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Krystyn Sosada

Publications and source records attributed to Krystyn Sosada.

8 recordsLinked to original sources
PubMed2005

[Diagnostic difficulties in rare causes of gastrointestinal bleeding].

Peptic and duodenal ulcer and haemorrhagic gastritis are the most common causes of gastrointestinal bleeding. Pathologic changes of the small intestine are rare and difficult to diagnose. The aim of the study is to evaluate the diagnostic strategy regarding patients with gastrointestinal bleeding of obscure origin. From 1996 to 1999, 626 patients were treated for gastrointestinal bleeding. There were difficulties in finding the source of bleeding in three out of 626 patients. Endoscopy of the upper and the lower gastrointestinal tract, hydrosonography of the large intestine and gastrointestinal passage were performed in these three patients. The site of bleeding was not determined after the above mentioned medical examinations. Three patients underwent exploratory laparotomy, and two of them also intraoperative endoscopy of the small intestine. One patient had tumor of the small intestine, and pathologic examination revealed leiomyoma. One patient had Meckel's diverticulum with presence of ectopic gastric mucosa diagnosed. One patient had inflammatory infiltration in the distal ileum. The presence of chronic, non-specific inflammation was proved by histologic examination. In case of patients for whom it was difficult to determine the source of gastrointestinal bleeding the very reason for such a bleeding is often found in the small intestine. It frequently happens that laparotomy and intraoperative endoscopy of the small intestine allows making the diagnosis.

Adult↗
PubMed2004

[Primary suture following the bile duct exploration in cholelithiasis].

Classical performance of bile duct exploration is always strictly connected with the problem of an incised bile duct closure. In majority of surgical centers an external T-tube drainage was carried out in last century. But is an external drainage the best method to be used? The aim of the paper was to establish criteria for including (or excluding) patients to groups undergoing primary suture of bile duct. The comparison of the patients in whom bile duct exploration was followed by primary suture with the group in which T-tube was left in bile duct lumen was performed. Recently in our Department a classical method has been used to operate on 65 patients with cholelithiasis. In 42 patients a preoperatively planned bile duct exploration has been performed. In 14 patients a T-tube was left after the exploration, in 24 patients bile duct was closed with a primary suture. In other 18 patients with residual and recurrent bile duct stones T-tube was left in bile duct only in two patients. Based on literature analysis, our observations, and surgical experience criteria for including and excluding patients for primary suture of bile duct have been established. Groups of patients with and without T-tube were compared, considering complications and economic aspects of hospitalization. Our opinion is that whenever in specialized surgical centers detailed criteria are established and followed precisely, primary bile duct closure is a simple and safe procedure, responsible for few complications. The cost of hospitalization in the case of primary suture is half as much as the price of the hospitalization in the case of T-tube.

Adult↗
PubMed2004

[Effect of palliative chemotherapy with topoisomerase inhibitor on the quality of life and survival of patients with advanced colorectal carcinoma].

Among several topoisomerase I inhibitors topotecan is worth taking into account because of its little toxicity, good tolerance and quick excretion. The study compared functioning of bone marrow, liver and kidneys during and after the treatment, as well as survival period and quality of life of patients treated with topotecan and patients who underwent symptomatic treatment. 35 patients aged 43-71 of both sexes, with advanced stage of large intestine cancer (IV grade in TNM scale) were included in the study. 20 hospitalized patients were administered topotecan, topoisomerase I inhibitor, intravenously in 5-day courses (1.5 mg/m2 of body surface daily) repeated 5 times with 21-day intervals. Before the beginning of therapy and after it the following were conducted: medical check-ups as well as surveys and test research including groups of somatic and vegetative symptoms connected with the disease (based on the questionnaire QLQ-C30). 15 patients with the similar stage of the disease who had not agreed to palliative treatment with chemotherapy were treated only symptomatically. Applying antineoplastic treatment with topotecan contributes to the extension of the survival time by 4 months on average, and mortality during and after the treatment is lower than in the group of patients with the symptomatic treatment only. Antineoplastic treatment improves the quality of life and delays the disease progression. The quality of life is better until the preterminal period of the disease and enables patients maintaining motor activity and independence.

Adult↗
PubMed2004

[The season's influence on the incidence of bacterial hand infection].

We estimated 911 patients who were treated at Surgical Clinic in the District Hospital in Prudnik in the period of time from 1st Jan 1996 to 31st Dec 2002 because of bacterial hand infection (BHI). The patients suffering from paronychia, panaritium or finger abscess were treated in the Outpatient Clinic and patients suffered from purulent tenosynovitis of the hand were hospitalized in the Department of General Surgery. In this paper we estimated correlation between incidence of the disease and the seasons of the year. We found out that people living in the countryside are more often affected with BHI in summer-time and autumn-time compared with people living in towns in whom the prevalence of BHI is not connected with the season of the year. Our results let us to conclude that the incidence of BHI is higher during the summer and the autumn. 75% of patients were treated during these seasons. During the study it was observed that 71% of patients lived in the country.

Adolescent↗
PubMed2003

[Analysis of causes of mechanical jaundice and treatment methods in a group of 103 hospitalized patients].

103 consecutive hospitalized patients at the age from 23 to 87 years with mechanical jaundice are presented in this study. In 58 patients, a cause of the jaundice was ductal calculosis, in four, a damage to bile duct after cholecystectomy. In 43 patients (74%), a calculus was removed through endoscopy, in 2 patients (4%) through Kehr's drain, 13 patients required an operation, in 41 patients, jaundice resulted from a neoplasm including 22 patients with a tumor of the head of pancreas, in 9 neoplasm of gall bladder, in 4 tumor of liver invagination, in 4 tumor of distal part of bile duct, in 2 neoplasm of Vater's papilla. 8 patients out of 28 with neoplastic tumor of pancreatoduodenal field had proximal pancreatoduodenectomy performed (29%). 1 patient out of 4 with a tumor of liver invagination had a tumor removed together with II and III segment of liver with the following right side hepatoenterostomy. No perioperational deaths were noted. In two patients after pancreatoduodenectomy (25%), a fistula in pancreatoenterostomy occurred. Due to the advanced stage of the neoplastic disease, resections in tumors of pancreatoduodenal fields and of liver invagination were only possible respectively in 29 and 25%. In most case of ductal calculosis or residual ductal calculosis, a removal of calculi was possible through endoscopy.

Adult↗
PubMed2003

[Simultaneous operation on the tumor of the pancreas head and abdominal aortic aneurysm-case study].

A case of 73 years old patient qualified for operative treatment due to the escalation of jaundice in the course of the tumor of the pancreas head was presented. During laparotomy, apart from resectable tumor of the pancreas head, abdominal aortic aneurysm of the size 45 x 55 mm was found in a section below renal arteries, not involving iliac arteries. The resection of the abdominal aortic aneurysm and pancreatoduodenectomy were performed simultaneously. The patient was able to leave the hospital on the 12th day after the operation in a good general condition.

Aged↗
PubMed2002

[Pharynx perforation caused by fishbone--diagnostic problems].

The authors presented a case of perforation of the left side of pharynx by fishbone, treated successfully in spite of wrong primary diagnosis and treatment. The fishbone quickly penetrated the pharynx wall and evoked inflammatory process similar to thyroid gland tumor (size 50 x 70 mm). It was the cause of the wrong first diagnosis of thyroid gland tumor. Because of the diagnosis the patient was qualified to surgical intervention--the removal of thyroid tumor. However, the patient suspected the relationship between the tumor and choking with a foreign body. The patient was diagnosed again in another hospital where the proper diagnosis was made. The removal of fishbone from the left subclavian region was performed after 41 days from the day of choking.

Adult↗