this study is experimental testing of various kinds of meshes. They are used for correction of abdominal wall defects during operations of hernias (especially by the laparoscopic technique). The following implants were tested: Goretex, Prolen, Mersilen and Vicryl. Each of them represents one group of artificial materials (nonabsorbable, monofilaments multifilament, absorbable) which are usually used. Semiabsorbable materials were not tested because they are not usually used. The objects of testing were firstly constant quality of implants lasting in the time and secondly the reaction of tissues after implantation of those materials.

[Congenital diaphragmatic cyst in a child]. / Vrozená bránicní cysta u dítete.

The case of 8-year-old boy with congenital diaphragmatic cyst is presented. The aspects of the origin of this anomalies, the surgical finding and the method of the reconstruction of diaphragma are described.