INTRODUCTION: High resolution anorectal manometry (HRAM) is a diagnostic method indicated in patients with anorectal dysfunction. The aim of the study was to evaluate the prevalence of anorectal dysfunctions and to assess therapeutic consequences. METHODS: Retrospective data of consecutive patients referred to HRAM in the period from March 2019 to February 2021 were evaluated. Basic manometric parameters were assessed: resting pressure (RP), maximal squeeze pressure (SP), rectal sensitivity (RS), and dyssynergic defecation (DD). RESULTS: 113 patients with combined fecal incontinence and obstructive defecation syndrome (FI + ODS: 44.2%), fecal incontinence (FI: 26.5%), obstructive defecation syndrome (ODS: 16.8 %), stoma before restoration of intestinal continuity (6.2%), functional pelvic pain (FP: 3.5 %) and controversial cases (2.7%) were analyzed. The average age was 54 years; female patients predominated (72 %). Patients with FI and FI+ODS had lower mean RP (57 mmHg and 53 mmHg) and/or lower SP (160 mmHg and 140 mmHg) compared to baseline. Patients with ODS had normal values of mean RP (75 mmHg) and SP (225 mmHg). DD was noted in most patients (FI: 76.6%, FI + ODS: 88%, ODS: 89.5%, FP: 100%). Conservative therapy with pelvic floor physiotherapy was provided in most cases (FI+ODS: 40%, ODS: 36.8%, FI: 13.3%, FP: 75%). CONCLUSION: In patients with defecation disorders there is a high prevalence of pathological manometric findings that combine with each other. Based on manometric findings, conservative treatment with individual pelvic floor physiotherapy can be initiated.

• Klíčová slova
• anorectal dysfunction, anorectal manometry, pelvic floor physiotherapy,
• MeSH
• anální kanál * MeSH
• defekace MeSH
• fekální inkontinence * diagnóza   epidemiologie   terapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• manometrie MeSH
• rektum MeSH
• retrospektivní studie MeSH
• zácpa diagnóza   epidemiologie   terapie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

A substantial body of literature has provided evidence that type 2 diabetes mellitus (T2DM) and colorectal neoplasia share several common factors. Both diseases are among the leading causes of death worldwide and have an increasing incidence. In addition to usual risk factors such as sedentary lifestyle, obesity, and family history, common pathophysiological mechanisms involved in the development of these diseases have been identified. These include changes in glucose metabolism associated with adipose tissue dysfunction including insulin resistance resulting to hyperinsulinemia and chronic hyperglycemia. In addition to altered glucose metabolism, abdominal obesity has been associated with accented carcinogenesis with chronic subclinical inflammation. An increasing number of studies have recently described the role of the gut microbiota in metabolic diseases including T2DM and the development of colorectal cancer (CRC). Due to the interconnectedness of different pathophysiological processes, it is not entirely clear which factor is crucial in the development of carcinogenesis in patients with T2DM. The aim of this work is to review the current knowledge on the pathophysiological mechanisms of colorectal neoplasia development in individuals with T2DM. Here, we review the potential pathophysiological processes involved in the onset and progression of colorectal neoplasia in patients with T2DM. Uncovering common pathophysiological characteristics is essential for understanding the nature of these diseases and may lead to effective treatment and prevention.

• MeSH
• adipozita MeSH
• diabetes mellitus 2. typu epidemiologie   mikrobiologie   patofyziologie   MeSH
• dysbióza MeSH
• energetický metabolismus MeSH
• hodnocení rizik MeSH
• hyperglykemie epidemiologie   patofyziologie   MeSH
• hyperinzulinismus epidemiologie   patofyziologie   MeSH
• incidence MeSH
• inzulinová rezistence MeSH
• kolorektální nádory epidemiologie   mikrobiologie   patofyziologie   MeSH
• lidé MeSH
• obezita epidemiologie   patofyziologie   MeSH
• rizikové faktory MeSH
• střevní mikroflóra MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Zenkers diverticulum is the most common type of esophageal diverticulum with a prevalence of 0.01 to 0.11 %, usually found in middle-aged and older patients. The prevalent symptoms are dysphagia and regurgitation. Treatment is recommended in symptomatic patients and consists of myotomy of the cricopharyngeal muscle. Both surgical and endoscopic methods are used in the treatment of Zenkers diverticulum. With technical advances, flexible endoscopy has come to the forefront in the treatment of Zenkers diverticulum, especially in older polymorbid patients. Its advantages include lower morbidity and mortality, shorter surgery time, the possibility of performing the procedure without general anesthesia, and a shorter hospital stay, including early oral food intake. In this paper we present our own experience with endoscopic treatment of Zenkers diverticulum and at the same time we provide a review of effectiveness with other methods of treatment.

• Klíčová slova
• Zenker’s diverticulum − cricopharyngeal muscle − myotomy − rigid endoscopy − flexible endoscopy,
• MeSH
• délka operace MeSH
• délka pobytu MeSH
• endoskopie MeSH
• lidé středního věku MeSH
• lidé MeSH
• poruchy polykání * MeSH
• senioři MeSH
• Zenkerův divertikl diagnostické zobrazování   chirurgie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Presented selected case reports are focused on the individual cases of patients suffering from functional anorectal disorders. During the examination algorithm, the emphasis is on 3D high-resolution anorectal manometry, which is a useful diagnostic technique and helps to understand the pathophysiological mechanisms in the field of functional anorectal disorders. Thanks to a comprehensive examination an individualized treatment plan can be determined for each patient.

• Klíčová slova
• 3D high-resolution anorectal manometry, fecal incontinence, functional anorectal disorders, obstructive defecation syndrome,
• MeSH
• anální kanál MeSH
• defekace MeSH
• fekální inkontinence * MeSH
• lidé MeSH
• manometrie MeSH
• plánování péče o pacienty MeSH
• rektum MeSH
• zácpa MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

Complex anorectal examination including a detailed medical history, physical proctological examination and evaluation of the sensorimotor and structural function of the anorectum is essential for the diagnosis and therapeutic management of functional anorectal dysfunction. The aim of the work is to provide an overview of diagnosing functional anorectal disorders according to the new update and consensus statement of the International Anorectal Physiology Working Group (IAPWG) with a focus on indications, a standardized examination protocol and introduction of the new London classification of anorectal dysfunction. The indications are: fecal incontinence, defecation disorders, functional pelvic (anorectal) pain, evaluation before an anorectal intervention and before planned delivery to assess the function of a previously traumatized anal sphincter. Standardization of the diagnosis and the evaluated data are the basis for multidisciplinary cooperation and determination of a treatment plan for each patient individually.

• Klíčová slova
• London classification, anorectal manometry, functional anorectal testing, indications, standardized protocol,
• MeSH
• anální kanál MeSH
• defekace MeSH
• fekální inkontinence diagnóza   MeSH
• lidé MeSH
• manometrie MeSH
• plánování péče o pacienty MeSH
• rektum MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Londýn MeSH

OBJECTIVES: The main objective is to compare the accuracy of EUS and CEH EUS for the diagnosis of pancreatic cancer (PC). The secondary objective is to evaluate the accuracy of EUS FNA and to determine to what extent EUS and CEH EUS findings are affected by endosonographer subjectivity. METHODS: A prospective single-centre study was conducted in patients with pancreatic lesions detected on CT. The patients were examined by EUS, CEH EUS and EUS FNA. The obtained results were compared with the final diagnosis that was based on cytology and further clinical findings and on histopathological findings from subjects who underwent surgery. A second reading of the EUS and CEH EUS images was performed by the endosonographer, who was blinded to clinical data of patients. RESULTS: We examined 116 patients, 73 had a final diagnosis of PC, 14 had NETs and 20 had other tumours. The sensitivity, specificity, NPV, PPV, and accuracy of EUS for diagnosis of PC were 83.1, 62.5, 83.1, 70.7 and 78.6%, for CEH EUS 94.5, 61.7, 84.1, 84 and 84.1% and for EUS FNA 87.6, 91.2, 95.5, 77.5 and 88.8, respectively. The inter-observer agreement for EUS marker of PC was good (κ = 0.75), and that for CEH EUS was average (κ = 0.59 for arterial phase and κ = 0.68 for washout in venous phase). CONCLUSION: CEH EUS is a non-invasive method that allows more accurate identification of PC than EUS. The subjectivity of CEH EUS evaluation is worse than that of EUS but acceptable.

• Klíčová slova
• Contrast-enhanced endosonography, FNA, pancreatic cancer,
• MeSH
• biopsie tenkou jehlou pod endosonografickou kontrolou * MeSH
• dospělí MeSH
• endosonografie * MeSH
• kontrastní látky aplikace a dávkování   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory slinivky břišní diagnóza   patologie   MeSH
• pankreas patologie   MeSH
• prospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• senzitivita a specificita 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
• časopisecké články MeSH
• srovnávací studie MeSH
• Geografické názvy
• Česká republika MeSH
• Názvy látek
• kontrastní látky MeSH

Colon perforation is a very serious complication of colonoscopy. The correct diagnosis and management of therapy improve the prognosis of patients. The treatment can be conservative, endoscopic and surgical. In this case report we present microperforation as a complication of polypectomy in the caecum during colonoscopy, followed by laparoscopic surgery.Key words: colonoscopy - complication -perforation polypectomy.

• MeSH
• cékum MeSH
• kolon MeSH
• kolonoskopie * škodlivé účinky   MeSH
• lidé MeSH
• nemoci tlustého střeva * MeSH
• perforace střeva * etiologie   chirurgie   MeSH
• pneumoperitoneum * etiologie   chirurgie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

Colon capsule endoscopy (CCE) is a noninvasive technique for diagnostic imaging of the colon that does not require air insufflation or sedation. CCE can be used in average-risk patients, in patients with incomplete colonoscopy and in patients with contraindications for conventional colonoscopy. In this paper, we review the technical characteristics, current application and possible future development of CCE.Key words: colorectal cancer - screening colon capsule endoscopy.

• MeSH
• kapslová endoskopie * MeSH
• kolonoskopie MeSH
• kolorektální nádory * diagnóza   MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Upside-down stomach syndrome is a rare type of a large paraoesophageal hiatal hernia, which requires an immediate surgical treatment in case of incarceration. The authors present a case report of a 53-year-old male patient with gastric volvulus related to the upside-down stomach syndrome. Surgical treatment was complicated by an injury to distal oesophagus, which was successfully treated using a self-expandable metallic stent among other methods. Despite the complicated postoperative course with a necessity of reoperation, insertion of an oesophageal stent, thoracotomy for a mediastinal abscess and secondary healing of the laparotomy, the patient was discharged in a good condition with healed oesophageal perforation and laparotomy after 52 days.

• MeSH
• absces chirurgie   MeSH
• chirurgie trávicího traktu škodlivé účinky   MeSH
• hiátová hernie komplikace   chirurgie   MeSH
• hojení ran MeSH
• lidé středního věku MeSH
• lidé MeSH
• nemoci mediastina chirurgie   MeSH
• perforace jícnu etiologie   chirurgie   MeSH
• pooperační komplikace chirurgie   MeSH
• reoperace MeSH
• samoexpandibilní metalické stenty MeSH
• torakotomie MeSH
• volvulus žaludku etiologie   chirurgie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

BACKGROUND: The mortality of colorectal cancer (CRC) is significant worldwide. There is good evidence for benefits of the CRC screening in mortality reduction. Since 2009, the population of the Czech Republic have had two CRC screening options from which to choose: a faecal occult blood test (FOBT) at the age of 50 to be repeated every two years or primary screening colonoscopy (PSC) at the age of 55. General practitioners play a crucial role in the CRC screening programme. The CRC screening adherence of the Czech population is poor and does not exceed 25%. MATERIAL AND METHODS: The aims of the study were to analyse the reasons behind the low CRC screening adherence of the Czech population, to classify the populations attitudes, and to identify the barriers. A questionnaire survey was conducted in a Czech energy company with 13,000 employees in 2011-2012. The questionnaire was administered electronically by e-mail or directly at the workplace. RESULTS: The questionnaire response rate was 31.3% (4070). The pool of respondents consisted of 2804 (68.9%) females and 1266 (31.1%) males. Of the respondents, 1345 (33.1%) were aged over 50 years (73.5% women and 26.5% men). Of the cohort aged over 50, 68.65% of women and 63.2% of men took a FOBT. Ten percent of respondents aged over 50 years have never heard of CRC screening and 32.8% of this age category have never participated in CRC screening. The main reasons for not taking a FOBT were feeling well and having no health problems (38.8%) or FOBT not offered the by the general practitioner (27.8%). Other reasons were no time to do so, fear of the result, unsure of the procedure, unawareness of what FOBT is, or uncomfortable about the test procedure. On the other hand, 8.37% of the participants aged between 15 and 39 years and 20.7% of those aged between 40 and 49 years have already taken a FOBT. Overall, 15.4% of respondents prefer the new alternative, PSC, as the CRC screening option. Significant differences in CRC screening adherence are seen between administrative regions of the Czech Republic and between education levels. CONCLUSIONS: From the results, it follows that a considerable proportion of the population of the Czech Republic do not understand the principle of CRC screening and its methods. Enough room has been left to promote education on CRC screening for both the public and general practitioners. On the other hand, a large part of proactive individuals participate in CRC screening before the age of 50.

• Klíčová slova
• colorectal cancer - screening - general practitioner - population - patient.,
• MeSH
• časná detekce nádoru metody   MeSH
• dospělí MeSH
• etnicita MeSH
• kolonoskopie * MeSH
• kolorektální nádory prevence a kontrola   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nejistota MeSH
• okultní krev MeSH
• plošný screening MeSH
• postoj MeSH
• pracoviště MeSH
• průzkumy a dotazníky MeSH
• sběr dat MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH