Teratomas are tumors originating from the three primary germ layers, most commonly located within gonads or in the sacral region. Chest locations are rare. Mediastinal teratoma showing no tumor-specific symptoms may be treated as exudative pneumonia. The goal of the article was to present a case encountered in our practice as a showcase of possible diagnostic problems and errors. Despite a thorough medical examination with additional exams (ultrasound scans of pleural cavities, chest X-ray and laboratory analyses), the diagnosis of a thoracic tumor was made only after chest computed tomography scan was performed following ineffective attempts at antibiotic therapy and pleural drainage. Following the diagnosis of mediastinal tumor, the patient was subjected to surgery. A giant teratoma (confirmed in histopathological examination) was removed upon left-sided thoracotomy. Following the procedure, lung expansion and patient recovery were observed. Computed tomography of the chest should be performed routinely upon encountering difficulties in the treatment of exudative pneumonia in children. In every case of pneumonia with pleural effusion in children, inflammatory mask of mediastinal tumors should be ruled out.
Percutaneous endoscopic gastrostomy (PEG) was performed for the first time in the world on 12 June 1979. At present, the method of using gastrostomy has almost entirely superseded classical methods, which is related with its simplicity, lower costs, lack of need for hospital stay (PEG is often placed in ambulatory conditions) or a shorter period of hospitalisation, as well as a smaller number of complications compared to classical methods. The indications for gastrostomy are possibilities of feeding directly into the gastrointestinal tract, avoiding the oral cavity, throat, and oesophagus (for various reasons), or decompression of the gastrointestinal tract in the case of its obstruction as a palliative procedure. Gastrostomy may be performed by a classical open technique or by laparoscopic or endoscopic methods. Percutaneous endoscopic gastrostomy is the most common form of gastrostomy. StreszczeniePrzezskórna gastrostomia endoskopowa (PEG) została wykonana po raz pierwszy na świecie 12 czerwca 1979 r. Obecnie endoskopowe zakładanie gastrostomii prawie całkowicie wyparło metody klasyczne ze względu na prostotę, niższe koszty, brak konieczności pobytu w szpitalu (często PEG zakłada się ambulatoryjnie) lub krótszy okres hospitalizacji, a także mniejszą liczbę powikłań niż w przypadku metod klasycznych. Wskazaniami do gastrostomii są żywienie poprzez przewód pokarmowy z ominięciem jamy ustnej, gardła i przełyku (z różnych przyczyn) lub odbarczenie przewodu pokarmowego przy niedrożności przewodu pokarmowego jako postępowanie paliatywne. Gastrostomia może być założona metodą klasyczną, laparoskopową lub endoskopową. Przezskórna gastrostomia endoskopowa jest najbardziej powszechną formą gastrostomii.
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