Surgery 2 [ChK/CH-ZL2/15]

Appendicitis acuta and Meckel diverticulum

Author: Martina Vidová Uğurbaş, Lucia Sukovská Lakyová

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Appendicitis is one of the most common reasons for surgery and emergency hospitalization due to acute abdominal pain. Accurate diagnosis of acute appendicitis and subsequent indication for surgery can prevent complications. Conversely, the surgeon´s decision to operate with the aim of avoiding the complications of a late surgical intervention in positive appendicitis cases leads to negative appendectomy in 10,5% of the cases.

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Acute abdomen - gallstone ileus

Author: Martina Vidová Uğurbaş, Lucia Sukovská Lakyová

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Gallstone ileus is an uncommon entity, which accounts for 1–4% of all presentations to hospital with small bowel obstruction and for up to 25% of all cases in patients over 65 years of age. Despite medical advances, gallstone ileus is still associated with high rates of morbidity and mortality. The management of gallstone ileus remains controversial. The clinical signs and symptoms of gallstone ileus are usually non-specific, contributing to a delay in diagnosis. We present our case admitted to the hospital with gallstone ileus.

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Journey of a swallowed wooden stick to the liver

Author: Martina Vidová Uğurbaş, Lucia Sukovská Lakyová

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Hepatic abscess due to perforation of the gastrointestinal tract caused by ingested foreign bodies is a rare complication. Pre-operative diagnosis is difficult because of negative anamnesis of the accident and symptoms are usually non-specific. Problems can occur after months or even years after incident. CT is the most suitable imaging method for diagnostic.
The authors report a case of 57 year old man who was admitted with liver abscess, who underwent surgery mid-year after swallowing of wooden stick.

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Management of pilonidal sinus

Author: Martina Vidová Uğurbaş, Lucia Sukovská Lakyová

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A pilonidal sinus is a sinus track which commonly contains hair. It occurs under the skin between the buttocks at a short distance above the anus. Most cases occur in young male adults. The most commonly used therapy is surgery including incisions, marsupialization, primary midline closure and skin flaps. We present two cases treated with different surgical techniques.

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Mitral valve replacement and MAZE procedure because of mitral valve stenosis and paroxysmal atrial fibrillation

Author: Tomáš Toporcer

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The case report describes the hospitalization of a 63-year-old patient admitted to the Department of heart surgery for mitral valve stenosis with diagnosed atrial fibrillation. The patient underwent mitral valve replacement and MAZE procedure. At the postoperative period, paroxysm of atrial fibrillation was successfully detected with a successful version. On the tenth postoperative day, the patient was placed in outpatient care.

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Aortic valve replacement because of aortic valve stenosis, repair of tricuspid valve because of regurgitation

Author: Tomáš Toporcer

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The case study describes the hospitalization of women with aortic valve stenosis and secondary regurgitation of the tricuspid valve. The patient underwent aortic valve replacement by bioprosthesis and repair surgery of the tricuspid valve. The postoperative course was complicated by pneumohorax on the right side. Drainage was performed. The patient was placed in outpatient care on the eighth postoperative day.

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Constrictive pericarditis, reoperation

Author: Tomáš Toporcer

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The case report describes the hospitalization of a 50-year-old man who underwent surgery for a constrictive pericarditis at a younger age. Current CT and ultrasonographic findings confirmed the recurrence of this disease. Partial pericardectomy was performed with the release of the left ventricular diaphragm wall in particular. The postoperative period was complicated by ventricular fibrillation with high speed response of chambers. After successful cardioversion, the patient was released to outpatient care on the seventh postoperative day.

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Aortocoronary bypass

Author: Tomáš Toporcer

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The case report describes the hospitalization of a 58 year old male admitted to our department for documented ischemic heart disease with affection of three coronary arteries. The patient underwent a cardiac surgery with the formation of one bypass with arterial graft and one bypass with venous graft. In the postoperative period, fibrillation of atrial fibrillation with successful cardioversion was noted. The patient was admitted to outpatient care on the seventh postoperative day.

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Mitral valve reconstruction because of Barlow's disease with mitral insufficiency, perioperative SAM (systolic anterior motion)

Author: Tomáš Toporcer

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The case report describes the hospitalization of a 26 year old male with M. Barlow. The mitral valvuloplasty was performed. However, the peroperative ultrasonographic finding documented prolapse of the anterior cusp of the mitral valve into the outflow tract of left ventricle. The surgery was supplemented with a suture of the A2-PA segments of mitral valve. The subsequent finding was satisfactory. No more serious postoperative complications were noted. The patient was admitted to outpatient care on the eighth postoperative day.

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Ascending aorta replacement and repair of aortic valve because of ascending aorta aneurysm and bicuspid aortic valve with regurgitation

Author: Tomáš Toporcer

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The case report describes the hospitalization of a patient with an ascending aortic aneurysm and a bicuspidal aortic valve. Valvular surgery with an annular annuloplasty ring implant was performed. At the same time, replacement of the ascending aorta was performed. There were no more serious complications in the postoperative period and the patient was released to outpatient care on the eighth postoperative day.

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