Teratomas are rare neoplasms. They account for 3% of all childhood tumors; 40-70% of them are located in the sacrococcygeal and presacral regions. Head and neck locations of the tumor are uncommon, account for only 2%. This article presents a case of a Polish Caucasian male infant born at 30 weeks of gestation, from the 3 rd pregnancy, the first delivery by c-section. The infant's general condition was very severe. Birth weight was 2980 g. A large craniofacial tumor was prenatally detected in the newborn, with the suspicion of immature teratoma, which was later confirmed in postnatal examinations. The infant was operated on the 2 nd day of life and the tumor size was 25-30 cm. After the surgery, birth weight decreased to 1600 g. Imaging tests provides prenatal diagnosis of craniofacial teratomas, which enables to plan early surgical treatment of the newborn with appropriate postoperative care, which increases the chances of survival.

Introduction: Pleurobiliary (PBF) and bronchobiliary (BBF) fistula is a rare complication seen in patients treated at hepatobiliary units with very scarce literature data. The aim of this study was to evaluate causes and management of patients with PBF and BBF. Methods: Clinical data of all patients hospitalized in the Department of General, Transplant and Liver Surgery (Medical University of Warsaw) between years 2008 and 2017 were retrospectively reviewed in order to identify patients with PBF or BBF. Data concerning primary disease, cause of fistula, treatment approach and clinical outcomes were collected. Results: Nine individuals with suspected PBF and BBF were identified. Further analysis revealed 7 patients with confirmed PBF or BBF. Two patients were excluded because both liver abscess and pleural empyema showed no radiologic signs of communication. Four out of 7 patients were diagnosed with BBF and 3 out of 7 patients had PBF. In 5 and 2 patients fistula occurred after percutaneous transhepatic biliary drainage and liver resection, respectively. Initial endoscopic management with biliary stenting was sufficient in 3 patients, while remaining 4 patients required pleurocentesis. One patient required mechanical ventilation following endoscopy. In addition, 2 patients with BBF underwent partial pneumonectomy. Conclusions: Pleurobiliary and bronchobiliary fistulas most commonly occur after percutaneous transhepatic biliary drainage. Majority of cases can be successfully treated applying endoscopic treatment and percutaneous drainage, yet BBF is often associated with the need of surgical management.

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Congenital central hypoventilation syndrome is a very rare genetic disorder. The disease involves respiratory failure associated with impaired central control of the breathing process. Hirschsprung’s disease is the cause of congenital intestinal obstruction as a result of the agenesis of ganglion cells in the submucosal and myenteric plexuses. If congenital central hypoventilation syndrome and Hirschsprung’s disease occur simultaneously, Haddad syndrome is diagnosed. A male infant was born at 37 weeks of gestation in a moderate general condition. Due to increasing respiratory effort and increased demand for oxygen, the newborn was intubated and mechanically ventilated. During an extubation attempt, respiratory symptoms intensified, and CO2 was accumulating on blood gas test. Genetic tests revealed a mutation in the PHOX2B gene, which confirmed congenital central hypoventilation syndrome. Lack of meconium and enteral nutrition intolerance were observed. Hirschsprung’s disease was diagnosed on the basis of intestinal biopsy. Loop ileostomy was created at 5 weeks of life. Due to coexistence of congenital central hypoventilation syndrome and Hirschsprung’s disease, Haddad syndrome was diagnosed.

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