Liver abscess as a rare complication of PEG.

INTRODUCTION: Percutaneous endoscopic gastrostomy (PEG) is one of the most effective methods of providing long-term enteral nutrition in patients with the impossibility of oral intake. Complications are relatively common. The most common is peristomal wound infection at the site of the insertion and leakage along the cannula. Lesscommon complications are colo-cutaneous fistulas and peritonitis. A very rare complication is liver abscess. CASE REPORT: The authors describe a case of a 51-year-old man with a hepatic abscess with inoperable pharyngeal carcinoma with PEG. The patient was admitted to hospital with a developing septic condition due to a liver abscess. The liverabscess resulted from the buried bumper syndrome of the PEG and subsequent complete dislocation of the bumper into the left liver lobe area.. This condition was treated by a surgical review with abscess drainage and the construction of classical gastrostomy. CONCLUSION: Buried bumper syndrome with its complications, such as a liver abscess is a relatively rare complication, but challenges both the diagnosis and therapy of the syndrome itself. Its management requires a close cooperation between a gastroenterologist and a surgeon. Early recognition and treatment can prevent the progression of the condition to sepsis or a septic shock, which can lead to death.

[Splenosis as a rare cause of abdominal pain]. / Splenóza ako zriedkavá prícina bolestí brucha.

INTRODUCTION: Splenosis is the autotransplantation of splenic tissue in atypical locations in the abdomen, chest or other parts of the body. CASE REPORT: Authors present a case of splenosis in a 35 years old woman hospitalized with abdominal pain, who underwent splenectomy for traumatic rupture with splenic tissue implantation in the omentum 19 years ago. Surgical revision was indicated for intensive pain. Histopathology confirmed the diagnosis of splenosis in the excised tissue. CONCLUSION: Despite the abandonment of splenic tissue autotransplantation after splenectomy, surgeons may still encounter the diagnosis of splenosis in patients after traumatic splenic rupture. Any incidental finding of splenosis during an operation for another indication should be sent for histopathology examination. KEY WORDS: splenosis, splenectomy abdominal pain scintigraphy.

[Cystic feochromocytoma, mimicing a liver cyst. A case review]. / Cystický feochromocytóm, imitujúci cystu pecene.

Cystic feochromocytoma is a special subtype of supraadrenal tumors, with a specific clinical course, symptomatology, CT and MRI pictures and histological findings. The above factors frequently contribute to a wrong diagnosis and increased risk during its surgery. The authors present a case review of a patient with a cystic tumor of the right liver lobe. Its laparoscopic fenestration attempt resulted in hypertonic crisis with cardial decompensation and lung edema. Furthermore, attempts to embolize the tumor resulted in another hypertonic crisis, despite of the preoperative care as appropriate in feochromocytoma procedures. Only complete surgical removal of the tumor relieved the patient of the clinical symptoms. The authors discuss diagnostic and therapeutical problems of this specific and rare feochromocytoma subtype and suggest radical surgical management following a standard preoperative care as appropriate in all feochromocytoma procedures.