We report two cases of gastric trichobezoar, recorded in the last 3 years in our Hospital. Both cases presented abdominal pain and epigastric mass, as well as upper obstructive symptoms. The cases were surgically treated with satisfactory evolution. the clinician has to consider this diagnosis. Surgery is a successful treatment for these cases.

Background: Appendix tumours present an incidence of 0.2 to 0.3% among all appendectomies. It is a rare condition, commonly found as an incidental diagnosis by imaging studies due to his lack of symptoms; nevertheless it is associated with many complications when undiagnosed like pseudomixoma peritonei a condition with high morbidity and mortality. This is the importance of recognize it to establish an opportune diagnose and treatment.

Obesity is a large and growing health problem in the UK with high associated costs to the NHS. Bariatric surgery is proven as an effective treatment for obesity associated with long term weight loss and a reduction in obesity related comorbidities [1]. The NICE guidance highlights the importance of follow-up post-surgery [2]. The guidelines state that in order to be eligible for surgery the patient must commit to long term follow-up and that in order for a centre to offer bariatric surgery it must ensure that it can provide regular MDT post-op assessment and support for at least two years [2].

Background: Gastric adenocarcinoma is the fourth most common malignancy worldwide and is globally the second leading cause of cancer-related deaths each year. Salted foods and exposure to H. pylori infection during the infancy have been considered the most important environment risk factors for gastric cancer. Despites increased access to electric energy, allowing the use of refrigerators to better conserve foods, many people keep consuming salted food, by washing them before eating with the intention of reducing salted flavor and also supposing to decrease or avoid risk of diseases. The aim of this study was to investigate the efficacy of reducing nitrites levels in salted fish by washing the fish before consuming, to find if washing salted food should be an efficient measure to reduce, or even avoid, the nitrites related gastric cancer risk.

Anaphylaxis and severe allergic transfusion reactions (ATR) are uncommon complications after blood transfusion. Nevertheless, these complications are associated with very severe outcomes, such as dyspnea, shock, and death. Patients with end-stage liver disease who require liver transplantation have a high tendency for bleeding because of splenomegaly-induced thrombocytopenia and decreased production of coagulation factors in the liver. Liver transplantation is a very long procedure and a significant perioperative blood loss is highly likely. Therefore, transfusion of platelets and other blood products is often necessary. We report a successful ABO-incompatible living donor liver transplantation in a patient with hepatitis B virus-related liver cirrhosis and hepatocellular carcinoma who had a history of platelet transfusion-related anaphylaxis.

Aim: To show if there is any connection between the activity of inflammatory bowel disease (IBD), infection with Clostridium difficile (C. difficile) and thrombocytosis in our hospitalized patients. Methods: We performed a retrospective observational study to determine the incidence of C. difficile infection (CDI) and thrombocytosis in our patients with IBD hospitalized from January 1, 2007- December 31, 2012. Results: A total of 363 hospitalized patients were identified during the observed 6-year period with a diagnosed IBD (258 patients with ulcerative colitis (UC) and 105 patients with Crohn’s disease (CD). 28 (21.7%) patients with the exacerbation of UC and 17 (34.7%) patients with the exacerbation of CD were positive for CDI. Thrombocytosis was present in 65 (50.4%) patients with the exacerbation of UC and 39 (79.6%) patients with the exacerbation of CD. 26 (14.6%) patients with IBD exacerbation (15 patients with UC and 11 patients with CD) had both CDI and thrombocytosis. Statistically significant difference was found only in the incidence of thrombocytosis in patients with UC compared to patients with CD and all IBD patients.

Aims and Objectives: To prospectively evaluate and compare effectiveness of topical 0.2% glyceryl trinitrate ointment vs lateral internal sphincterotomy in treatment of patients with chronic anal fissure. Material and Methods: The study included a total of 50 patients presented with chronic anal fissure, divided into two groups by computer generated randomization. Group A included 25 patients with chronic anal fissure treated with local glyceryl trinitrate ointment 0.2% whereas Group B included 25 patients managed by lateral internal sphincterotomy.

Incisional hernias are the most frequent “late complications” after laparotomy. They develop in more than 10% of patients and their incidence is related to numerous risk factors (Table 1). The most important risk factors are obesity, impaired wound healing of the laparotomy wound, malnutrition and tobacco smoking. Regarding the multifactorial pathogenesis of the disease local tissue ischemia is one of the most important risk factors. This causes weakness of the fascia and finally incisional hernia [4,5]. In addition, there are more rare causes, such as immunosuppression, diseases of the collagen metabolism and connective tissue diseases (e.g. patients with aneurysms, Ehlers-Danlos-syndrome). Any factors which are characterized by a persistent or frequent high intra-abdominal pressure (e.g. chronic cough) contribute to the development of an incisional hernia. An important risk factor is the surgeon her/himself, i.e. the quality of the abdominal closure and this is not sufficiently considered in the scientific literature. The pathogenesis of an incisional hernia is in general multifactorial.

Von Hippel-Lindaudisease (VHLD) is a rare hereditary tumor syndrome, inherited in autosomal dominant manner. Patients diagnosed with VHLD have a high risk of developing neoplasms of various organs (eyes, central nervous system, bone, kidney, adrenal glands, epididymis, broad ligament and pancreas). Due to its rarity, most of the physicians fail to properly diagnose it in time, and they might expose patients to a risk of unnecessary surgeries with important consequences in a long run. When this condition is diagnosed, lifelong follow-up is necessary. Pancreatic involvement it is seen in most patients with VHLD and various pancreatic lesions have been described, including cystic lesions (simple unilocular or serous microcystic or macro/micro-cystic adenomas), neuroendocrine tumors (NET), renal cell cancer metastasis and adenocarcinoma. These lesions are rarely the primary presenting tumor and frequently diagnosed during the screening of family members with VHLD, by imaging techniques such as magnetic resonance imaging (MRI), computed tomography (CT). Cystic lesions are the most common, generally asymptomatic and are rarely associated with malignant degeneration, except mucinous cysts. It is recommended follow-up and intervention if these lesions become symptomatic or mucinous aspect. NET are usually multiple, nonfunctional and have malignant potential. The management of NET depends on size, doubling time and underlying genetics. Because of their malignant potential, it is necessary careful observation in a long-term follow-up. If treatment is necessary, more conservative management is preferable. Molecular targets for treatment of NET in VHLD have also been proposed and some drugs are in preclinical or clinical trials.

In Hungary, the mortality rates from colorectal cancer are dramatically high, therefore the reduction by population screening as a public health measure is considered as one of the priorities of the National Public Health Programme. The aim of screening is to reduce the burden of cancer on the population by discovering latent disease in its early stage and treating it more effectively than if diagnosed later in a symptomatic stage. In the beginning, a human-specific immunological test was applied in the “model programmes”, as a screening tool to detect the occult blood in the stool; compliance was 32% in average. However, the objectives of the model programmes have not been achieved, because – among other reasons – a debate on method of choice and the strategy to follow have divided the professional public opinion. In this paper the debated issues are critically discussed, being convinced that – at present – population screening seems to be the most promising way to alleviate the burden of colorectal cancer.

Introduction: The systemic amyloidosis usually doesn’t save the digestive tract, but this involvement is present in approximately 60% of patients with AA Amyloidosis and only in 8% and 1% of patients with AL Amyloidosis (respectively through biopsy and clinically). Beside gastrointestinal involvement is rarely symptomatic and clinical events are not specific. Enteropathy protein-losing is a rare condition caused by excessive loss of serum protein in the gastrointestinal tract, resulting in hypoproteinaemia, edema, and, sometimes, pleural/pericardial effusions. The diagnosis should be taken into account only when other causes have been excluded. Gastrointestinal AL amyloidosis usually appears with constipation and mechanical obstruction/ pseudobstruction, on the contrary enteropathy protein-losing and malabsorption are rare.

Isolated pancreatic trauma (IPT) secondary to an abdominal blunt trauma, is an uncommon condition- IPT diagnosis usually is insidious, requiring the integration of multiple parameters, regarding anamnesis, physical examination, blood analysis and radiologic tests. Nowadays, exists controversy in the literature about management of the IPT. We report a case of a young male with a body-tail pancreatic transection, secondary to an abdominal blunt trauma. Distal pancreatectomy with spleen preservation was performed with successful postoperative course. We discuss diagnostic and therapeutical options in IPT.

Ingestion of a corrosive substance can produce severe injury to the gastrointestinal tract and can even result in death. The degree and extent of damage depends on several factors like the type of substance, the morphologic form of the agent, the quantity, and the intent. In the acute stage, perforation and necrosis may occur. Long-term complications include stricture formation in the esophagus, antral stenosis and the development of esophageal carcinoma. Endoscopy should be attempted and can be safely performed in most cases to assess the extent of damage. Procedure related perforation is rare. Stricture formation is more common in patients with second and third degree burns. This review summarizes our current knowledge and evidence based management of this unique but not uncommon pathology of the upper gastrointestinal tract.