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Gastropleural fistula is an extremely uncommon lesion, especially in children. Only a few cases have been reported and most of them have related to adults. We describe a case of gastropleural fistula in a 7-years-old boy with craniocerebral injuries and nonpenetrating trauma of thorax and abdomen. The child underwent emergency laparotomy with subsequent splenectomy and suturing of the ruptured hepar. Due to chest radiograph which showed bilateral hydrothorax, intercostal drainage was used. On the 10th day after admission, leak of nasogastric feeds through the left intercostal drainage tube was noticed (foul-smelling, bile-stained fluid) and the possibility of gastropleural fistula was taken under consideration. Gastropleural fistula was demonstrated and confirmed by contrast study through nasogastric tube. During relaparotomy, the pathological communication of about 2 cm in diameter, between the across the left posterolateral part of the diaphragm was visualized and closed. A gastrostomy was created. Postoperatively his course was complicated by left pleural cavity empyema. The authors emphasize that successful treatment of gastropleural fistula depends on early diagnosis and quickly surgical intervention. [ABSTRACT FROM AUTHOR]

On the base of medical documentation, we presented epidemiological analysis of 215 patients treated for traumas of facial skeleton, which occurred during agricultural tasks. It was concluded that the injuries mentioned above occurred more frequently in males at the age between 18-40. The traumas in this group occurred mainly during use of jig saw or other tools and machinery used in agriculture. However in the female population injuries of facial skeleton resulted mainly from zoogenous trauma and accidental fall downs.

The reported case was a boy aged 13 with, traumatic carotido-cavernous fistula admitted to hospital with right exophthalmos and paresis of right abducens nerve. After two failed trials of endo-vascular closure of the fistula it was decided to use venous bypass ICA-MCA (internal carotid artery in its extracranial part--M1 segment of middle cerebral artery) for bypassing the fistula. This made possible closure of the fistula with regression of neurological symptoms.

Purpose: Analysis of diagnostic and therapeutic ophthalmological problems after severe cerebrocranial lesions with liquorrhea., Material: 3 children between 5 months and 5 years in whom the ophthalmological symptoms were the first and important signs of the cerebrospinal fluid leakage after skull lesion. These patients were observed and diagnosed at the department of ophthalmology and then operated at the department of neurosurgery., Results: In all children skull trauma has led to dura mater tear and leakage of cerebrospinal fluid with its complications. As a result of the ophthalmological complications, two patients developed worse visual acuity evoked potentials. Blind eyeball of the third patient was enucleated., Conclusions: The ocular findings are not typical for liquorrhea after cerebrocranial trauma and they must be diagnosed and treated by a team of ophthalmologists and neurosurgeons.

A case is presented of impaction of a metal bar into the cranium i an 8-year-old child. The significant importance for the therapeutic management was radiological examination, especially CT of the head. It made easier the determination of the foreign body locality in relation to the anterior cranial fossa and could allow to do the assessment of the resolution of air accumulation in the frontal lobe.

Codubix plates made of polypropylene-polyester fabric were used for reconstructive cranioplasty of cranial vault defects after trauma. This method protected well the brain against secondary trauma with a good cosmetic result of the operation. By eliminating the necessity of use of patient's own bones the duration of operation was shortened, the patient avoided postoperative pain, and the possibility of postoperative complications was reduced. During a two-year period of follow-up no complications were observed.

The paper presents in compact form some anomalies of craniovertebral region; 77 cases of minor and 30 cases of major anomalies were reported. The aim of this paper is to indicate morphological heterogeneity of these anomalies and necessity of differentiation in cases of cranio-cervical injuries.

In the years 1967-76 at the laryngological clinic 35 patients with faciocranial traumas sustained during work at a light industry plant were treated. Considerable amounts of serious faciocranial injuries (10 cases), and frequent accompanying injuries (mostly lesions of eyes and central nervous system) were found. Direct social cost of those accidents in terms of hospitalization was 482 days and in terms of disability for work--738 days.