To compare epidemiological analysis concerning sex, age, location of blockage, and frequency of occurrence of etiological factors in 2 groups of patients treated for mechanical bowel obstruction 100 years apart. Design: Epidemiological analysis of patients undergoing an operation for small-bowel obstruction (SBO) or large-bowel obstruction (LBO) from 1868 to 1898 (group 1) and from 2000 to 2003 (group 2). Setting: Second Clinic of Surgery of the Jagiellonian University Medical College. Patients: One hundred ninety-three patients in group 1 and 207 in group 2. Main Outcome Measure: Change in demographic and etiological patterns of mechanical bowel obstruction during the past 100 years. Results: In both groups, the prevalence of bowel obstruction was similar in particular segments of the intestine (approximately 75% for SBO and 25% for LBO). The primary cause of SBO in group 2 remained incarcerated abdominal hernia (30.8% for group 1 compared with 55.0%). The second most common cause of SBO was intraperitoneal adhesions (29.4% compared with 34.4%). Isolated small-bowel volvulus as the cause of bowel obstruction decreased significantly (PՅ.05) (16.8% compared with 2.7%). Significant changes were also observed in the etiology of LBO. A century ago, the most common cause was volvulus of the sigmoid colon or of the cecum (72.0%); in the later group, obstruction was caused by cancer in 80.4% of cases. Conclusions: During the past 100 years, no changes were observed concerning the location of bowel obstruction or the patients' sex. Etiological factors in SBO and LBO changed significantly. The age of surgical patients also increased significantly.

BackgroundThroughout recent decades there has been noticeable change in the incidence of peptic ulcer disease and its complications. The aim of the present study was to determine the character of changes over the last 45 years in the localization of perforation, in patient age, and in patient gender.MethodsA group of 881 patients admitted to the Second Department of General Surgery in Krakow, Poland, from 1962 to 2006 were included in the study and constituted the material for the analysis. The study was divided into three time periods (1962–1976, 1977–1991, and 1992–2006) to allow statistical analysis of trends.ResultsThe general incidence of perforations of peptic ulcer did not show changes; however, the percentage of women with perforated duodenal ulcer markedly increased. Patients with perforated stomach ulcer—regardless of gender—and females suffering from perforated duodenal ulcer were, on the average, about 10 years older than males with perforated duodenal ulcers. The mean age of male and female patients with perforated duodenal ulcer over the last 45 years showed an insignificant upward trend.Conclusions(1) The percentage of women with perforated duodenal ulcer continuously and statistically significantly rose. (2) Men with perforated duodenal ulcer were significantly younger than other patients. (3) The mean ages of male and female patients with perforated duodenal ulcer over the last 45 years showed an insignificant upward trend.

SummaryBackgroundA persistent sciatic artery (PSA) is a rare vascular anomaly with an estimated incidence of 0.02–0.04% and with a high rate of complications such as aneurysm formation, thromboembolism, and ischemia, that may lead to amputation.Case ReportWe present a case of a female patient with complete symptomatic ambilateral PSA and with unilateral aneurysm. The aneurysm was excised and the PTFE graft was interposed at the aneurismal sac (femoro-popliteal bypass could not be performed because of the high degree hypoplasia of the superficial femoral artery). The graft endured continuous compression and stretching during regular daily life of the patient. At check-up 18 years after the operation, the Doppler ultrasound showed a patent graft and no new aneurismal dilatation of the sciatic artery.ConclusionsTo our knowledge the follow-up of the presented case is the longest reported so far in the literature. The uneventful course of the patient confirms that classical aneurysmectomy still constitutes one of the treatment options of PSA aneurysm.

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