[Intestinal endometriosis - a case report]. / Endometrióza hrubého creva - kazuistika.

Endometriosis is defined as the presence of functional endometrial tissue outside the uterine cavity. The most common clinical symptoms of endometriosis are infertility and chronic pelvic pain. Endometriosis affects 8-10% of women of reproductive age and the condition is highly associated with infertility. Ectopic endometrial tissue is usually found in the small pelvis and the peritoneum, but endometrial tissue deposits have also been reported in other anatomical locations in the human body. We describe the case of a young patient with persistent abdominal pain and bleeding via the rectum during menstrual periods, hospitalised at the Second Department of Surgery, Pavol Jozef Safárik University, Faculty of Medicine and Louis Pasteur University Hospital Kosice.

[A "dumbell" tumor of the mediastinum--case report]. / "Dumbbell" tumor mediastína--kazuistika.

Tumours situated in the posterior mediastinum and spreading to the spinal canal via the intervertebral opening are described as "dumbbell" tumours. The authors submit the case-history of a 44-year-old patient admitted to the Second Surgical Clinic Pasteur Faculty Hospital, Safarík University Kosice after repeated laminectomy and extirpation of the intraspinally spreading part of a mediastinal tumour. The mediastinal part of the tumour was removed surgically, the histological result was described as a melanotic schwannoma. The postoperative course was without complications, the patient was discharged home in a good condition on the 8th day after the operation. In the conclusion the authors emphasize the necessity to remove the tumour in toto. A one-stage operation in collaboration with a neurosurgeon seems appropriate.

[Actinomycosis of the small intestine--an unusual cause of acute abdomen]. / Aktinomykóza tenkého creva--vzácna prícina náhlej príhody brusnej.

Actinomycosis is subacute or chronic disease manifested by a defined granulomatous inflammation with the development of infiltrates, abscesses and fistulae. A 35-year-old female patient was admitted and operated at the Second Surgical Clinic because of symptoms of diffuse peritonitis. Laparotomy revealed a duplicit tumour of the small intestine, an abscess of the abdominal wall in the left mesogastrium and pyoovarium bilaterale. 70 cm of the small intestine were resected, incision of the abscess and bilateral adnexotomy were performed. Histological examination revealed a suppurative, partly fibroproductive inflammation with an actinomycotic etiopathology. After antibiotic treatment the patient was discharged home, the gynaecologist removed an intrauterine device. Three months after the first operation the patient in a serious septic condition was readmitted to the clinic with signs of diffuse peritonitis. A double perforation of the small intestine was found and an end-to-end anastomosis was made after resection of the small intestine. The postoperative course was complicated by respiratory failure and failure of the circulation associated with septic shock and subsequent death. In the conclusion the authors emphasize the problem of preoperative diagnosis of the abdominal form of actinomycosis, its possible development in relation to intrauterine contraceptive devices and its clinical manifestation as acute abdomen.

[Recurrent acute hemorrhage in the duodenum as a symptom of Bouveret's syndrome]. / Opakované akútne krvácanie do duodena ako príznak zacínajúceho Bouveretovho syndrómu.

The authors demonstrate on the case-history of a 51-year-old patient the rare cause of repeated haemorrhage into the digestive tract calling for emergency surgery. On operation they found as the cause a solitary biliary concrement which penetrated into the duodenum and caused haemorrhage of its wall. The disease was described in 1896 by Bouveret as a syndrome of duodenal obturation by a large gallstone. In the described case the whole concrement did not yet penetrate into the duodenum to cause its obturation but it produced repeated haemorrhage which could not be treated by conservative methods.

[Mediastinal teratomas--diagnosis and therapy]. / Teratómy mediastína--diagnostika a liecba.

The authors present an account on patients with a teratoma of the mediastinum who were operated at the Second Surgical Clinic, L. Pasteur Faculty Hospital in Kosice. In the course of 10 years (Jan. 1, 1990-Dec. 31 1999) 73 patients with tumours of the mediastinum were operated. In four the diagnosis of teratoma of the mediastinum was confirmed by histological examination (5.47%): three adult patients and one child. In two patients the tumour of the mediastinum was diagnosed accidentally during X-ray examination of the chest. In one female patient surgical revision was indicated on account of a relapse of the process. In the conclusion the authors emphasize that teratomas of the mediastinum are frequently asymptomatic, and in case the process is in the anterior or upper mediastinum, teratomas must be taken into account and removed as a whole during surgical intervention.

[Aggressive angiomyxoma--a new clinico-pathologic entity]. / Agresívny angiomyxóm--nová klinicko patologická jednotka.

The authors present a report on a new clinical and pathological entity--aggressive angiomyxoma which was described in 1983. They draw attention to the genesis of this tumour and its macro- and microscopic picture. They emphasize that treatment of this tumour involves its complete surgical extirpation and frequent local relapses without secondaries. The authors describe in detail two of their observations of aggressive angiomyxoma in a 32- an 38-year-old woman where the tumour started in the lesser pelvis. In both instances, despite radical extirpation of the tumour, within a relatively short time a local relapse developed detected by USG and CT without clinical symptoms.