Penetrating thoraco-abdominal gunshot wounds procedure.

Gunshot injuries of the trunk in the peace time are rare, but always represent great therapeutic and organisational problems. It concern especially thoraco-abdominal injury. Aim of this report is to present our treatment experiences with 19 wounded patients. Different procedure was applied. In 16 cases wounded laparotomy was done, in 4 cases following pleura cavity drainage. After that in 4 wounded thoracotomy was performed. In the 3 rest wounded thoraco-phrenolaparotomy was done. All of them had lung injury and a few of them have had great vessel and heart lesions. In the abdomen we found 1-4 organs injury. 7 (37%) wounded died, among these 6 after abdominal complications. Injuries mentioned above are severe, complicated and required individual and differentiated procedure. Above all severity of abdominal organs injury determined prognosis. Not enough experienced thoracic surgeon can cooperate with abdominal specialist surgeon during treatment procedure such a patients.

Nonepithelial neoplasmas of the esophagus.

Nonepithelial neoplasms of the esophagus are rare and represent only 1-3% of the treated tumor of the esophagus. Aim of this report is to present our experiences with treatment patients suffering from that kind of neoplasm. During the last 12 years we treated 12 patients: 6 males and 6 females in the age of 23-65 years (average 41 years). The basic symptom was long-duration dysphagia. Esophagoscopia, radiopaque contrast, CT examinations in the all of our patients were done. Correct recognition before operation (only 1 patient--leiomyoma) was done. The tumors were removed in 6 patients by right-side thoracotomy, in 5 patients by left-side thoracotomy and 1 has had right-side thoracoscopy. The lumen of the esophagus was opened in 3 patients. Definitive recognition was as follow: 6--leiomyoma, 3--fibroma, 1--fibroleiomyoma, 1--lipoma, 1--cystis lymphomatosa. Operative treatment was done by enucleation of the tumor and in the postoperative period we did not observe complications. Early and late results were very good as well.

[Abdominal hernia as risk for continuation of continuous ambulatory peritoneal dialysis: case report]. / Przepuklina brzuszna jako zagrozenie dla kontynuacji ciaglej ambulatoryjnej dializy otrzewnowej--opis przypadku.

On the case of 37 old patient with diabetic nephropathy, treated with peritoneal dialysis since 12 months, actual problems of clinical and imaging diagnostics of abdominal hernias in continuous ambulatory peritoneal dialysis patients are presented. We paid special attention to the postoperative management and prophylaxis of abdominal hernia recurrences.

[A case of juvenile embryonal germ cell tumor of the mediastinum]. / Przypadek raka zarodkowego typu dzieciecego w sródpiersiu.

A rare case of a embryonal germ cell tumor of the mediastinum is presented in a 22 year old male. A radical excision of the tumor was performed, followed by chemotherapy. A five year survival was observed without evidence of a recurrence.

[Rare site and complication of metastasis of lung cancer]. / Rzadkie umiejscowienie i powiklanie przerzutu raka pluca.

A case of a 69 year old male hospitalized due to uncharacteristic respiratory symptoms and successfully treated for intestinal obstruction is presented. The intestinal obstruction was caused by a tumor which microscopically was a metastatic squamous cell bronchial carcinoma. Further diagnostic procedures revealed an advanced squamous cell right main bronchus cancer.

Gunshot wounds caused by modern firearms in the light of our investigations.

The experiment was carried out on 27 sheep with traumatic-haemorrhagic shock caused by a gunshot wound produced using high-velocity missiles from the HM16 rifle. Sixty minutes after injury treatment with blood-replacing fluids was started. In Group I Ringer's solution with sodium lactate pH 8.2 was infused, Group II received Ringer's solution with sodium lactate pH 6.5, and Group III was given Ringer's solution alone. Volume of the infused fluid exceeded threefold the volume of lost blood. During and after fluid replacement blood samples were drawn for biochemical investigations and haemodynamic disturbances were carefully observed. In conclusion, we can say that Ringer's solution filled the vascular bed and improved tissue perfusion, but it failed to correct metabolic and acid-base equilibrium disturbances to such a degree and for as long a long time as did Ringer's solution with lactate.