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Introduction. Tracheobronchial disruption is a rare disorder, usually accompanied by a severe blunt chest trauma that quite rarely appears as an isolated event. Case Report. This is a case report of a right main bronchus disruption, due to an injury to the right hemithorax, caused by a falling tree trunk. The disruption was accompanied by mediastinal emphysema, fractures of the 4th and 5th ribs on the right side and compound sternal fracture. The patient was operated in general anesthesia, through right thoracotomy approach, followed by successful right main bronchus reconstruction by interrupted suture technique, without anatomic resection of the lung parenchyma. Conclusion. Although this injury is rare, with suspicion of bronchial rupture, bronchoscopy confirms the diagnosis and leads to better prognosis.

Introduction: The nature of juvenile patients' gynecological problems requires a teamwork of experts specialized in different fields of medicine, specifically: juvenile gynecologist, pediatrician and neonatologist, pediatric surgeon and psychologist/pedagogue. Vulvovaginitis is the most frequent gynecological diagnose related to children and it comprises 60% of pediatric gynecological pathology. This condition is the inflammation of vulva and vagina which can be manifested through: itching, pain, burning sensation in vulva area and it is commonly associated with increased secretion. Aim: The analysis of frequency and causis of vulvovaginitis among children and adolescents from 2009 to 2014 and the determination of the most common isolated pathogens. Material and methods: A retrospective study was conducted and the data from medical documentation was used, precisely The Protocol for Juvenile Gynecology, as well as medical reports. The research was conducted in the time period of six years, and the test group was consisted of3792 patients divided into three groups. Results: It was concluded that out of 3792 patients, 1011 were diagnosed with vulvovaginitis, and most common isolated pathogens are Enterococcus, E.coli i Candida albicans. Conclusion: The causes of vulvovaginitis depend on the age of the patient. The most common cause of vulvovaginitis is inadequate hygiene of genital, anal region, and hands. With serving the informations and detailed description of genital hygiene, comes a great success in preventing and reducing the number of vulvovaginitis.

Background The clear cell “sugar“ tumor of the lung is an extremely rare benign mesenchymal tumor. Aim: To report a case of the sugar tumor and discuss diagnostic differentiation of the tumor.

Introduction. Bronchial leiomyoma is extremely rare. Most reported have been resected by either lobectomy or pneumonectomy. We presented a case treated by sleeve bronchoplasty without pulmonary resection. Case report. The presented case, 39-year-old male, had been admitted to our hospital complaining of hemoptysis. Chest X-ray showed no abnormality in either lung field, but computed tomography scan found the tumor in the upper right bronchus. The diagnosis was made by histological and immunohistochemical examination of the specimens obtained during bronchoscopy. Conclusion. The presented patient was treated by thoracotomy and sleeve resection of the right upper lobe bronchus with the removal of all the tumor.

The aim of this study is to compare usefulness of Semi-Fowler position vs. lateral decubitus position for thoracoscopic sympathectomy in treatment of primary focal hyperhidrosis.From January 2009 to January 2010, 263 consecutive patients with palmar and axillar hyperhidrosis underwent thoracoscopic sympathectomy Th2-Th4. Patients were divided into two groups: group A (n=133) underwent thoracoscopic sympathectomy through lateral decubitus using double lumen endotracheal intubation, and group B (n=130) underwent thoracoscopic sympathectomy through Semi-Fowler supine position (semi sitting with arm abducted) using single lumen endotracheal intubation without insufflation of CO2, but with short apnea period. All operations were performed through two 5 mm operating ports, videothoracoscopic camera 0° and endoscopic ultrasound activated harmonic scalpel.There were 107 males and 156 females with median age 30.31±8.35 years. Two groups were comparable in gender, age, severity of sweating. All operations were successfully performed with no complications or perioperative morbidity. For group A average operation time for both sides was 31.2±3.87 min and for group B average time was 14.19±4.98 min. In group B apnea period per one lung lasts 2.86±1.15 min and during that period observed saturation was 92.65%±5.66% without significant cardiorespiratory disturbances. Pleural drains were taken off on operation table after forced manually lung reexpansion. Patients were discharged from hospital for few hours, after the operation and radiologic confirmation of complete lung reexpansion.Based on this data (shorter operating time, lack of incomplete lung collapse, insignificant apnea and better reexpansion of lungs) we concluded that thoracoscopic sympathectomy through Semi-Fowler supine position is highly effective and easy to perform for primary hyperhidrosis.