VATS is an effective, safe method for spontaneous pneumothorax in children. In 11 children with pneumothorax, we made a wedge resection of the apical part of the lung with an endostapler device plus mechanical pleurodesis.

The aim of this study was to evaluate our results during and after the Nuss operation in children with pectus excavatum. We have performed the Nuss procedure in 128 patients with pectus excavatum since 2001, and 74 patients underwent bar removal. Of the 128 patients 96 were male and 32 were female; age ranged from eight to 21 years with an average of 13.8 years. In 46% of patients psychological reasons for operative treatment were dominant while in the other 54% of patients clinical signs were the indications. Complications in 128 patients included 36 pneumothorax, 28 of which resolved spontaneously. Postoperative pneumonia developed in six patients. In two patients we had infection of the implanted bar, and there were two patients with cellulitis. We had six patients with bar displacement and reoperation was needed. During the Nuss procedure we had one injury of the intercostal artery. We had pericardial tears in two patients without clinical significance. In two patients we had pericardial effusion six months after the Nuss procedure, requiring pericardiocentesis. In one patient we had fracture of the sternum. There were no complications following bar removal. After bar removal in 74 patients, 54 patients (72.9%) maintained excellent results with normal chest anatomy, good results were found in 16 patients (21.6%) with mild residual pectus and poor results in four patients (5.5%) with severe recurrence. Our experience with the Nuss procedure demonstrated excellent results with few minor complications.

Introduction: There are many ways how children with mental illness have actually tried to hurt themselves. Suicidal thinking or attempts always indicate that professional help is needed (2). Every object which can be potential dangerous should be removed but this is very difficult to do. Some of children with these symptoms had Pica diseases. Pica is a medical disorder characterized by an appetite for substances largely non-nutritive (e.g. metal, coal, soil, feces, paper, soap, gum, etc.) or an abnormal appetite for some things that may be considered foods. Material and Methods: The patient swallow sponge from a pillow over a long period of time and she came into our hospital with abdominal pain. She was 16 years old and had abdominal distension, vomiting, abdominal cramping and failure to pass gas or stool. Immediately we suspected mechanical blockade of the intestine. Diagnosis was clinically confirmed by X-rays of the abdomen and with ultrasound. Results: The operative treatment was indicated and we found the proximal bowel distended and the distal segment collapsed. The part of bowel necrosis was removed and anastomosis was done. Conclusion: When patients are determined to attempt suicide or have Pica disorder it is very difficult to prevent.

Primary splenic cysts are uncommon lesions of the spleen. Splenic cysts are classified as primary or secondary on the basis of presence or absence of an epithelial lining. The primary cysts are further subdivided as parasitic or non-parasitic. The congenital non-parasitic cysts are rarely met in clinical practice and it constitutes approximately 10% of all splenic cysts. Congenital cysts are true cysts with an epithelial. Secondary cysts are in most cases posttraumatic. Patient at admission had lower abdominal pain and splenic cyst was asymptomatic. In routine abdominal pain investigation we found cyst of the spleen in diameter 2 cm. We made serodiagnostic tests for echinococcosis which were negative. After 3 years she came with left upper quadrant enlargement with tangible abdominal mass, increasing abdominal girth, decrease of appetite and sometimes vomiting. CT scan showed cyst enlargement in diameter 8 x 6 cm. Operative treatment was necessary and splenectomy was done. However, splenectomy remains a relatively safe procedure, associated with few complications and avoiding any future problems.

A b s t r a c t Background. Ovarian haemangioma are very rare type of tumors, although the ovary itself is a highly vascularised organ. Such benign tumors of the blood vessels are rare in ovaries during childhood. Clinical case. We described a 13-year-old girl with an ovarian haemangioma presented clinically with acute abdomen symptoms -abdominal and pelvic pain and vomiting. The pelvic mass was noted and sonography revealed a huge cystic tumor with probably ovarian torsion. A left salpingo-oophorectomy and appendectomy were performed with an uneventful postoperative course. Pathology examination revealed a cavernous haemangioma of the ovary.Conclusion. Haemangiomas of the ovary, especially in children, are very rare type of the benign tumor. Surgical extirpation of the involved areas is the treatment of the choice.