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The permanent lesion of damaged recurrent laryngeal nerve (RLN) often manifests as an irreversible dysfunction of phonation and is the most common complication following thyroid surgery. The frequency of this complication ranges from 0.5 to 5% in different thyroid surgery centres and increases in case of both recurrent goiter and complete thyroidectomy due to thyroid cancer. The RLN lesion varies from irreversible, persistent and transient dysfunction with good prognosis of complete recovery. The time of RLN function recovery ranges from several weeks to two years (mainly 6 months). The aim of this study was to evaluate early and persistent RLN paralysis. We operated in our clinic 2323 patients between 1994 and 1997. 2137 patients were operated for the first time due to benign goiter. On the 3rd post-operative day 190 patients (8.9%) presented RLN paralysis of different grade. The follow-up examination (indirect laryngoscopy) was performed in 100 patients with early RLN paralysis in the period between 6 months and 3 years after surgery. The complete RLN recovery was diagnosed in 78%. The permanent paralysis was diagnosed in 1.9% of operated patients. In the light of law and medical aspects we suggest obligatory laryngological examination with the evaluation of vocal cords mobility before surgery and on the 3rd post-operative day in order to identify early RLN lesion. Permanent RLN paralysis may be diagnosed on the basis of multiple laryngological examination in the period between 3 and 24 months after surgery.

Preface: Nonpalpable nodules in the thyroid are frequent and estimated to be found in 50% of people above 50 year of age when goiter in adult population is found in 4-10%. Thyroid nodules in 5% are of neoplastic character and their diligent investigation is necessary with USG, FNA and certain biochemical factors evaluation. Screening is an important part of diagnosing thyroid gland., Material and Methods: Prophylactic examination donated by Krakow's City Government was performed in 140 persons aged 18-71 among whom 93.3% were women. Clinical examination, USG, FNA (when it was necessary), and TSH serum level evaluation were conducted in these patients., Results: In 42.2% (group I) no abnormalities were detected. In 28.5% (group II) USG revealed thyroid nodules when clinical examination was negative. In 29.3% (group III) the presence of palpable nodules was confirmed by USG. In consecutive groups I-III following factors were presented: mean age, frequency of performed FNA's and thyroids volume., Conclusion: USG is an efficient method in prophylaxis of thyroid disorders.

A case of malignant hemangioendothelioma, developing in a goiter of a 52-year-old woman is presented. This bleeding tumor of the thyroid gland has caused four operations within one month. Histologically, the tumor was composed of widely dilated, ramifying and intercommunicating vascular spaces lined by atypical malignant endothelial cells. Positive immunohistochemical reactions with endothelial markers including factor VIII-related protein, and CD34 and non reactivity with epithelial membrane antigen (EMA) and thyroglobulin, confirmed the endothelial origin of this tumor.

The authors presented 4 cases of primary malignant neoplasm of the intestine caused by small intestine obstruction. These patients underwent emergency surgery. In all cases, a segmental resection of the intestine was performed. There were two cases of adenocarcinoma and two cases of carcinoid. Three patients were complementarily treated using chemotherapeutics. One of them died two years post operation. The last three patients survived 0.5-5 years post operation.

The paper presents clinical signs, diagnosis, treatment and therapeutic results in the group of patients with a primary gastrointestinal lymphomas. All of the patients had a surgical procedure: 5 of them were operated on according to a fixed plan and 3 had an emergency operation. 6 patients were subjected to chemotherapy and radiotherapy. The patients were analyzed along with the obtained therapeutic results.

Since 1986 till 1996 in the Third Department of Surgery of the Collegium Medicum of the Jagiellonian University in Cracow, nine patients with biliary ileus were operated. Initial diagnosis, additional tests results, concomitant diseases, kinds of operative procedures and complications were analysed. Biliary ileus is still generally recognized during operation. Endoscopy, X-ray examination with contrast, ultrasound, and computed tomography are worth recommendation in preoperative diagnosis. Early decision about operative treatment and application of antibiotic prophylaxis may have an influence on improvement of treatment results.