Lyme borreliosis is the most known and frequent disease caused by ticks. This disease may be limited to the skin, involve muscle and articular system, the heart, or the nervous system. Erythema migrans is a skin manifestation of an early Lyme borreliosis. Physicians specializing in infectious diseases, family doctors and dermatologists deal with treating the erythema. Its diagnosis is made on the basis of clinical presentation and patient's history. Seldom is it easy since skin lesions may resemble other diseases, and the patient often fails to associate the lesion with a tick bite. This article presents interesting examples of atypical manifestations of erythema migrans, and discusses differential diagnostics. Moreover, the work shows diagnostic possibilities and therapeutic recommendations regarding the disease. StRESzczEniEBorelioza z Lyme jest najbardziej znaną i najczęstszą chorobą odkleszczową, która może ograniczać się do zajęcia skóry, obejmować układ stawowo-mięśniowy, serce lub układ nerwowy. Rumień wędrujący jest skórną manifestacją wczesnej boreliozy. Jego leczeniem zajmują się lekarze specjaliści chorób zakaźnych, lekarze rodzinni, a także dermatolodzy. Rozpoznanie ustala się na podstawie obrazu klinicznego i wywiadu. Często nie jest to łatwe, bo zmiany na skórze mogą przypominać inne choroby, a pacjent może nie kojarzyć objawów z ukłuciem przez kleszcza. Przedstawiamy interesujące przykłady nietypowych obrazów klinicznych rumienia wędrującego z uwzględnieniem diagnostyki różnicowej. Ponadto prezentujemy możliwości diagnostyczne oraz zalecenia terapeutyczne dotyczące tej choroby.

Background and Objectives: Gastrointestinal stromal tumors (GISTs) are rare mesenchymal neoplasms located mainly in the fundus (60–70%). The incidence of GIST is approximately 10 per million population per year in Europe, with a peak incidence at the age of 63. Recent studies suggest that morbidly obese patients have a higher incidence of GIST than the general population. The aim of this study was to analyze the incidence of GIST in patients undergoing laparoscopic sleeve gastrectomy (LSG) in our department. Materials and Methods: this paper present the retrospective study of prospectively collected data of 1564 patients who underwent LSG in a single large bariatric center from October 2013 to September 2021. After surgery, each sample of the resected stomach was sent for histopathological examination. For the analysis, we included patients diagnosed with GIST intraoperatively or postoperatively. Results: GISTs were found in five patients (0.31%). There were three men and two women. The mean age was 50.2 (range 32–63 ± 11.8) and the mean preoperative body mass index was 43.3 kg/m2 (40–49.4 ± 3.2). In four cases, GISTs were found in the fundus (80%), and in one in the pylorus (20%). None of the tumors were larger than 7 mm in diameter and all were diagnosed as a very low-risk category. No adjuvant treatment was required. All patients achieved good or satisfactory bariatric and metabolic results. Conclusions: The incidence of GIST in our study was estimated at 0.31%. All patients had a very low-risk GIST and no recurrence until follow-up. Recent literature suggests that the risk of GIST is higher in the obese population, and therefore surgeons should be aware of the risk of incidental GIST during LSG.

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