Therapeutic tactics in the treatment of acute necrotizing pancreatitis.

Background/aims: The authors analyze the possibilities for the delay of surgery with special consideration regarding percutaneous peripancreatic drainage in the treatment of acute necrotizing pancreatitis.

Methodology: In addition to intensive care therapy, 61 patients were also given antibiotic prophylaxis, and early nasojejunal enteral feeding was commenced. In a total of 22 cases where peripancreatic fluid was found, percutaneous drainage was performed.

[Successful surgical removal of adrenocortical carcinoma growing into the inferior vena cava and the right atrium].

The authors discuss a case of a 47-year old female, who underwent a left adrenalectomy for adrenocortical carcinoma. A few months later the tumour locally recurred and spread through the inferior vena cava into the right atrium. The tumour thrombus almost completely occluded the lumen of the inferior vena cava resulting in significant hepatic congestion, ascites and oedema of the lower extremities.

[Adenomatoid malformation as peripheral round shadow in lung].

The authors present a case report of a 17 years old female patient who had a peripheral round shadow on the chest X-ray. After the operation the histological examination verified cystic adenomatoid malformation. The cystic adenomatoid malformation is an abnormal growth of the terminal bronchiolar structures.

New reconstructive surgery of remnant pancreas in cases of cancer of Vater's papilla.

Background/aims: The radical surgical procedure for treatment of the carcinoma of papilla of Vater is the pancreatoduodenectomy. The mortality rate of the surgery highly decreased in the last decade, nevertheless there are complications related to the complication of anastomosis of the remnant pancreas.

Methodology: The authors introduce a new reconstructional procedure to decrease the complications.