INTRODUCTION: Ileocolic intussusception is one of the most frequent causes of acute abdomen in infants and toddlers. The purpose of this study was to evaluate the treatment of ileocolic intussusception in the Czech Republic in 2019. METHODS: Fourteen departments of paediatric surgery participated in this multicentre retrospective study. A SurveyMonkey Inc. questionnaire was used for anonymous data collection of patients with ileocolic intussusception. RESULTS: In 2019, ileocolic intussusception was diagnosed in 162 patients; median age was 30 months (3 months to 9.5 years). Contrast enema was indicated in 133 patients, primary surgery in 14 patients and spontaneous reduction was found in 15 patients. All departments using contrast enema had a success rate of 89.5%; 12 departments approached the contrast enema procedure under general anaesthesia (including myorelaxation at 7 departments) and 2 departments under sedation. Contrast enema under general anaesthesia with/without myorelaxation was significantly more successful than contrast enema under sedation (108/113, 95.6% vs 11/20, 55%; p.

• Klíčová slova
• Intussusception, feeding, ileocolic, reduction,
• MeSH
• intususcepce * chirurgie   MeSH
• klyzma MeSH
• kojenec MeSH
• lidé MeSH
• nemoci ilea * MeSH
• předškolní dítě MeSH
• retrospektivní studie MeSH
• výsledek terapie MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• předškolní dítě MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Geografické názvy
• Česká republika MeSH

INTRODUCTION: Malrotation is understood as a congenital anomaly of the intestinal position formed during embryonic development. Disorders of intestinal rotation and its manifestations in adulthood are less common; the symptoms of these disorders are characteristic of childhood. An asymptomatic bowel rotation disorder occurs in up to 1 of 200 newborns and symptomatic malrotation occurs in 1 of 6,000 live newborns. The incidence of intestinal rotation disorders in adulthood is estimated to be between 0.0001% and 0.19%. Acute complications in adulthood include volvulus with ischemia of the small bowel. CASE REPORT: A 36-year-old man with a previously diagnosed bowel rotation disorder with intermittent abdominal pain was examined for sudden convulsive pain. The CT scan showed volvulus of small bowel. During surgery, a small bowel volvulus with venostasis and dilated mesenteric veins rotated 360 degrees clockwise, the mesenterium commune, and the presence of Ladds bands causing partial compression of the duodenum were found. The condition was managed surgically to derotate the loops into nonrotation with preserved viability of the intestinal loops, interrupt the Ladds bands and mobilize the duodenum, including fixation of the mesentery to the retroperitoneum and invagination appendectomy. The patient has been without problems and without any signs of complications based on his 2-year follow-up from the surgery. CONCLUSION: Early surgical treatment of intestinal malrotation complications helps maintain intestinal viability and can prevent the development of the short bowel post-resection syndrome. Prophylactic surgery should be considered in symptomatic rotation disorders, although the determination of the indication for surgery and its timing remain uncertain.

• Klíčová slova
• adult − midgut − malrotation − acute abdomen,
• MeSH
• apendektomie MeSH
• dospělí MeSH
• duodenum MeSH
• lidé MeSH
• novorozenec MeSH
• střeva MeSH
• tenké střevo MeSH
• volvulus intestini * komplikace   diagnostické zobrazování   chirurgie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

INTRODUCTION: Diffuse peritonitis is a serious disease with rather poor therapeutic results. Management traditionally consists in the surgical treatment of its etiology, combined with targeted antibiotic therapy and complex intensive care of the patient. The basic procedure includes the identification and treatment of the origin of peritonitis, followed by thorough abdominal cavity toilet, lavage and drainage. There are currently two major procedures for carrying out complex surgical care of a patient suffering from diffuse peritonitis. The first one is primary sanation of the abdominal cavity, in which toilet, peroperative lavage and postoperative drainage is performed. The second procedure involves similar steps, but postoperative irrigation with saline or another solution is performed, usually over 2448 hours - continuous lavage. Both procedures, albeit often modified, are still used in most surgical departments in the Czech Republic; therefore, we decided to compare them in terms of morbidity, mortality and hospital length of stay. METHOD: We conducted a prospective randomized study involving 55 patients with peritonitis operated on from 10/2012 to 4/2014. Whenever possible, we tried to use both methods alternately method regularly to enable randomization and ensure presentable outcomes. RESULTS: No statistically significant difference related to morbidity, mortality and hospital length of stay was recorded in our group. CONCLUSION: Based on our results, we can state that both methods are equal and suitable for all types of diffuse peritonitis without any impact on mortality, morbidity and hospital length of stay. Key words: peritonitis - drainage peritoneal lavage.

• Klíčová slova
• peritonitis - drainage peritoneal lavage,
• MeSH
• drenáž MeSH
• lidé MeSH
• peritoneální výplach * MeSH
• peritonitida * terapie   MeSH
• pooperační péče * MeSH
• prospektivní studie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH
• Geografické názvy
• Česká republika MeSH

INTRODUCTION: Cases of localized and diffuse peritonitis are severe surgical conditions. Despite expanding possibilities for the diagnosis and therapy, patients with peritonitis, its diffuse form in particular, still suffer from high morbidity and mortality. The management of this condition, both in the healthy and especially seriously ill population, is not satisfactory. Recently, we have witnessed an increase in bariatric and metabolic surgery in response to an ever rising number of extremely obese patients worldwide. Bariatric patients belong to a group of seriously ill patients with a significant risk of post-operative complications due to an infection. Although their treatment is identical to that of the normal population, a great emphasis is put on early recognition of complications, and the decision on any potential surgical revision should be actively approached, often necessitating the absence of frequently lengthy paraclinical assessments. METHODS: We conducted a retrospective analysis of 346 obese bariatric patients undergoing surgical treatment for morbid obesity between August 2011 and August 2015. RESULTS: A total of 6 patients experienced severe complications including two cases of diffuse peritonitis, two cases of localized peritonitis and two cases of intraperitoneal bleeding. One patient died after her discharge from hospital due to toxic shock caused by stomach perforation. We describe two case reports in greater detail to highlight the importance of early detection of complications and a timely surgical intervention. CONCLUSION: In principle, bariatric patients are a severely ill population where standard diagnostic procedures for post-operative complications often fail. Clinical findings and the surgeons experience are commonly the only diagnostic signs that trigger a surgical revision. In contrast, surgical treatment of post-operative complications in obese patients with peritonitis is virtually identical to that in patients with normal or slightly increased BMI. It involves thorough toilette of the abdominal cavity, lavage and drainage. Due to high morbidity and large peritoneal surface, obese patients may deteriorate rapidly. Timely surgical intervention is thus the only proper therapeutic approach, even without any, often lengthy paraclinical assessments. KEY WORDS: peritonitis - bariatric surgery - complications in bariatric surgery.

• MeSH
• bariatrická chirurgie škodlivé účinky   MeSH
• časná diagnóza MeSH
• dospělí MeSH
• drenáž MeSH
• hemoperitoneum diagnóza   etiologie   chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• peritonitida diagnóza   etiologie   chirurgie   MeSH
• pooperační komplikace etiologie   MeSH
• poranění břicha komplikace   MeSH
• reoperace MeSH
• retrospektivní studie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

BACKGROUND: A scale for the Assessment and Rating of Ataxia (SARA) was developed for evaluation of autosomal dominant cerebellar ataxias (ADCA) and was also recommended for clinical trials of Friedreich's ataxia patients (FRDA). FRDA, unlike ADCA, is characterized as being a sensory type of ataxia for which the disease-specific Friedreich ataxia rating scale (FARS) was developed. The objective of this study was to determine whether SARA and FARS scores are associated with posturographic parameters in FRDA patients. METHOD: Adult patients with genetically confirmed FRDA (n=11) and ADCA (n=13) were evaluated by SARA, FARS and posturography. RESULTS: FRDA patients' postural stability parameters, in stance with visual control, correlated with balance impairment in FARS (r=0.622; p<0.05) and SARA (r=0.735; p<0.05). Without visual control, only FARS correlated with balance impairment (r=0.732; p<0.05). CONCLUSION: The SARA, in FRDA patients, correlates with stance with visual control but not without visual control which emphasizes sensory ataxia. This suggests that application of the SARA in Friedreich's ataxia patients according to posturography is possible but presumably limited and FARS, although being a more time consuming scale, may have advantages over SARA in FRDA patients.

• Klíčová slova
• Autosomal dominant spinocerebellar ataxia, Clinical rating scale, FARS, Friedreich's ataxia, Posturography, SARA,
• MeSH
• ataxiny MeSH
• dítě MeSH
• dospělí MeSH
• Friedreichova ataxie diagnóza   genetika   patofyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• neparametrická statistika MeSH
• postura těla fyziologie   MeSH
• posturální rovnováha fyziologie   MeSH
• proteiny nervové tkáně genetika   MeSH
• stupeň závažnosti nemoci * MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• ataxiny MeSH
• proteiny nervové tkáně MeSH

OBJECTIVE: A case of HELLP syndrome complicated by liver rupture in the 36th week of pregnancy. DESIGNS: A case report. SETTING: Department of Obstetrics and Gynaecology, FN Olomouc. CASE REPORT: The authors report a case of 31 years old female patient who came to the hospital at 36th week of pregnancy with epigastric pain lasting about 14 days. The problems became worse in the last 10 hours. At admission, the patient was pale with repeatedly unmeasurable blood pressure, and she had lower limbs oedema. There was performed the caesarian section, during the operation the liver rupture was found. Both, patient and her baby, was saved thanks to the concerted interdisciplinary team work. CONCLUSION: One of the most serious complications of HELLP syndrome is liver rupture. It occurs in 3.8% of HELLP syndrome cases. The solution of this complication is to perform an acute operation. The operation is based on liver suture with application of deep mattress suture, applying hemostatic materials, liver compression by Mikulicz´s tamponade or ligation of liver artery. There is also possibility to use omentoplasty. If there is necessity of liver resection for necrotic focus, the argon coagulative laser is used preferably.

• MeSH
• císařský řez MeSH
• dospělí MeSH
• HELLP syndrom diagnóza   MeSH
• lidé MeSH
• nemoci jater diagnóza   etiologie   MeSH
• počítačová rentgenová tomografie MeSH
• spontánní ruptura MeSH
• těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

Friedreich's ataxia (FRDA) and spinocerebellar ataxia type 2 (SCA 2) are among the most commonly diagnosed hereditary ataxias in Czech Republic. Although criteria differentiate the ataxias, disorder onset symptoms may be similar. Our goal was to determine whether and to what degree of validity posturographic examination may be utilized, with the aim of differential diagnosis; which specific posturographic parametres are suitable for differential diagnosis; and which differences in FRDA and SCA 2 patient posturographic findings may be established. 17 SCA 2 and 12 FRDA patients were examined with ten healthy controls. A multi-sensor tenzometric platform was used for posturographic examination. Toe standing position was added to basic tests, including standing position with and without visual control. There was no difference between patients in standing position with visual control but there were distinct differences between FRDA and SCA 2 patients, based on upright stance without visual control and medio-lateral deviation. There were no differences between patients in toe standing position, suggesting not only the cerebellum, but also deep sensation, helps to create the so-called adaptive controller. Posturography is attested to as a useful method for differential diagnosis of hereditary ataxias and provides neurophysiological findings in cerebellar and sensoric ataxias.

• MeSH
• diagnostické techniky neurologické normy   MeSH
• diferenciální diagnóza MeSH
• dospělí MeSH
• Friedreichova ataxie diagnóza   epidemiologie   patofyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• postura těla fyziologie   MeSH
• posturální rovnováha fyziologie   MeSH
• psychomotorický výkon fyziologie   MeSH
• spinocerebelární ataxie diagnóza   epidemiologie   patofyziologie   MeSH
• spinocerebelární degenerace diagnóza   epidemiologie   patofyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

INTRODUCTION: Umbilicus is a scar, which is the place of the previous merger of the fetus with the umbilical cord. After birth, it has no known function, however, unless the umbilical annulus is completely closed, umbilical hernia may occur. Umbilical scar is also an area where may occur a number of anomalies that may be present alone or together with umbilical hernia. Failure of involution leads to persistence of omphalomesenteric duct and urachal remnants. These embryonic remnants may cause more or less significant clinical problems, or may be completely asymptomatic and may be diagnosed at random. MATERIALS AND METHODS: The authors present their own group of patients who were diagnosed and dealt with the defect omphalomesenteric duct or urachus. In past 7 years we observed 35 children with these abnormalities. A large group of patients represents incidental findings during elective surgery for umbilical hernia. Another large group are patients with symptomatic or asymptomatic Meckel's diverticulum. The anatomical observations, clinical manifestations, complications and treatment of these anomalies are mentioned. RESULTS: A total of 35 children were found with these birth defects. In 23 cases we observed omphalomesenteric duct disorders and 12 urachal remnants were reported. Of these, 12 abnormalities were found incidentally during elative procedure for umbilical hernia. Asymptomatic or symptomatic Meckel's diverticulum appeared in 16 cases. Surgical treatment included resection or exstirpation, if urachal anomaly was accompanied then partial resection of the bladder vertex was added. Postoperative complications emerged in 4 cases, three times it was ileus from adhesions 6 months after surgery, once postoperative cystitis appeared and was treated conservatively. CONCLUSION: Birth abnormalities of the umbilicus are relatively rare diseases that may occur in the pediatric population. Omfalomesenteric duct and urachal anomalies constitute a major group of these congenital disorders and are often associated with umbilical hernia. They can be diagnosed soon after birth or later in life. Surgical treatment involves excision or radical exstirpation to prevent early or late complications (urachal carcinoma in adulthood).

• MeSH
• dítě MeSH
• ductus vitellinus abnormality   MeSH
• kojenec MeSH
• lidé MeSH
• Meckelův divertikl diagnóza   MeSH
• mladiství MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• umbilicus abnormality   MeSH
• urachus abnormality   MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

The aim is to present gastrectomy/D2 lymphadenectomy technique with stomach substitution with "J-pouch". The description of gastrectomy/D2 lymphadenectomy with the following reconstruction of upper GI part comes from a standardized technique as well as from the experiences of the authors. The technique of "J-pouch" with the anti-reflux cuff is a reconstruction modification created by the authors. "J-pouch" is created in the aboral half of interponate jejunal loop with the following reconstruction with esophagojejunostomy end-to-side and antireflux cuff creation. On the distal end is the jejuno-duodenostomie side-to-end created. The reconstruction with "J-pouch" after gastrectomy is an advantageous technique. It creates the needed reservoir and retains the physiological orientation through duodenum. These two factors lead to the improvement of life quality for patients after gastrectomy. This technique is safe and standard to perform according to the authors' experience.

• MeSH
• gastrektomie * MeSH
• jejunum chirurgie   MeSH
• lidé MeSH
• lymfadenektomie MeSH
• nádory žaludku chirurgie   MeSH
• pouch MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

AIM: The comparison of quality of life after gastrectomy. METHOD: Quality of life after gastrectomy is compared in open, prospective, randomised trial. The group with Roux-en-Y reconctruction and "J-pouch" reconstruction are compared. "J-pouch" is created using interponate jejunum loop with keeping duodenum in passage. The standardized questionnaire according to Eypasch is tool for comparison of quality life. The statistical evaluation was performed using Student t-test. RESULTS: 67 patients were analyzed altogether. The average quality of life in the group with Roux-en-Y reconstruction was 92.6 points and in the "J-pouch" group was 102.5 points. The statistical comparison of quality of life using Student t-test in the group with Roux-en-Y and "J-pouch" reconstructions confirmed significant difference (p = 0.0067). CONCLUSION: Quality of life in patient after gastrectomy represents the most important factors after surgery. The standardised questionnaries help to quantify quality of life and provide the necessary data for evidence based medicine. The statistical comparison confirmed the higher quality of life in patients with "J-pouch" reconstruction. The possibility of reconstruction providing better nutrition and higher quality of life should be considered.

• MeSH
• dospělí MeSH
• gastrektomie * MeSH
• kvalita života * MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory žaludku chirurgie   MeSH
• pouch * MeSH
• Rouxova Y-anastomóza MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• randomizované kontrolované studie MeSH