Introduction: Obstruction of the appendiceal lumen is the primary cause of appendicitis. The most common causes of luminal obstruction are fecaliths and lymphoid follicle hyperplasia. Additionally, bacterial infections or enteric and systemic viral diseases can cause a reaction of the lymphoid follicle. Case presentation: An 11-year-old boy with active phase of chickenpox presented on our Pediatric surgery emergency department under the impression of acute appendicitis. An appendectomy was performed on the same day. An inflamed and edematous retrocecal appendix was removed during surgery. Histological investigation of the appendix revealed transmural acute inflammation, with diffuse proliferation of inflammatory cells, with characteristic intranuclear inclusion surrounded by a clear halo. The PCR analysis of peripheral blood and appendix tissue specimen revealed positive VZV DNA. Conclusion: We have shown that varicella-zoster virus infection of the appendix is associated with acute appendicitis and possibly also with severity of the disease., Zenon Pogorelić, Mihovil Biočić, Ivo Jurić, Klaudio Pjer Milunović, Ivana Mrklić, and Literatura 11
Krvácení do trávicího traktu je jednou z náhlých příhod břišních, se kterou se setkáváme relativně často. Většina těchto příhod je v současné době řešitelná endoskopicky, urgentní chirurgickou revizi si žádají spíše výjimečně. Přibližně 5 % krvácení do GIT je skrytých v jejunoileální oblasti. Předložená kazuistika masivního krvácení z tenkého střeva přináší současný názor na diagnostiku a léčebné možnosti z pohledu každodenní klinické praxe službu konajících chirurgů. Klíčová slova: angiektázie – krvácení do tenkého střeva – krvácení do dolní části trávicího traktu – CT-angiografie, Gastrointestinal bleeding is one of acute abdomen conditions that occur relatively frequently. Most cases can nowadays be managed endoscopically, surgery is rarely required. Approximately 5% of gastrointestinal bleeding cases are cases of so-called obscure gastrointestinal bleeding. The presented massive gastrointestinal bleed case report provides a current view on diagnostic and therapeutic modalities in the context of everyday clinical practice. Key words: angiectasia – obscure gastrointestinal bleeding – lower gastrointestinal bleeding – CT-angiography, and J. Halamka, P. Chmátal
Akutní subdurální hematom (ASDH) je nejčastější typ traumatického nitrolebního krvácení s vysokou morbiditou a mortalitou. Ve většině případů je nezbytné akutní operační řešení, vzácně je možné menší asymptomatické ASDH sledovat, jejich resorpce je většinou dlouhodobá, často s vytvořením chronického subdurálního hematomu (CSDH). Bylo popsáno pouze několik případů promptní resorpce ASDH, ale někteří autoři tvrdí, že je jejich incidence podhodnocena. Prezentujeme případ traumaticky vzniklého ASDH u mladé alkoholičky, u níž došlo k téměř kompletní resorpci hematomu za cca 20 hod., Acute subdural hematoma (ASDH) is the most common type of traumatic intracranial hemorrhage associated with high morbidity and mortality. The majority of cases require acute surgery. Monitoring may rarely be sufficient in smaller asymptomatic ASDH. Their resorption is usually prolonged and often associated with formation of chronic subdural hematoma (CSDH). Prompt resorption of hematomas have been described in a few cases only but some authors argue that their incidence is underestimated. We present a case of traumatic ASDH in a young alcoholic patient, in whom a follow-up CT of the brain performed about 20 hours later revealed almost complete resorption of the hematoma. Key words: acute subdural hematoma – chronic subdural hematoma – prompt resorption The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers., and J. Kašík, J. Klener, L. Tittelbach, R. Tomáš, J. Šroubek, M. Mašek
We report the case of a 22-year old male, a self-confessed recreational drug user who developed cardiogenic shock because of severe destruction of the aortic valve by rapidly progressive aortic valve endocarditis. The disease progression was acute; in a matter of days, the clinical manifestations were life-threatening necessitating urgent aortic valve replacement surgery. Cultivation revealed Streptococcus viridans as the microbial agent. Subsequent recovery with antibiotic treatment was without complication. This case report shows that immediately performed transoesophageal echocardiography and early consultation with a cardiac surgeon has fundamental importance in diagnosis and management of acute infective endocarditis in haemodynamically instable patients., Malkia S. Swedi, Pudil Radek, Jiří Manďák, and Literatura 17