Scintiscanning and laboratory and clinical examinations in most cases lead to accurate preoperative hydatid cyst diagnosis and reveal the localization of the cyst in the liver. Selecting the adequate operative procedure and taking all precautions to prevent contamination during surgery, ensure good results and minimize the incidence of postoperative complications. Experience with 204 patients is presented.

An experimental study was carried out to evaluate the protective role of an endoluminal prosthesis on high risk colo-colonic anastomoses. One hundred and fifty rats were divided into two groups: Group E with endoluminal latex prosthesis and Group C without. Bursting pressure and collagen concentration in the perianastomotic tissue were tested, respectively, on the 4th, 7th and 12th, and 4th, 7th, 12th, 18th and 38th postoperative days. Bursting pressure was significantly higher in Group E on the 4th postoperative day. There was no significant difference in the anastomotic collagen concentration between the two groups. The presence of the prosthesis did not produce any macroscopic or microscopic evidence of impaired healing or stricture at the suture line. Death due to anastomotic dehiscence occurred in 11/75 (15%) in Group C and in 1/75 (1.3%) in Group E (p less than 0.01). Endoluminal prosthesis appears to have a protective effect on anastomotic healing. The mechanism is probably due to mechanical protection and not to differences in collegen concentration.

Introduction. Eosinophilic esophagitis (EoE) represents chronic, a local immune-mediated disease with symptoms of esophageal dysfunction and histologically eosinophil-predominant inflammation and requires immediate endoscopy. Male gender is a strong risk factor. Case report. We presented a case of a 25-year-old young man with a history of allergic rhino-conjunctivitis, asthma, and intermittent severe feeding disturbance. The patient had begun sublingual immunotherapy therapy, containing specific soluble allergens for ambrosia. Six weeks after starting the ambrosia sublingual immunotherapy he developed burning epigastric pain, dysphagia, and odynophagia. Six days later, he was admitted to an emergency department due to choking on a solid of food. Esophageal histopathological findings were in favor of EoE. Sublingual immunotherapy was discontinued. He feels well now. Conclusion. The majority of cases of Eosinophilic esophagitis are diagnosed in spring or fall, 1-2 months following the peak of pollen season. Dysphagia, chest pain, food sticking, and bolus obstruction are the most common symptoms. Endoscopic findings are Schatzki ring, edema, exudates, furrows, and strictures. Six biopsies should be taken from areas with endoscopic mucosal abnormalities, and infiltration of eosinophils (more than 15 eosinophils/HRI) (HRI - high resolution imaging) is necessary for the diagnosis confirmation. Treatment options are proton pump inhibitors - oral dispersible tablets of budesonide or fluticasone propionate, an elimination diet. Sublingual immunotherapy should be discontinued. Family physicians should be aware of this complication in evaluating patients with dysphagia.

Introduction. Opioid addiction is a chronic condition related to different morbidities. The methadone substitution therapy of the opioid addict, combined with social, health, and psychological services is a gold standard of the treatment. All opioids display numerous side effects. Kidney damage in opioid addicts is due to sepsis, rhabdomyolysis, decreased glomerular filtration, hypotension, pulmonary edema, renal lipidosis, or amyloidosis. Case report. The male patient, 40, on methadone substitution therapy feels weak, sweats excessively. Lab work: potassium 9.87 mmol/L, BUN 18.3 mmol/L, creatinine 268 µmol/L, urea clearance 0,20 ml/s, creatinine clearance 0,81 ml/s, eGFR 23 ml/min/1,73m2 , creatine phosphokinase 1180 IU/L, Hgb 79 g/L, Er 2.81x1012/L, C-reactive protein 13.2 µg/ mL, Le 7.41x109 /L, PCO2 41 mmHg, HCO3 22 mmol/L, and acidosis, pH 7.21. Blood pressure 130/80 mmHg and heart rate 64 bpm, ECG shows prolonged PR interval and high T waves. He was treated with crystalloid IV solutions, 8.4% bicarbonate solutions, diuretics, calcium gluconate, short-acting insulin, antibiotics, and anticoagulants. After therapy, there is an improvement in his potassium levels, diuresis, and ECG. After 24 days of hospital treatment, he was discharged to home care. Conclusion. Patients on methadone substitution therapy have a higher risk of multiple organ damage. Kidney function is especially at risk. It is of utmost importance to raise awareness among physicians of the danger of rabdomyolysis in these patients. Regular lab checks in patients on methadone substitution therapy can timely detect severe acute and chronic kidney complications and enable timely treatment.