The first cases of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection were identified at the end of 2019 and, in the next few months, coronavirus disease (COVID-19) spread throughout the world. Initially, it was believed that this disease mainly affected elderly individuals with comorbidities, in whom respiratory failure often occurs. It was believed that children fell ill from the infection more often, although the course of infection in the vast majority of pediatric cases has been asymptomatic or mildly symptomatic. In April and May 2020, the first report of a rapidly progressing disease, similar to Kawasaki syndrome, was found in children who had been infected with SARS-CoV-2. Shortly thereafter, children with symptoms of pediatric inflammatory multisystem syndrome (PIMS-ST [temporally associated with SARS-CoV-2 infection]) began presenting to pediatric hospitals around the world. The syndrome has a mortality rate of up to 2%. Symptoms of PIMS-TS include those that may suggest the need for surgical treatment (severe abdominal pain with the presence of peritoneal symptoms, ascites, high levels of inflammatory markers, intestinal inflammation, and appendages revealed on ultrasound examination). However, there are few reports addressing surgical cases associated with this condition. The authors present a case involving an 11-year-old boy who was admitted to hospital with severe abdominal pain and underwent surgery for symptoms of peritonitis and was diagnosed with PIMS in the post-operative period. Due to the large number of illnesses caused by SARS-CoV-2 infection in recent months, the diagnosis of PIMS-TS/MISC should be considered in the differential diagnosis of acute abdominal symptoms, especially in atypical courses and interviews indicating exposure to SARS-CoV-2.

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Introduction: Hydronephrosis is one of the most commonly diagnosed urinary tract defects in children. It is characterised by various degrees of dilation of the renal pelvis and calyces with concomitant thinning of the renal parenchyma. The dilation is caused by a ureteropelvic junction defect obstructing the outflow of urine from the kidney. Extreme hydronephrosis can lead to a complete lack of function of the affected kidney. The treatment of hydronephrosis involves restoring normal urine outflow from the kidney and depends on the cause of the condition. The decision to perform surgery depends on the rate of progression of abnormalities observed in the renal parenchyma, among other aspects. Aim of the study: The paper presents the experiences of a single centre in the surgical treatment of hydronephrosis in children aged up to 18 years. Materials and methods: In 2016–2020, 77 children underwent surgery for hydronephrosis at the present authors’ department. In 40% of cases, hydronephrosis was diagnosed on antenatal screening, in 31% it was observed on abdominal ultrasound performed due to abdominal pain, in 17% the condition was detected incidentally when the causes of other diseases were being investigated, in 9% urinary tract infection led to the discovery of hydronephrosis and in 3% of cases abdominal trauma was the reason the patient was examined in the first place. In 58% of the subjects, the cause of hydronephrosis was intramural stenosis of the ureteropelvic junction, in 22% it was the presence of accessory vessels and in 20% various other causes were found. In all patients, Anderson–Hynes ureteropyeloplasty was performed. Results: Surgical outcomes were assessed 12 months after the procedure, and in 97.4% of cases they were considered good. A repeat operation was performed in only 2 cases due to a lack of improvement after the original hydronephrosis surgery. Conclusions: Surgical treatment of hydronephrosis caused by ureteropelvic obstruction is an effective and safe method with a low risk of early and late complications.

Urolithiasis is a disease unit more common in adult patients. However in the pediatric population it is also an important clinical problem due to high risk of recurrence in the patient's life among others. Hyperkalciuria, hyperuricemia, hyperoxaluria and cystinuria secondary to metabolic disorders promote stone formation. The aim of this study is the presentation of a case of a girl with multiple congenital anomalies, bilateral staghorn urolithiasis and bladder stones developing in the course of hypercalcemia. The patient was diagnosed with urolithiasis at the age of 2 months. The course of the disease in her case is characterized by extremely frequent recurrences and numerous urinary tract infections of various aetiology, including high-resistant bacterial strains. These infections were often turbulent and required hospitalization. Due to the extent of urolithiasis, invasive treatment was necessary, both in the lower and upper urinary tract. Endoscopic techniques (transurethral cystolithotrypsy and ureterorenoscopy) were used in urinary bladder and ureter urolithiasis. Renal deposits were removed by the use of open access surgery (pyelolithotomy with intrarenal lithotrypsy). Although the ongoing development technology and miniaturization of equipment have allowed and popularized minimally invasive treatment of urolithiasis, some exceptional cases still require surgical treatment with open surgery. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee (LEC) of all institutions. No conflict of interest was declared by the authors.