Methods helping the diagnosis of "acute scrotum" based on medical practice in our department.

Authors have analysed the case records of their patients admitted in the last 2.5 years. The color-doppler US is stated to be the most efficient method in differential diagnostics, but the conventional ultrasound + Doppler + scintigraphy can also help in establishing quick and reliable diagnosis as it has been proved in practice.

Rare case of the utero-vesical fistula caused by intrauterine contraceptive device.

The vesico-uterine fistula is a very rare disease. There have only been 150-200 causes. We are reporting on a case in which the chronic fistula was caused by an IUD having been placed 4 years ago and it "wandered" through the bladder. A 30 year-old patient in 1992 and IUD was inserted. She had gynecological controls twice, in 1993 last time. She has problem of urination very often. A cyclical bladder bleeding drew the attention to the disease. In ambulanterely performed cystoscopy we found an IUD perforating towards the interior of bladder in the borderline of its bottom and back wall and was situated in the bladder with its 3/4. We have removed it with forceps. After six weeks of expectation and strict observation did we want to manage the fistula after having consolidated the symptoms of the inflamed surroundings. During the operation we have noticed a wallment size mass of scar between the uterus and the bladder expanding to the height of the orifice of the uterus. The scarily fixed bladder has been separated from the cervix and the scarry wall of the fistula has been cut out. We have brained the cervix towards the vagina and then we've sutured the cervix and the bladder with Dexon 'O' treat, as well. We have interposed a surgical net between the cervix and the bladder followed by blood-clotting and peritonisation. We should take the follows into consideration: careful separation, fine operative technique, and strong well absorbing thread as well as trying to keep the organ. In our opinion the bioplast--interpositum used on our case maker the efficiency of the operation higher.

[Fournier gangrene (manifestation of anogenital necrotizing fasciitis)]. / Fournier-gangraena (a fasciitis necrotisans anogenitalis manifesztációja).

In connection with a typical case, clinical features of genitaly extended Fournier gangrene--its pathogenic factors and the standpoints of treatment--are demonstrated. This infection of foudroyant nature, going on with significant mortality is held to be a characteristic form of necrotizing fasciitis, constituting main manifestation of toxic shock-like syndrome. Attention is drawn to the fact, that in case of internal diseases, predisposing factors respectively-even by adequate therapy-outcome of the infection may be lethal nowadays as well.

[Percutaneous nephropexy]. / Percutan nephropexia.

We present a new, minimally invasive method for the treatment of nephroptosis. We are suggesting the more spreaded use of this method after the good results we found during the long term observation of our 40 patients with percutaneous nephropexy.

[Percutaneous transhepatic cholecysto-lithotripsy]. / Percutan transhepatikus cholecysto-lithotripsia.

Authors were the first in Hungary to perform the percutaneous transhepatic cholecystolithotripsy for the removing of gallbladder stones. The method can be performed easily with the necessary skill and it is not too troublesome for the patients. They present their beginning experience.