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2 Polish Journal of Surgery

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Splenic Site Abscess as a Symptom of Colorectal Carcinoma - Case Report

100%

Murawa D. , Nowaczyk P. , Murawa P.

Polish Journal of Surgery

2007

tom 79

nr 12

779-784

Splenic abscess occurs only rarely. However, in recent years its frequency has been growing, which is related not only to the improvement in diagnostics but also to the increasingly common problem of immunosuppression caused by multiple factors and the occurrence of diabetes in the population. This paper presents a case of splenic flexure carcinoma, which was manifested clinically by a splenic site abscess and earlier probably by splenic abscess. Its aetiology was not specified after splenectomy had been carried out at the local hospital; only symptomatic treatment was applied. Due to the low occurrence of splenic abscess and non-specific clinical symptoms, doctors must show a great deal of prudence and alertness to make the right diagnosis. Furthermore, knowing that the presence of such lesions in the spleen is a consequence of other local or distant pathogenic processes, appropriate management and treatment of such patients requires investigating the cause and specifying the aetiology of the abscess. Failure to do so exposes the patient to the danger of serious consequences, frequently making early and successful treatment of many diseases, including neoplasms in the abdominal cavity, impossible.

Sentinel Lymph Node Biopsy in Cutaneous Melanoma - Analysis of 227 Cases

88%

Spychała A. , Murawa D. , Połom K. , Gracz A. , Murawa P.

Polish Journal of Surgery

2008

tom 80

nr 5

241-247

The aim of the study was to evaluate the experience of the centre in carrying out and assessing the use of sentinel node biopsy in skin melanoma.Material and methods. From 2000 to 2004, a sentinel node biopsy was carried out on 227 patients being treated for skin melanoma. In all the patients, the sentinel node was subjected to a standard histological evaluation with the application of H+E staining. If no melanoma cells were visualised within the sentinel node, the material was subjected to an immunohistochemical investigation. The patients whose sentinel node included metastases found in the H+E examination or micrometastases identified by means of the immunohistochemical investigation were subjected to a supplementary lymphadenectomy.Results. The sentinel node was identified in all the patients. In a group of 28 patients (12.3%), the presence of metastases within the sentinel node was visualised by means of H+E examination. A group of 199 patients (87.66%) with a metastases-negative sentinel node (H+E staining) was subjected to immunohistochemical evaluation, which revealed the presence of micrometastases in 45 patients (19.82%). Supplementary lymphadenectomy was carried out in patients who screened positive, and metastases were identified in other regional lymph nodes in 11 (4.8%) patients.Conclusions. 1. After finishing the learning curve, the sentinel node biopsy is a simple and effective method, enabling precise assessment of the lymphatic system in patients with skin melanoma. 2. The application of immunohistochemical investigation enabled the identification of micrometastases in 19.8% of the patients, where these were not found in the H+E examination. 3. The application of sentinel node biopsy allowed lymphadenectomy to be avoided in 154 (67.8%) patients.