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Foreign Body Impaction Within the Pseudopylorus after Mason's Vertical Bariatric Gastroplasty - A Case Report

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Szczęsny W., Dąbrowiecki S., Szmytkowski J., Reśliński A.
Polish Journal of Surgery
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2010
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vol. 82
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issue 11
631-633
EN
A rare case of solid foreign body impaction within the pseudopylorus created during Mason's bariatric vertical banded gastroplasty is discussed in the report. The patient was referred to the authors' center with symptoms of high gastrointestinal obstruction, which had appeared 48 hours prior to admission. The situation was resolved by endoscopic removal of the impacting foreign body with the use of Dormia basket. Anastomoses and strictures resulting from bariatric procedures are a frequent location of food bolus obstructions and bezoars. It is therefore important to perform a diagnostic gastroscopy prior to performing a bariatric procedure in order to check for preexisting conditions, including malignant tumors.
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Intragastric Balloon (BIB System) in the Treatment of Obesity and Preparation of Patients for Surgery - Own Experience and Literature Review

100%
Dąbrowiecki S., Szczęsny W., Popławski C., Sosnowski D.
Polish Journal of Surgery
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2011
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vol. 83
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issue 4
181-187
EN
Despite the recognition of bariatric surgery as the only effective method of weight reduction, we remain in search of minimally invasive methods, both for the treatment of obesity and preparation of patients for surgical procedures.The aim of the study was to determine intragastric balloon (Allergan) implantation results as the only method of treating obesity, and patient preparation for further stages of abdominal hernia operations, as well as other surgical procedures.Material and methods. The study presented own results considering the use of Bioenteric Intragastric Balloons (BIB system) in the treatment of pathological obesity, and preparation of patients for bariatric surgery and abdominal hernia operations. The study group comprised 18 female and 7 male patients. Average patient age amounted to 50.6 and 54 years, respectively. Indications for intragastric balloon insertion were as follows: preparation for hernia (10 cases) and bariatric (5 patients) operations, and weight reduction management (8 patients). In two cases the implantation of the intragastric balloon served the preparation for gynecological and orthopedic (vertebral column) operations. One female patient was prepared for both bariatric and hernial surgery. The procedure was performed under general anesthesia. Statistical analysis considered 22 patients (one female patient was excluded from analysis, due to death, two other were excluded because of lack of sufficient data).Results. In case of two patients the intragastric balloon system was removed before 6 months had elapsed because of intolerance. One female patient died during the observation period for reasons not related to the procedure. The obtained BMI reduction ranged between 2 and 6 kg/m2, which amounted to a maximum weight loss of 24 kg. In one patient a weight gain of 2 kg was observed. Considering patients prepared for abdominal hernia operations weight reduction was greater and better maintained after the removal of the BIB system.Conclusions. According to the authors of the presented study the intragastric balloon serves its role as a bridge to bariatric procedures and weight reduction, before planned extensive postoperative hernia operations. The use of the intragastric balloon only to reduce weight has no medical and economic justification.
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An unusual case of a tuberculous granuloma of the liver presenting thirteen years after intravesical BCG – therapy for bladder cancer

88%
Szczęsny W., Szylberg Ł., Słupski M., Marszałek A., Szmytkowski J.
Polish Journal of Surgery
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2021
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vol. 93
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issue 5
1-5
EN
The authors present the case of a female patient with a tumor of segment VII of the liver, which was postoperatively identified as a tuberculous granuloma. The patient was admitted for elective surgery for a liver tumor, which had been diagnosed a few months before. Computed tomography and nuclear magnetic resonance were performed, based on which focal nodular hyperplasia was suspected. Thirteen years prior to admission the patient had undergone a transurethral resection of superficial bladder carcinoma, followed by adjuvant intravesical Bacillus Calmette-Guérin (BCG-therapy). Upon surgery, segment VII of the liver was resected; postoperative course was uneventful. After the identification of granuloma, the patient was referred to a phthysiatric clinic for further diagnostics and treatment. The authors have deemed this case worthy of reporting primarily due to the exceptionally long period between the completion of BCG therapy and the onset of hepatic tumor.
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