Duplication of the gastrointestinal tract is a rare congenital malformation that can occur throughout the length of the digestive tract. The duplication of the colon on a long section connected with the light of the digestive tract is a relatively rare form of gastrointestinal tract duplication. This defect is a difficult diagnostic and therapeutic problem due to non-characteristic symptoms. Imaging diagnostics allows to correctly recognize gastrointestinal duplication in only 25% of cases. The authors present the case of a girl who was hospitalized many times at the Department of Pediatric Surgery due to recurrent abdominal pain of various types character. Variable clinical symptoms and diagnostic difficulties have caused delay in making a diagnosis of tubular double colon. The final diagnosis was made only after two computed tomography, which was performed due to the rapidly deteriorating and unclear patients condition. The postoperative period after resection of the double intestine proceeded with a wide spectrum of complications that required long-term hospitalization. Duplication of the colon is a difficult diagnostic problem. Non-characteristic symptoms and unclear imaging results delay the diagnosis and expose the patient to complications.
Introduction:The current trend in adnexal surgery in children is to minimize the invasiveness of diagnostic and therapeutic procedures, reduce the number of complications and reduce the risk of infertility. Aim: Evaluation of the usefulness and effectiveness of laparoscopy in diagnostics and treatment of pathological lesions of adnexa in the pediatric population and evaluation of the correlation of imaging with the intraoperative diagnosis during laparoscopy. Material and methods: The study included 89 patients aged 0-18 years (mean: 12.62) who underwent an emergency or elective laparoscopic procedure due to the suspicion of adnexa pathology in the imaging tests or in which intraoperative pathology of the adnexa was found without previous suspicion of these changes in the imaging tests. Patients were divided into 2 groups according to the procedure (emergency or elective) and into 4 age groups. Results: The most frequent postoperative diagnosis was an adnexal cyst and ovarian tumor. The ratio of malignant to benign lesions was 0.087. In 32.58% of patients appendix pathology was found. Coexistence of adnexa and appendix pathology was statistically significantly more frequent in patients undergoing emergency surgery (p = 0.013). There was no correlation between the size of the tumor or ovarian cyst and the occurrence of adnexal torsion, and no correlation between the size of the tumor and the degree of torsion of the adnexa. Three conversions were performed. The average operation time was 63.7 min. Conclusions: Laparoscopic diagnosis and treatment of adnexal pathology seems to be safe due to the low percentage of perioperative complications. It shows high sensitivity in recognizing adnexal pathologies and other defects.
Paediatric and adolescent gynaecology is a narrow field of medicine dealing with the diagnosis of and treatment of gynaecological diseases from the neonatal period to sexual maturity. The current trend in surgical gynaecology in the paediatric population is to minimise the degree of invasiveness of diagnostic and therapeutic procedures. This contributes to reducing the number of complications and the risk of infertility. Laparoscopic procedures are a challenge for paediatric surgeons and gynaecologists, not only because of the age of treated patients, and anatomical and physiological differences between different age groups but also because of the complexity of the pathology, the differentiation of cancer tumours, and the presence of congenital developmental defects.
Introduction: Fibromatosis is a very rare desmoid tumour. It is characterised by local invasion and infiltration of close structures. The treatment is mainly surgical. Material and methods: We report the case of 1.5-year-old boy admitted to the Paediatric Hospital, with a diagnosis of mediastinal desmoid fibromatosis. He was treated surgically (thoracoscopy and thoracotomy), chemotherapy was used, and he was hospitalised in the Intensive Care Unit more than once. Despite intensive treatment, the patient perished. Results and conclusions: Fibromatosis is classified as a desmoid tumour. Rare tumour localisation and invasive tumour characteristics causes considerable difficulty in the diagnosis, despite the use of many diagnostic methods.
WstępRak jelita grubego (<i>colorectal cancer</i> – CRC) jest jednym z najczęstszych nowotworów na świecie – odpowiada za 10% rocznej globalnej zapadalności na raka. Przez długi czas może pozostać bezobjawowy i mimo postępu medycyny zbyt często zostaje zdiagnozowany za późno. Białko YKL-40 jest czynnikiem wzrostu stymulującym migrację komórek śródbłonka, odgrywającym rolę w stanach zapalnych oraz nowotworowych. Celem pracy była ocena znaczenia YKL-40 jako biomarkera w CRC oraz określenie powiązań stężeń YKL-40 w surowicy u chorych na CRC z wybranymi parametrami kliniczno-patologicznymi.Materiał i metodyW badaniu prospektywnym, obejmującym 133 osoby powyżej 50 roku życia, oznaczono stężenie białka YKL-40 w surowicy metodą ELISA. Pacjentów podzielono na dwie grupy: 91 osób chorujących na CRC oraz 42 osoby zdrowe. W analizie statystycznej wykorzystano testy t-Studenta dla danych niezależnych, U Manna-Whitneya i regresję logistyczną.WynikiStężenie YKL-40 w surowicy było znacznie wyższe u chorych na CRC (163 ± 36 μg/l) niż u osób zdrowych (54 ± 20 μg/l; p < 0,0001). U osób z CRC nie wykazano zależności między parametrami klinicznymi, tj. płcią, wiekiem i wskaźnikiem masy ciała (<i>body mass index</i> – BMI), a stężeniem białka YKL-40 w surowicy. U chorych z CRC stężenie YKL-40 w surowicy statystycznie istotnie różniło się we wczesnym i średniozaawansowanym stadium nowotworowym.WnioskiBiałko YKL-40 wydaje się obiecującym biomarkerem CRC. Jego stężenie w surowicy jest skorelowane ze stopniem zaawansowania nowotworu zależnie od głębokości nacieku w stosunku do błony podśluzowej i może być czynnikiem rokowniczo niepomyślnym dla tego nowotworu.
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