[Pathology of the spleen in children--current possibilities of surgical treatment].

In the submitted paper the authors review the contemporary state of surgery of the spleen in child age. Surgical treatment is used most frequently in injuries of the spleen, in portal hypertension and in haematological diseases. In a group of patients during the last decade efforts to preserve the spleen are emphasized and experience is reported with the use of therapeutic procedures.

[Hemodynamic changes after sclerotherapy of esophageal varices in children].

The authors present an account on favourable late results of sclerotization of oesophageal varices in children. After sclerotization not only an immediate effect can be observed such as arrest of haemorrhage but also long-term favourable effects are found in the venous circulation of the splanchnic area.

[Mini-invasive osteosynthesis in injuries of the finger phalangeal bones in children].

Injuries of the skeleton of phalanges of the fingers are along with injuries of the forearm the most frequent fractures in childhood and in the great majority conservative treatment is possible. Only exceptionally primary surgery is needed and if it fails and redislocation occurs, surgical treatment is indicated. Then the method of choice is miniinvasive osteosynthesis--percutaneous fixation.

[Mini-invasive osteosynthesis in injuries of the metacarpal bones in children].

Injuries of the metacarpal bones in child and adolescent age are much less frequent than in adult age. Most frequently the IVth and Vth metacarpal bone are affected where paradoxically in the distal area metaphyseal fractures predominate over injuries of the physes. During the period between 1994-1998 on account of this injury in our department a total of 11 patients were treated by the method of miniinvasive osteosynthesis.

Arteriovenous malformations of the orofacial area.

Vascular lesions are pathological residues of the embryonic vascular system and can be divided into two main groups. The first group comprises haemangiomas, which are typical of childhood and involute spontaneously. The second group is formed by lesions without active proliferation, which include, among others, arteriovenous malformations that are congenital and grow proportionately with the subject.

[Laparoscopic cholecystectomy in children].

Objective: Retrospective evaluation of laparoscopic cholecystectomy in children. The authors deal with the asset of the method in child surgery and emphasize the differences of treatment of cholelithiasis in children by a laparoscopic approach.

Method: During 1994 to 1998 the authors made 54 laparoscopic cholecystectomies in children 5 to 18 years old (mean age 14.

[Treatment of fractures in the elbow region in children using the Fragment Fixation System--initial experience].

In child traumatology among implants an irreplaceable place is held by Kirschner wires. An improved version of this implant is the Orthofix Fragment Fixation System (FFS) of Kendall Co. which combines the advantages of Kirschner wires with the compressive properties of a screw.

[Comparison of the results of minimally invasive and open osteosynthesis in treatment of injuries of the proximal radius in children].

The authors present their experience with treatment of injuries of the proximal radius in children. During the period between 1994 and 1998 they treated on account of this injury a total of 59 patients. Ten times they used the open method, 15 times percutaneous fixation and 34 times a conservative approach.

[Tragic results of an untreated compartment syndrome of the lower extremity].

Despite its notorious extensive consequences compartment syndrome is generally underrated high risk states are not adequately monitored and treated and therefore there is a number of seriously injured child patients. Late surgical intervention and incorrect therapy are responsible for consequences and incomplete recovery. The authors present the case of a 9-year-old boy treated for a diaphyseal fracture of the thigh by vertical traction, where compartment syndrome developed during treatment and did not receive adequate attention.

[Systemic enzyme therapy in the treatment of supracondylar fractures of the humerus in children].

The authors present their experience with enzyme therapy--the preparation Wobenzym--in comprehensive treatment of supracondylar fractures of the humerus in children. On monitoring the condition of the extremity by Doppler ultrasound, where the flow through the radial artery was quantified they obtained better results in the group of patients treated by systemic enzyme therapy than in the control group. Systemic enzyme therapy is recommended as a suitable supplement in comprehensive treatment where the most important part is played by correct and early treatment along with precise monitoring of the extremity during the postoperative course.

[Fractures and physeal injuries of proximal humeral end in children.].

A total of 102 children and adolescents, 27 girls and 75 boys of the median age of 10.9 years, were treated for injuries to the proximal humerus at the PediatricTrauma Centre of the Clinic of Pediatric Surgery and Traumatology in Brno over the period of 1993-1997. A conservative approach was indicated in 51 cases (50%), percutaneous pinning after conservative reduction in 50 cases (49%) and an open surgical approach in one case (1%).

[Transcutaneous anorectal sphincteromyectomy--possible use in pediatric anorectal surgery].

Anorectal sphincteromyectomy (SME) is a simple operation: after accurate localization of the inner anal sphincter from the latter a longitudinal strip 3-4 cm long and 2-4 mm wide is resected, depending on the child s age. In the submitted paper the author describes the surgical method which is used less frequently although it gives comparable results, it is simple and the number of complications is minimal.

[Problems in the diagnosis and treatment of splenic injuries in children].

The diagnosis and treatment of the injured spleen in children changed markedly during the last 20 years. However even when contemporary diagnostic algorithms and therapeutic procedures are used, there are still problems for which we lack an unequivocal answer. Based on their own experience and data in the literature the authors try to contribute to the solution of this important traumatological problem.

[Current results of endoscopic therapy of esophageal varices in children].

The authors present their experience with the endoscopic treatment of oesophageal varices in children. During 1991-1994 they treated 21 children where they performed a total of 156 sclerotizations. The mean age of the patients was 10.

[A non-traditional procedure in the surgical treatment of portal hypertension in a child].

The authors present the case-history with a uncommon surgical procedure in a child with portal hypertension and hypersplenism. Half the spleen was resected and concurrently a distal splenorenal anastomosis of the Warren type was created. This procedure was selected because the child had a very enlarged spleen and marked hypersplenism.

[Choledochal cysts in children].

The author presents an account of cysts of the choledochus in children. With present possibilities of ultrasonic examination in abdominal pain, jaundice or a palpable resistance in the abdomen cystic formations in the subhepatic region are diagnosed with increasing frequency in child age and are operated. At present the best and most permanent results are achieved after extirpation of the cyst and substitution of the extrahepatic biliary pathways by a jejunal loop, as recommended by Roux.

[Retroperitoneal fibrosis in children].

The authors describe retroperitoneal fibrosis (RPF) in general and the case of a six-year-old child who suffered from RPF. Due to the atypical course of the disease the diagnosis was very difficult not only due to the clinical course but also because of the histological examination. The atypical course was manifested by affection of the lungs, liver, pancreas and porta hepatis.

[Therapy of bleeding esophageal varices in children--present and future aspects].

The authors' department has devoted the past 25 years to treatment of portal hypertension in children and above all to the most dramatic manifestations-haemorrhage from oesophageal varicosities. In previous years a number of surgical and conservative methods was used. The milestone in therapeutic strategy and tactics was the year 1990 when endoscopic sclerotization of oesophageal varices was introduced as a routine method.

[Rehbein's operation in the treatment of Hirschsprung's disease].

The authors give an account of Rehbein's operation which they use with increasing frequency in the treatment of Hirschsprung's disease. This operation extended the range of operations and meets the basic requirements for treatment of Hirschsprung's disease. As compared with other operations of this disease, it is simpler from the technical aspect, has a favourable postoperative course and long-term results and can thus be recommended to departments of paediatric surgery.

[Perineal infiltrates after amputation procedures in carcinoma of the rectum].

The authors present their experience with perineal infiltrates amputations on account of rectal carcinoma. In the course of 1986 in the Oncological Research Institute in Brno 58 patients with this diagnosis were hospitalized. After amputations three types of surgical complications were observed: 1.