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Introduction: Focal lesions in the liver, due to the wide availability of modern diagnostic imaging methods are often detectable pathology of this organ. For diagnostic imaging of liver lesions are used: abdominal ultrasound examination (including Doppler-ultrasound), computed tomography, selective angiography, magnetic resonance imaging (MRI) and studies using radioactive tracers for example - positron emission tomography (PET). Fine needle aspiration biopsy (FNAB) and core needle biopsy under ultrasound control are a perfect complement to imaging studies. These procedures allow a cytological and histological examination of the collected tissues. Aim of the study: the study aimed to determine the prevalence and nature of lesions in the liver in patients hospitalized in the Department ' of Gastroenterology and Hepatology, Wroclaw Medical University in years 2004-2008. Material and methods: The analysis included the medical records of 8482 patients hospitalized in the years 2004-2008 in the Department of Gastroenterology and Hepatology, Wroclaw Medical University. From among all the hospitalized a group of patients with focal liver lesions was separated. This group was fixed on the basis of a definitive diagnosis made during the hospitalization of diagnostic tests, laboratory and imaging (ultrasound, computed tomography, magnetic resonance imaging), including the location and nature of the changes observed in focal length. Results: In the cohort of 8482 patients hospitalized in the Department of Gastroenterology and Hepatology, Wroclaw Medical University in the years 2004-2008, 535 patients (6.3%) with diagnosed focal liver lesions were isolated. In this group 414 patients (77.38%) suffered from benign lesions, including: simple cysts - found in 246 patients (59.42% of benign changes), hemangiomas - showed in 140 patients (33.82% of benign lesions), calcification - 10 patients (2.42% of benign changes), atypical cysts - abscess - in 9 patients (2.17% of benign lesions), focal nodular hyperplasia in 6 patients (1.45%), adenomas - 2 patients (0.48%). Malignant changes in the liver were diagnosed in 122 patients (22.8%). The highest percentage of malignant tumors were metastases - 108 patients (88.52%). In 11 patients the diagnose was primary hepatocellular carcinoma (9.02% of malignant tumors), while in 3 cases it was a cholangiocellular carcinoma (2.46% of malignant tumors). Conclusions: In this analysis, the most common focal liver lesions are benign simple cysts, while among malignant tumors the metastatic lesions predominated. The primary focus of cancer metastases to the liver was located most commonly in the large intestine. [ABSTRACT FROM AUTHOR]

Introduction: As the course of pancreatic disorders is usually uncharacteristic, diagnosis of the disease is late and the results of applied treatment therefore poor. Among patients with diagnosed neoplastic tumor of the pancreas 5-year survival is only 4%. The growing accessibility of various diagnostic methods, such as endoscopic ultrasound, computed tomography (CT), and magnetic resonance (MR) has significantly influenced the diagnostic process. With these methods it is possible to estimate more precisely the extent and character of the pancreatic lesion than with abdomen ultrasound examination. Despite these advanced techniques, there are still cases in which a final diagnosis cannot be made before surgery. The aim of the study was to establish the prevalence and character of tumor lesions of the pancreas in a group of patients hospitalized at the Department of Gastroenetrology and Hepatology, Wroclaw Medical University, from 2007 to 2008. Materials and methods: The medical records of 3649 patients were analyzed and those with pancreatic tumors were separated. Age, sex, established diagnosis (considering tumor location and type), reported symptoms, laboratory tests, and imaging findings were defined. Results: Eighty patients (2.2%) with diagnosed pancreatic tumors were selected from the 3649. In this group, neoplastic tumor was diagnosed in 19 (23.75%) and 7 (8.75%) had a suspected neoplastic etiology of the tumor and were referred for the further surgical treatment. In 54 patients (67.5%), chronic pancreatitis was the final diagnosis. In the group of 26 patients with a diagnosis or suspicion of neoplastic process solid tumors were stated as the majority (23 patients, 88.5%), whereas among the 54 cases with diagnosed chronic pancreatitis cyst-like lesions predominated (37 patients, 68.5%). Conclusions: As there is a high risk of a neoplastic process among patients with pancreatic tumors (32.5%), accurate and careful diagnostic evaluation is necessary. It is not possible to differentiate between chronic pancreatitis and a neoplastic process of the pancreas based on the reported symptoms of the disease. Despite accurate diagnostic evaluation, including percutaneous pancreatic biopsy, surgical intervention was necessary in some cases to establish the diagnosis. [ABSTRACT FROM AUTHOR]

Colonoscopy is one of basic diagnostic procedures, used for the purposes of lower gastrointestinal tract examination. There are strict indications and counter indications for this examination. The colon must be prepared before performing the test, what allows envisioning it properly and establishing the diagnosis. Nowadays, two main laxative groups are used in pre-colonoscopy preparation: sodium phosphate-containing drugs and polyethylene glycol. Numerous studies have shown that the efficiency of both laxative groups is similar. Their usage has several different advantages and disadvantages and current medicine is still lacking an optimal drug for colonoscopy preparation. [ABSTRACT FROM AUTHOR]

Introduction: The family doctors often refer patients to the gastroenterology departments with a preliminary diagnosis of irritable bowel syndrome (IBS). However, some of the patients report also "alarm symptoms", which suggest a presence of the organic disease. Diagnostic procedures can lead to the change of the preliminary diagnosis in some cases. Aim of study: Our study was designed to evaluate the frequency of a neoplasm and inflammatory bowel disease (IBD) in patients with the preliminary diagnosis of IBS. Material and methods: Medical records of the 581 consecutive patients admitted in years 2001-2008 to the Department of Gastroenterology and Hepatology of Wrocław Medical University with the preliminary diagnosis of IBS were reviewed. The group of the patients with the final diagnosis of neoplasm or IBD was selected. In the study group: age, gender, symptoms, the Rome III diagnostic criteria for the functional bowel disorders and diagnostic procedures were evaluated. Results: The neoplasm or IBD were finally diagnosed in 60 (10.3%) of the patients with the preliminary diagnosis of IBS. Among these patients 58.3% individuals met the Rome III diagnostic criteria for IBS. Conclusions: The knowledge of the Rome III criteria for IBS among family doctors is at insufficient level as we demonstrated low agreement between the preliminary diagnosis of IBS and the diagnostic criteria. Moreover, patients who meet Rome III criteria and report alarm symptoms always require careful diagnostic to exclude the neoplasm or IBD. [ABSTRACT FROM AUTHOR]

Symptoms of the irritable bowel syndrome (IBS) were already described in XIX century. IBS belongs to the group of the gastrointestinal functional disorders. There are no biological markers of this disorder, so the diagnosis of IBS can be established only when all organic causes of the pa- tient's symptoms are excluded. In the study all changes in the diagnostic criteria of the IBS are discussed - beginning from Manning's Criteria dated 1978 to the newest Rome III Criteria published in 2006. [ABSTRACT FROM AUTHOR]

Introduction: Synchronous and/or metachronous multiple neoplasms in humans have been observed for many years. Increasing incidence of multiple neoplasms has been attributed to genetic predisposition, impaired immune state, chemicals (cancerogens) and antineoplastic therapy in the past (radiotherapy, chemotherapy). Although special surveillance is required in patients with genetic predisposition to multiple neoplasms, it seems to be necessary in people with so called sporadic malignancy as well with the aim of early detection of a successive primary neoplasm. Aim of study: To assess the occurrence of multiple primary malignancies, both synchronous and metachronous, their localization, age at onset and interval time between the onset of the first and successive primary neoplasms in patients hospitalized in Gastroenterology and Hepatology Department of Wroclaw Medical University within the last 11.5 years. Special attention was paid to the origin of primary neoplasms associating gastric and colorectal cancer. Material and methods: From 16 550 history records of patients hospitalized in our Department in the period from January 1996 to June 2007 the records of patients in whom anamnesis and diagnostic tests performed during hospitalization indicated the occurrence of two and more primary malignancies in the course of life were chosen and thoroughly analyzed. Additionally, patients with gastric and colorectal cancer were separated and associating neoplasms were analyzed. Results: In our study patients with multiple primary neoplasms (n=34) constituted a small percentage (3.2%) of all patients hospitalized with neoplastic disease. Among them 77 primary malignancies of different origin were diagnosed all together. In females gastric cancer coexisted most frequently with breast cancer and then with malignancies originating from uterus, whereas in males with colorectal adenocarcinoma. In our observation in females colorectal cancer was associated most frequently with breast cancer and then with malignancies originating from uterus, ova- ry, kidney and thyroid gland. In males colorectal cancer was associated mainly with gastric cancer and carcinoma of the larynx, then with prostate cancer and primary tumors of the kidney. Conclusions: Presented data confirm the need of a life-long observation of patients with the history of malignancy, not only being members of families with increased risk of neoplastic disease and not only because of the risk of recurrence and metastases, but also because of the risk of a successive primary neoplasm. Such surveillance could allow for earlier detection of new neoplastic sites, increase treatment efficacy and improve prognosis leading to the better outcome in patients with multiple primary malignancies. [ABSTRACT FROM AUTHOR]