IntroductionSciatica is a common reason for a medical consultation throughout the population. Piriformis pyomyositis is a rare cause of these symptoms. Its probable etiology is transient bacteraemia co-existing temporarily with a muscle injury.AimThe aim of the study is to present a method for treating a piriformis muscle abscess with transabdominal ultrasound-guided transrectal drainage.Case studyA 14-year old boy, previously healthy, was admitted with symptoms of sciatica that appeared after intense physical exertion. Laboratory tests revealed elevated inflammatory parameters and positive blood culture results indicating Staphylococcus aureus. Antibiotic therapy was implemented. MRI of the small pelvis revealed a forming abscess of the right piriformis muscle. On day 6 of the antibiotic therapy, in the absence of improvement, it was decided to perform transrectal drainage under ultrasound guidance. Clinical improvement was achieved, and the inflammatory parameters decreased.Results and discussionCo-existence of sciatica symptoms and signs of an inflammatory condition should prompt the consideration of piriformis pyomyositis. The mainstay of treatment for piriformis pyomyositis is antibiotic therapy. The abscess formation reduces its effectiveness, which necessitates surgical intervention. The authors present the application of transrectal drainage under transabdominal ultrasound guidance as the shortest route of abscess evacuation.ConclusionsTransrectal drainage of piriformis pyomyositis is an effective and safe method. Concomitant use of ultrasound scans reduces the patient’s exposure to ionising radiation. However, the widespread use of this method requires more in-depth research and broadened experience.

IntroductionA long-term intragastric feeding is the indication for percutaneous endoscopic gastrostomy (PEG) placement in a patient. The procedure is performed in children with central nervous system (CNS) disorders, congenital heart defects and neoplastic or metabolic diseases. The PEG placement procedure is most commonly performed by a gastroscopy procedure.AimThe study aimed to retrospectively analyse the methods applied and complications following PEG tube insertion in patients of the Regional Specialist Children's Hospital in Olsztyn, Poland, in the years 2000–2019.Material and methodsA retrospective analysis was conducted of medical histories and records of children qualified for PEG placement procedure. PEG procedure was performed on 48 children: 24 boys and 24 girls. The mean age was 7 years. PEG was inserted in cerebral plasy in 30 patients, congenital defects in 11 and genetic disorders in 7.Results and discussionThe reasons for PEG insertion included dysphagia in 30 children, no weight gain in 7, aspiration of gastric contents to the bronchial tree in 6, and feeding difficulties in 10. Two methods for performing PEG insertion procedure were employed: a gastroscopy alone (31 cases) and a laparoscopic-assisted gastroscopy (17). The following complications were: local complications at the incision site (28), PEG dysfunction (13), vomiting (9), sepsis (2), buried bumper syndrome (1), oesophagitis (1), and gastrointestinal fistula (1).ConclusionsThe PEG placement procedure is burdened with a significant number of complications, however, they are mainly related to local inflammation or PEG dysfunction.

Introduction: The first thoracoscopic esophageal atresia (EA) surgery in Poland was performed by Professor Dariusz Patkowski in 2005 in Wrocław. In the Clinical Ward of Pediatric Surgery and Urology, Regional Specialistic Children’s Hospital in Olsztyn, thoracoscopic EA surgery was performed on 16 January 2009. Aim: Data presentation on thoracoscopic treatment of congenital EA. Material and methods: Between 2009 and 2018 in our Clinical Ward, 28 children (11 females and 17 males) diagnosed with EA underwent treatment. All patients presented with type III EA based on the Gross classification (lower tracheoesophageal fistula and atresia of the upper segment of the trachea) and 8 of them (29.6%) were diagnosed with coexisting diseases. Results and discussion: The duration of the surgery was 70–290 minutes with a mean time of 180 minutes. Conversion was performed in 6 (21.4%) cases. Leakage of the lymph occurred in 2 (7.1%) cases . In 3 (10.7%) cases, a radiographic image showed leakage of the anastomosis. Only 1 (3.6%) patient needed reoperation due to re-canalization of tracheoesophageal fistula. Pneumothorax occurred in 2 (7.1%) cases. In total, 4 (14.3%) patients died and 23 (82.1%) patients required additional esophageal dilatation due to its narrowing. Conclusions: The treatment results of thoracoscopic EA surgeries and undeniable advantages for the patient makes this technique a highly recommended method.