[Torsion of dystopic spleen--possible solutions]. / Torzia dystopickej sleziny--moznosti riesenia.

Early diagnosis the torsion of wandering spleen and surgical intervention are necessary to preserve the spleen, because persistant torsion can lead to splenic infarction. We present two cases with torsion of wandering spleen and different disease process and result. Diagnosis was by ultrasonography and CT angiography found. The 7-year-old boy with recurrent abdominal pain was admitted early and operated with spleenpreserving splenopexy. The 8-year-old girl with acute torsion of a wandering spleen was sent of after an initial misdiagnosis too late. Patient was managed by urgent laparotomy and splenectomy, because of splenic vessels thrombosis and splenic infarction. No complications occurred during two year postoperative follow up period of both patients.

[Congenital diaphragmatic hernia manifesting after the neonatal period]. / Vrodená bránicná hernia prejavujúca sa po novorodeneckom období.

In the course of 16 years at the authors department 46 children with congenital malformation of the diaphragm were operated. This group comprised 12 children (26%) where the first symptoms developed only after the neonatal period. Most frequently the symptoms were repeated respiratory infections (in 9 children), and gastrointestinal complaints in 4 children. The children were operated electively: in 8 patients a left-sided Bochdalek hernia (1x with a sac) was involved, 3 children had a hiatus hernia and one child a Morgagni hernia. After surgery no early or late complications were recorded. In the discussion the authors deal with inborn diaphragmatic hernia with a late manifestation which is mainly a diagnostic problem. Therefore, based on their own experience and consistent with data in the literature, the authors recommend careful aimed examination of children with chronic non-specific respiratory or gastrointestinal complaints.

[When and how we perform surgery for inguinal hernia in children]. / Kedy a ako operujeme inguinálne hernie u detí.

In the course of 15 years in the authors department 4,694 operations of inguinal hernias and hydrocele were performed in children at the age of 0-15 years. Most frequently children aged 2-5 years were involved (45%). There were 4.5 times more boys than girls and the lateral distribution was also consistent with data in the literature. A relapse of hernia occurred in 33 children (i.e. 0.7%) operated in the authors department and in 19 children originally operated elsewhere. The total percentage of relapses in the group is 1.1%. In 25 children factors were identified which predispose for relapses. Relapses were most frequent in children operated before the age of one year (52%). The authors recommend therefore that operations of these children should be entrusted to a paediatric surgeon.

[Freely moving circular shadows in the abdominal cavity--the exudative enteropathy syndrome?]. / Vol'ne pohyblivé gul'ovité tiene v dutine brusnej--syndróm exsudatívnej enteropátie?

The authors describe a 14-year-old gypsy girl with the clinical picture of exudative enteropathy where they observed on X-ray examination of the abdominal cavity circular formations which changed position. On laparotomy they found on the serous membrane of the entire enlarged and inflamed ileum numerous pseudo-polypous formations the majority of which were released and floated freely in the chylous ascites. The description of similar globular lesions of the lymphatic system was found in the literature only in accounts on post-mortem findings.

[Prepyloric atresia of the stomach]. / Prepylorická atrézia zalúdka.

The authors report a case of a rare anomaly--prepyloric gastric atresia of the membranous type cured by the excision of the membrana and by pyloroplasty.