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Splenic cyst is a rare illness of the spleen. Usually they cause no symptoms, and if they do, these are rather uncharacteristic. Very often the diagnosis is made accidentaly during ultrasonography or computed tomographic scans. Symptomatic, especially large and complicated cysts demand surgical treatment. Spleen parenchyma preserving operations reduce the risk of early and late septic complications, particularly overwhelming postsplenectomy sepsis. Among surgical procedures saving spleen parenchyma are: percutaneous drainage, decapsulation, marsupialization, total cystectomy and partial splenectomy. Nowadays splenectomy is the treatment of choice in the case of very large cysts, multiple cysts, infected or situated near the hilum of the spleen. In this report, we describe two patients treated for splenic cysts. In both cases the total cystectomy was performed. The aim of the study was to review surgical procedures and analyze their efficacy. [ABSTRACT FROM AUTHOR]

Pneumothorax is defined as air accumulated in the pleural cavity. It can be categorized as spontaneous, traumatic or iatrogenic. Spontaneous pneumothorax can be further classified into primary or secondary. Primary spontaneous pneumothorax usually is caused by rupture of a subpleural bleb or bulla. The current treatment options for pneumothorax include observation, needle aspiration, tube thoracostomy, thoracotomy or thoracoscopy. There are few reports on treatment of SP in the pediatric population. Between 2007 and 2010 in the Department of Pediatric Surgery and Oncology Medical University of Łodż 3 patients (2 boys and 1 girl) underwent thoracoscopy for primary spontaneous pneumothorax. The indications for thoracoscopy were failure of lung expansion after chest tube placement, persistent air leak (>7 days) and contralateral pneumothorax. Patients' age was 15, 16 and 17 years, respectively. In all cases resection of a bulla was performed. We did not observe any ipsilateral recurrences. One patient had recurrence of pneumothorax on the opposite side. The authors underline that thoracoscopy is a safe and effective method in children with primary spontaneous pneumothorax. High recurrence rates after treatment with chest tube drainage support early thoracoscopy. [ABSTRACT FROM AUTHOR]

Spontaneous splenic rupture in the course of infectious mononucleosis is a rare but potentially fatal complication. Atraumatic splenic rupture of infectious mononucleosis is estimated at approximately 0.1-0.5%. The spleen is most vulnerable to rupture during the second or third week of the illness when capsular and trabecular changes are most pronounced. The spleen remains susceptible to trauma for several weeks after the resolution of symptoms. The proper diagnosis of spontaneous splenic rupture may be difficult. The diagnosis is usually stated by an emergency laparoscopy due to lack of typical symptoms of splenic rupture revealed by the first physical and ultrasound examination, as well as generally good condition of the patient. We report the case of an 18-years-old boy with infectious mononucleosis who had a spontaneous splenic rupture. On the day of admission, he noted abdominal pain and weakness. In the first physical and ultrasound examination splenic rupture was not revealed. No symptoms of oligovolemic shock were observed during hospitalization. On day 8 the patient's condition became worse. Explorative laparoscopy revealed splenic fragmentation. Splenectomy was successfully performed. The above case reminds us that diseased spleen could submit to spontaneous rupture, which can be life-threatening. The paper presents analysis of publications related to spontaneous splenic rupture in the course of infectious mononucleosis. The current options of treatment in this case are discussed in the summary. [ABSTRACT FROM AUTHOR]

Clinical issues of sunken chest are reported. Pectus excavatum (PE) is one of the most frequent congenital deformations of the anterior chest wall. It is said to be indicated by abnormalities of homeostasis at the stage of osteo- and chondrogenesis. The deformation negatively influences not only the esthetics and patients' appearance, but also his psychic development and social relations. Pectus excavatum may cause many health problems, especially concerned with cardiovascular and respiratory systems. The methods of physical therapy and parameters used in the assessment of the degree of chest wall deformity are also discussed. In addition to that, authors present modern way of operative treatment of PE - the Nuss procedure. The operating technique, eventual complications and further therapy are reported. [ABSTRACT FROM AUTHOR]

Congenital cystic adenomatoid malformation (CCAM) is a rare pulmonary abnormality that results from aberrant fetal lung development. It about 4-26% of cases it can be associated with other congenital abnormalities. We describe a case of congenital cystic adenomatoid malformation 2 associated with polycystic kidney disease. The association of these two congenital malformations is exceptional. Only four similar cases have been reported in the literature. A 2-year-old girl was referred to the Department of Paediatric Surgery and Oncology Medical University of Lodz with pneumonia and left pneumothorax. For three weeks prior to referral the patient was treated with antibiotics. Chest x-ray revealed hyperinflation of left upper lobe with mediastinal shift to right. Computer tomographic scan of the lung revealed multiple cyst in the left upper lobe, left-site pneumothorax and mediastinal shift to the right. The patient underwent thoracotomy. Intraoperatively, multiple cysts in the left upper lobe were found and left upper lobectomy was performed. Histologic study was compatible with type 2 congenital cystic adenomatoid malformation. Ultrasound examination showed multilocular cysts in both kidneys. The dimensions of the cysts were: MWR4. 54x45x45 mm and 25x21x24 mm on the left and right sides, respectively. Significant increase in cyst size on the left side was observed. Ten months after first hospitalization resection of the cystic lower pole of the left kidney was performed. The presence of even a single renal cyst in a child with CCAM is an indication for further follow up examinations.

Background: The pathogenesis of infantile hypertrophic pyloric stenosis (IHPS) is not fully understood. Hypertrophy of the pyloric muscle is probably regulated by growth factors. Recent studies reported an increase in the local synthesis of insulin-like growth factor-1 (IGF-1). There are no reports concerning platelet-derived endothelial cell growth factor (PDEGF) playing an important role in the pathological angiogenesis. The aim of this study was to analyze the expressions of IGF-1 and PDEGF by immunohistochemistry (IHC) in the muscularis propria of the pyloric muscle in children with IHPS., Material/methods: Twenty-two muscle biopsies were obtained at the time of pyloromyotomy. The control group consisted of seven children. Specimens were evaluated by routine histopathological methods and by immunohistochemistry using monoclonal mouse anti-PDEGF or -IGF-1 antibodies. Cells showing positive reaction were counted in five random 200x high-power fields. Values were expressed as the mean +/-SD of the real expression area of the analyzed marker to the total analyzed area., Results: In children with IHPS the average area of PDEGF expression was 62+/-52.5, whereas in the control group it was 15+/-12.1. The average area of IGF-1 expression was 1037+/-491.9) in study group and 259+/-221.44 in the controls. Statistically significant differences were found., Conclusions: These results show a local increase in the expressions of IGF-1 and PDEGF in the muscularis propria of the pyloric muscle in children with IHPS, which may have implications to the pathogenesis of the disease.