Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti
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The study presents a rare isolated rupture of the gall bladder following a blunt abdominal injury. The diagnostics was complicated by inaccurate anamnestic data, because the patient was injured in the drunken state and could not remember it. ⋯ A possibility of the gall bladder perforation following blunt injuries of the abdomen must be considered mainly in younger patients with nonspecific abdominal pains. The risk increases after abuse of alcohol or after prolonged starvation.
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The most experienced surgeons should be called to conduct reoperations in the aorto-femoral region. It is always advisable to be aware of possible injuries to the urether and to prevent such cases by bandaging. A long-term follow-up of the patient in the same clinic, or at least consultation of his/hers condition helps to minimize any diagnostic hesitations as well as iatrogening harmings. Haemorrhaging aorto-enteric fistules must be surgically managed in clinics specialized in vascular surgery.
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Bezoars consist of swallowed foreign materials or indigestible organic matter and form a mass in gastrointestinal tract, usually in stomach. Trichobezoars are formed by swallowed hair, they are rare, and occur often in patients with psychiatric disorders. ⋯ Gastric trichobezoar with a tail reaching small intestine is called Rapunzel syndrom. Authors present a case of Rapunzel syndrome in a 13-year-old girl with only a short history of mild abdominal pain in who a gastric trichobezoar weighting 700g and measuring 24 x 16 x 10 cm was removed from laparotomy.
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Pneumaturia is sometimes the first symptom of colovesical fistula. Colovesical fistula presents a difficult problem with complicated diagnosis and therapy. ⋯ The paper reports the case of a 61-year-old man with diagnosis of diverticulitis and symptom of pneumaturia in duration of 3 months. The operation was successfully performed in cooperation with a surgeon and an urologist.
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The authors summarize ten years if their experience with the method of trans-anal endoscopic microsurgery (TEM). It has been used to treat 247 patients so far. The aim of the paper is to inform about the problems of solving the lesions of rectum employing the TEM method, a comparison with the application of other methods in this localization and the evaluation of this method after 10 years of practice.