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Bartosz Wnęk, Marcin Strugała, Aleksandra Łożyńska-Nelke, Robert Burdyński and Piotr Krokowicz

Abstract

Familial adenomatous polyposis (FAP) is a colorectal cancer syndrome caused by a germline mutation inherited in an autosomal-dominant pattern with a 100% penetrance.

Our detailed case report presents a history of a 55-year-old FAP female patient who had been under constant clinical observation for 30 years. The disease was diagnosed at the age of 22. The patient underwent restorative proctocolectomy with ileal pouch-anal anastomosis (PRC-IPAA). During our follow-up extra-colonic manifestations occurred such as a desmoidtumour, fundic gland polyps in the stomach and duodenal polyps also in the periampullary region. Apart from disease-related symptoms the patient manifested other complications such as small bowel adhesive obstruction, benign breast tumours, uterine myomas, cholelithiasisand thyroid nodules.

Our analysis of the above case presents advantages of a long-term medical observation of a FAP patient carried out by a specialist surgical medical centre

Open access

Bartosz Wnęk, Aleksandra łożyńska-Nelke and Jacek Karoń

Abstract

The presence of a foreign body in the gastrointestinal tract constitutes a common pathology, considering surgical clinical practice. The management of the ingestion of a foreign body depends on many factors. The study presented a case of a 33-year-old female patient subjected to surgical treatment, due to deliberate swallowing of a balloon. The above-mentioned was the amateur equivalent of intragastric balloon insertion, inducing weight loss. This is a rare cause of a foreign body ingestion, seldomly found in literature data. The patient reported to the Emergency Department on the second day after ingestion with symptoms of mechanical subobstruction, and after initial diagnostics, was qualified for surgery. The postoperative period proved uneventful. The study illustrated the often unfavourable access to false data on the internet, which may stimulate towards the above-mentioned behaviour.

Open access

Bartosz Wnęk, Krystian Waraczewski, Michał Chalcarz, Agnieszka Kędzia, Aleksandra Łożyńska-Nelke and Paulina Hołodyńska

Abstract

Rectal prolapse belongs to the group of rare diseases of the rectum and anus. It is mostly observed in elderly multiparous women in the seventh and eighth decade. The precise cause of this pathology is not thoroughly understood that is why there are no optimal standards of treatment.

The aim of the study was to present pathophysiology, diagnostics and optimal surgical procedures employed in young patients with rectal prolapse.

Material and methods. Out of a 56-patient group treated in Department of General and Colorectal Surgery in the years 2006-2011 a smaller one consisting of 11 young women between the ages 20-40 was selected. According to the literature this is a very rare time of the mentioned pathology occurrence. In the studied females grade of rectal prolapse as well as faecal incontinence based on Jorge-Wexner’s (Cleveland) scale were assessed before and after the operative treatment. All of them underwent transabdominal Wells and Frikman-Goldberg prolapse procedures.

Results. Transabdominal approaches repair pathologies of the pelvic floor and have promising longstanding results improving quality of life. No rectal prolapse recurrences were observed. The mean score of the Wexner’s grading system was 7.81 diminishing to 1.9 points postoperatively.

Conclusions. Rectal prolapse if untreated, is a pathology that substantially changes patients’ quality of life for the worse. Individual, standardized surgical approach to each patient is necessary. Transabdominal methods carry a low risk of complications and improve quality of life of young patients enabling a relatively quick return to normal life