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Aim: The differential diagnosis for a child with abdominal pain is extensive. It includes problems from organs within the abdomen as well as from organs outside of the abdomen. Testicular torsion can present with abdominal pain that mimics appendicitis, and can lead to significant morbidity if not quickly diagnosed. As a result, it is important to always perform a complete physical examination, including examining the genitals, when a child presents with abdominal pain. The aim of this paper was to evaluate management and outcomes of pediatric patients with testicular torsion initially presented as acute abdominal pain. Methods: From January 1999 through January 2013 case records of 92 children operated on for testicular torsion were retrospectively reviewed. Of total number of operated patients 21 (23%) patient presented with abdominal and scrotal pain and 9 (10%) patients presented with abdominal pain only without initial scrotal pain and only they were included in study. Results: The most common presenting symptoms were abdominal pain and vomiting. The patient's scrotum and testicles were never examined during the first evaluation in 6 cases, while in 3 cases testicles were examined during the first physical examination of abdominal pain. At surgery, 4 testes have been salvaged, while 5 has been lost because of testicular necrosis. The mean duration of symptoms was 4 hours in group of salvaged testes and 39 hours in group of orchidectomies. There were no major complications. Conclusion: Testicular torsion should always be included in differential diagnosis when evaluating lower abdominal pain in young males. An external genital organ has to be examined in every child or adolescent with acute abdominal pain. Bearing in mind this fact, if the patients come in time, the testicle can be salvaged.

The aim of the study was to estimate the prevalence and causes of obstructive icterus in patients operated on during the 2003-2004 period at University Department of Surgery, Split University Hospital in Split. In addition, data on the patient age and sex, type of surgical treatment, and existence and impact of risk factors on operative outcome were analyzed. Data on 114 patients with obstructive icterus treated at the Department during the 2-year period were retrospectively analyzed. Obstructive jaundice is a disease predominantly affecting female population (61.4% of patients), mostly those aged 60-74 (40% of patients). Cholelithiasis with choledocholithiasis is the most common cause of obstructive jaundice. Therefore, the most frequently used procedure for obstructive jaundice is cholecystectomy with or without choledochotomy and concrement extraction. The number of patients diagnosed with obstructive icterus shows a considerable increase. Although the same surgical methods have been applied for years, endoscopic surgery has gradually displaced classic methods of surgical treatment., Cilj rada bio je ispitati učestalost i uzroke opstrukcijskog ikterusa kod bolesnika koji su u razdoblju od 2003. do 2004. godine operirani u Klinici za kirurgiju Kliničke bolnice Split. Uz navedeno analizirali smo dob i spol bolesnika, vrstu primijenjenog kirurškog liječenja, te postojanje i utjecaj čimbenika rizika na ishod kirurškog liječenja. U dvogodišnjem razdoblju retrospektivno su analizirani podaci 114 bolesnika koji su zbog opstrukcijskog ikterusa liječeni u Klinici za kirurgiju KB Split. Opstrukcijska žutica je bolest koja pretežito zahvaća žensku populaciju (61,4% bolesnika) i to najčešće u dobi od 60 do 74 godine (40% bolesnika). Kolelitijaza s koledokolitijazom i dalje je najčešći uzrok opstrukcijske žutice. Sukladno navedenom, najčešće izvođeni zahvat u liječenju opstrukcijske žutice je kolecistektomija s koledokotomijom i ekstrakcijom konkrementa ili bez toga. Broj bolesnika kojima se dijagnosticira opstrukcijski ikterus pokazuje značajan porast. Iako se već dugi niz godina u liječenju primjenjuju iste kirurške metode, endoskopska (laparoskopska) kirurgija postupno istiskuje klasične oblike kirurškog liječenja.