[Traumatic obstruction of the duodenum]. / Urazová obstrukce duodena.

The authors describe a rare observation of traumatic duodenal obstruction by an intramural haematoma with concurrent extensive retroperitoneal haemorrhage and a minor haemoperitoneum in a six-year-old girl who fell and hurt her abdomen on a flat stone. The first symptoms--abdominal pain and vomiting--developed 24 hours after the injury. She was referred to hospital and admitted only three days after the injury with the clinical picture of an inflammatory acute abdomen with peritoneal irritation, concurrent with a respiratory infection persisting for four days. Based on the authors' own observation and data in the literature the diagnostic possibilities are analyzed as well as pitfalls and the optimal therapeutic procedure in this rare type of injury.

[Posttraumatic biliary pseudocyst of the liver in a child]. / Poúrazová biliární pseudocysta jater u dítete.

The authors describe a rare complication of a severe liver injury--the development of a post-traumatic biliary pseudocyst--in a 5-year-old child with a multiple injury. The pseudocyst was detected by ultrasound and computed tomography when searching for the cause of the persisting septic condition following prolonged resuscitation during the postoperative period. Percutaneous puncture drainage by means of a pigtail made under sonographic control, although because of limited experience it was repeated, led to recovery of the child. Thus it proved possible to resolve a post-traumatic infected biliary hepatic pseudocyst without a major invasion into the child's organism which was severely affected by the multiple injury as well as septic condition.

Ceftriaxon in the treatment of severe bacterial infections.

The efficacy of ceftriaxon (Rocephin Roche) therapy has been studied by our team in two groups of patients. The first one consisted of 10 children suffering from a diffuse purulent appendical peritonitis brought about by a mixed aerobe and anaerobe microbial flora, the second one comprising 7 patients with severe infections caused by problematic aerobe pathogens. The clinical effect of the treatment was good in 16 out of the 17 cases, in one patient it could not be evaluated. Even though a high degree of sensitivity to Rocephin could be demonstrated bacteriologically by the disc method in all the aerobe germs present, the results of titration of the bactericide capacity of the sera during treatment indicate the need for laboratory monitoring of the course of therapy of severe infections due to pseudomonas aeruginosa. Parenteral administration of Rocephin was well tolerated and the laboratory alterations seemin the course of therapy of severe infections due to Pseudomonas aeruginosa. Parenteral administration of Recephin was well tolerated and the laboratory alterations seen in the postoperative ileus due to strangulation and adhesions--cannot be recommended.