A RARE CASE OF RIGHT DIAPHRAGM AGENESIS.

Diaphragmatic agenesis is the most extreme and rare form of congenital diaphragmatic maldevelopment and therefore diagnosis of it are only few in literature, especially in children. It may be unilateral or bilateral. Frequently, diaphragmatic agenesis is accompanied with diaphragmatic hernia, when through a congenital defect of the diaphragm liver, intestine and other viscera herniate into the chest. Diagnostics typically are made early in infancy and is generally associated with other genetic anomalies, especially aneuploidy syndromes. It is associated with a high mortality, if not treated in infancy. However, according to published literature only a few patients have survived till adulthood. In this report, we describe the case of a 63 years old male patient who admitted in a hospital with small bowel intussusception because of strangulated intestinal obstruction and peritonitis. While surgical operation and revision of abdominal cavity, partial right-sided agenesis of the diaphragm was revealed. Two operations were performed on a patient; one because of strangulated intestinal obstruction and accompanied peritonitis and the second, because of stitch insufficiency after 5 days from the first surgical operation. Taking into account the heavy overall status of the patient, diaphragm plastic was not performed and its performance postponed for future.

[Surgical treatment for complicated forms of colorectal cancer].

The aim of the study is to evaluate surgical options in complicated forms of colorectal cancer. It was found that radical single-stage surgery as alternative to two- and three stage procedures is the optimal surgical approach in treatment of complicated forms of colorectal cancer. An important role in the prognosis of the rectal cancer patients plays surgeon and his specific interest in colorectal surgery.