{"title":"Isolated inflammatory process of the caecum.","authors":"L Truong, H H Truong, P Kofroň","doi":"10.48095/ccrvch202571","DOIUrl":"10.48095/ccrvch202571","url":null,"abstract":"<p><p>Acute abdomen represents a large complex of acute situations in general surgery. There could be inflammatory (such as acute appendicitis, acute cholecystitis etc.), non-inflammatory (ileus), hemorrhage or traumatic situations (perforation of the gastrointestinal tract etc.). Our work presents two case reports of two not significantly ill female patients with an uncommon inflammatory process of the caecum. Acute typhlitis is an archaism for most of surgeons. It used to be a synonym for acute appendicitis; however, the modern literature defines this diagnose as a different disease - neutropenic enterocolitis. It is a rare but serious disease causing a right lower quadrant pain, often mimics acute appendicitis. Usually, it occurs in immunocompromised patients (patients after an immunosuppressive therapy, neutropenic patients, people with hematologic malignancies, AIDS positive patients, etc.); however, a few case reports of entirely healthy patients have been published. Nevertheless, there is however a limited number of these cases.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"104 2","pages":"71-75"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Retained gallstone as a rare cause of recurrent fistula in the scar after laparoscopic cholecystectomy.","authors":"M Škrabal, V Pěkný, J Bělehrádek, A Polcar","doi":"10.48095/ccrvch202576","DOIUrl":"10.48095/ccrvch202576","url":null,"abstract":"<p><strong>Introduction: </strong>Cholecystectomy is one of the most common operations in surgical departments. Complications after gallbladder removal are mainly bleeding, infection including abscess in the gallbladder bed or in the abdominal wall, wound dehiscence, acute pancreatitis or injury of the bile ducts. In the further course, hernias in the scar may appear after both laparoscopic and open cholecystectomy, strictures of the bile ducts and symptoms of the so-called postcholecystectomy syndrome. The presence of residual gallstones is rare, statistically reported in 0.08-0.3%.</p><p><strong>Case report: </strong>The goal of our message is to present the case of a patient taken into our care 7 years after laparoscopic cholecystectomy indicated for cholecystitis with wedged lithiasis in the gallbladder neck, proven by ultrasound. In our department, the -patient was treated for a re-current fistula in the scar of the right subcostal area. Definitive -healing from the initial manifestation of the fistula occurred despite repeated revisions after the precise localization and removal of the retained gallstone.</p><p><strong>Conclusion: </strong>Thanks to the use of an extensive spectrum of diagnostic methods and at the same time thinking about the rare causes of a recurrent purulent collection with a fistula, we purposefully searched for an infectious source. Only perioperative radiography with injection of contrast material identified the presence of a retained gallstone. It was possible to extirpate it from the space between the intercostal muscles and the peritoneum, thereby relieving the patient of her problems.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"104 2","pages":"76-81"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Use of Amnioderm in combination with negative pressure wound therapy in a patient with trauma of the lower limb - first experience.","authors":"J Křečková, D Šmíd","doi":"10.48095/ccrvch2025160","DOIUrl":"https://doi.org/10.48095/ccrvch2025160","url":null,"abstract":"<p><strong>Introduction: </strong>Dislocation fractures of the distal lower leg require surgical treatment. If the quality of the soft tissues and skin does not allow primary suture of the wound, it presents a serious challenge for the surgeon. In our case, after reposition and fixation of the fractures, we were able to perform a fascia suture with a residual large skin and subcutaneous defect. We decided to use a combination of Amnioderm application and negative pressure therapy.</p><p><strong>Methods: </strong>The authors describe the procedure for the treatment of an acute wound in a young, morbidly obese patient with an ankle injury following a traffic accident.</p><p><strong>Discussion: </strong>Closure of the surgical wound in the field of swelling and hematoma is a frequent problem encountered in patients after ankle osteosynthesis. There are several possible approaches, one of which is the use of negative pressure therapy. Its effect can be enhanced by the application of Amnioderm.</p><p><strong>Conclusion: </strong>Although this is the first use of the presented technique, based on our other general experience with Amnioderm and the frequent use of negative pressure wound therapy from other indications, we dare to say that it is a safe method that offers an effective solution to a complex, critical situation.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"104 4","pages":"160-164"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Carotid surgery from the perspective of a vascular surgeon.","authors":"B Čertík, J Moláček, R Šulc, K Houdek, V Opatrný","doi":"10.48095/ccrvch2025238","DOIUrl":"https://doi.org/10.48095/ccrvch2025238","url":null,"abstract":"<p><p>Since the beginning of carotid surgery, there has been an effort to find the safest technique for carotid endarterectomy and ensure sufficient brain perfusion during the procedure. Similarly, endovascular procedures have been modernized from simple balloon angioplasty to stent placement, and protective systems have been developed to prevent periprocedural embolization. The second half of the last century became an important stage in examining and comparing the results of carotid endarterectomy and carotid stenting, -searching for and establishing indication criteria in the context of highly effective antiplatelet -therapy. At the turn of the century, with the advent of modern techniques of regional anesthesia and intravenous analgosedation, most vascular departments gradually moved away from carotid surgery under general anesthesia and there was a renaissance of eversion endarterectomy techniques. From a vascular perspective, carotid surgery underwent a long, closely monitored development and defended its place as the first choice in the treatment of carotid stenoses.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"104 6","pages":"238-241"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Volar approaches to the distal radius.","authors":"V Kunc","doi":"10.48095/ccrvch2025326","DOIUrl":"10.48095/ccrvch2025326","url":null,"abstract":"<p><strong>Introduction: </strong>The modified Henry approach is predominantly used in the treatment of distal radius fractures. Over the years, it has undergone numerous modifications, and its original interpretation varies significantly. This summary also discusses other volar approaches to the distal radius. The original description of the approach is attributed to Arnold Kirkpatrick Henry, who, in his three publications, mentions the interval between the radial artery and the flexor carpi radialis muscle. Currently, many controversies are being debated, including extended approaches, techniques and options for transecting the pronator quadratus muscle, indications and methods for carpal tunnel release, transection of the brachioradialis muscle, and others. Variations: Anatomical structures visualized during the modified Henry approach are not highly variable. Occasionally, an accessory flexor carpi radialis brevis muscle and several variants of the pronator quadratus muscle may be present, which have only been described in case reports.</p><p><strong>Conclusion: </strong>Among the many controversies debated regarding the modified Henry ap-proach, the most clinically significant are the proper release of the brachioradialis muscle and the early detection of carpal tunnel symptoms followed by appropriate intervention. Other volar approaches are used less frequently and typically in specific indications.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"104 8","pages":"326-331"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Surprising finding of desmoid in a young man by an urologist.","authors":"J Marešová, J Kočárek-, M Čermák, L Plincelnerová","doi":"10.48095/ccrvch202561","DOIUrl":"10.48095/ccrvch202561","url":null,"abstract":"<p><p>We present a case report of a 26-year-old patient with an incidental finding of intra-abdominal fibromatosis (desmoid) in the small pelvis who presented to the urology outpatient clinic for erectile dysfunction. Ultrasound examination revealed hydronephrosis of the right kidney with parenchymal reduction, and a bulky tumor was detected in the small pelvis, which was compressing the right-sided ureter. The patient was followed up with a CT scan which confirmed a solid tumour in the small pelvis of unclear origin, the nature of the tumour and the treatment were discussed by the multidisciplinary team and a decision was made to resect the tumour. Pathologist confirmed sporadic variant of desmoid. Desmoid tumors are characterized by both locally aggressive carcinomas mimicking growth and frequent recurrences after resection, which may require subsequent oncological treatment. For these reasons, patients with desmoids should be fol-lowed up by an oncologist, ideally at centers experienced in treating this rare disease.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"104 2","pages":"61-66"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Acute examination to rule out cervical spine injuries in adults.","authors":"J Konečný, M Reška, J Habr, R Hasara, L Veverková","doi":"10.48095/ccrvch2025295","DOIUrl":"10.48095/ccrvch2025295","url":null,"abstract":"<p><p>This paper provides a brief overview of current information and recommendations regard-ing acute imaging of adult patients to rule out cervical spine injuries. It summarizes the possibilities of plain X-ray examination of the cervical spine, which is technically demand-ing and has low diagnostic yield. Therefore, it is no longer recommended. Exceptions are locations where CT is not available and patients for whom exposure to medium or high doses of ionizing radiation is contraindicated. Routinely performed CT examinations of the cervical spine to rule out injury have a significant medical and financial impact. For this reason, internationally recognized criteria sets NEXUS (National Emergency X-Radiography Utilization Study) and CCR (Canadian C-spine Rule) have been introduced. These include information from the patient's history and clinical examination and are used to indicate the need for cervical spine CT to exclude trauma. Both systems are described and compared. According to some recommendations and in the opinion of the authors, combining the two systems could further improve their effectiveness.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"104 7","pages":"295-299"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L Veverková, P Doležal, J Habr, M Reška, P Vlček, J Konečný, I Čapov, J Žák, I Penka
{"title":"SSIs - analysis of self-report data and economic impact.","authors":"L Veverková, P Doležal, J Habr, M Reška, P Vlček, J Konečný, I Čapov, J Žák, I Penka","doi":"10.48095/ccrvch2025289","DOIUrl":"https://doi.org/10.48095/ccrvch2025289","url":null,"abstract":"<p><strong>Background: </strong>Surgical site infections (SSIs) are a major health and economic problem. Increased morbidity, prolonged hospital stay and the need for additional treatments increase the financial costs of healthcare institutions. The aim of this article is to analyze the incidence of SSIs, their impact on hospital length of stay and economic burden under Czech conditions.</p><p><strong>Methods: </strong>We analyzed hospitalizations in the period from 1st January 2021 to 31st December 2024 that were classified as SSI according to the CZ-DRG. A total of 2,134 hospitalizations were included, of which 212 (9.93%) were complicated by SSI. We recorded the length of hospital stay, number of reoperations and their duration.</p><p><strong>Results: </strong>SSI hospitalizations accounted for 9.93% of all cases but 25.3% of hospital days. The economic impact of SSIs was expressed as a case-mix of 24.07%. SSI cases required 19.66% of all operations and 16.43% of total operating time.</p><p><strong>Conclusion: </strong>It is evident from the findings of this study that SSIs are not only a medical problem, but also an economic one. The economic analysis conducted in this study demonstrates that, even with higher reimbursement for SSI cases, this reimbursement does not cover the additional costs associated with prolonged hospitalization and the necessity for reoperations.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"104 7","pages":"289-294"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M Mišánik, M Grajciar, I Daňová, D Musová, J Miklušica, K Tobiášová, M Smolár
{"title":"Four synchronous primary malignancies in one patient.","authors":"M Mišánik, M Grajciar, I Daňová, D Musová, J Miklušica, K Tobiášová, M Smolár","doi":"10.48095/ccrvch202555","DOIUrl":"10.48095/ccrvch202555","url":null,"abstract":"<p><p>Multiple primary malignancy is defined as the occurrence of two or more primary malignancies in one patient. Although this is a rare situation, its occurrence has been increasing over the last decade. Patients with an oncological disease have up to a 20% higher risk of a new primary oncological disease compared to the general population. Depending on the time interval between the diagnosis of individual malignancies, we divide multiple cancer cases into synchronous and metachronous. The diagnosis of four synchronous malignancies is extremely rare. In our case report, we present a patient with caecal adenocarcinoma, hepatic flexure adenocarcinoma, clear cell carcinoma of the right kidney and pheochromocytoma of the right adrenal gland occurring synchronously.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"104 2","pages":"55-60"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Enteroatmospheric fistula - literature review and current recommendations.","authors":"J Šturma, Z Šubrt, J Gojda, M Laboš","doi":"10.48095/ccrvch2025191","DOIUrl":"https://doi.org/10.48095/ccrvch2025191","url":null,"abstract":"<p><p>Enteroatmospheric fistula (EAF) is one of the most severe and life-threatening surgical complications, significantly increasing the cost of patient treatment. It is classified as a postoperative complication, collectively referred to as abdominal catastrophes. EAF is a specific type of intestinal fistula that occurs when the intestinal lumen opens into an unhealed defect in the abdominal wall, leading to continuous wound contamination that complicates healing. Treatment of this complication is challenging, prolonged, and requires a multidisciplinary approach in three distinct phases. In the first phase, the goal is aggressive therapy of abdominal sepsis and management of its source. -After stabilizing the patient, the second, chronic phase focuses on care for the defect and reversing the nutritional status from catabolism to anabolism. Following the maturation of adhesions in the abdominal cavity, healing of the wound around the EAF, and adequate nutritional preparation, the patient undergoes the reconstructive phase, which involves restoring the continuity of the digestive tract and reconstructing the abdominal wall. Throughout all phases, the patient is at risk for numerous secondary complications related to malnutrition and prolonged hospitalization. Therefore, preventing the development of EAF is of paramount importance. The aim of this paper is to summarize current recommendations for the treatment of EAF and discuss some of the modern approaches to managing this condition.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"104 5","pages":"191-198"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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