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Giant hiatal hernias with massive displacement of abdominal organs into the thoracic cage are known as non-typical hiatal hernias. They can occur with few clinical symptoms across many years, which often makes the diagnosis difficult. The method of choice for diagnosis is computer tomography. We present 4 cases of a giant hiatal hernia. Three out of 4 patients have been operated on because of an obstruction in the upper digestive system, whereas 1 had elective surgery. In all cases, we performed a fundoplication with good results and no mortality. [ABSTRACT FROM AUTHOR]

Introduction: Colorectal cancer (CRC) is the most common cancer among patients, and its aetiology is still not precisely known. It is believed that 15-30% of colorectal cancers are genetically determined. P-glycoprotein (P-gp) encoded by the MDR1 gene in normal conditions plays an important role in the action of colon epithelial cells. However, the MDR1 polymorphism influences the P-gp expression and can weaken its effect against xenobiotics (procarcinogens) and increase the frequency of CRC., Aim: To evaluate the correlation between the MDR1 C3435T and G2677T/A polymorphisms and the risk of colorectal cancer., Material and Methods: The study group with colorectal cancer included 47 women and 60 men while the control group consisted of 110 healthy patients. The diagnosis in patients suffering from CRC was confirmed by histopathological report. Genetic analysis was performed using PCR-RFLP method., Results: We showed only a correlation between the frequency of CT and TT genotypes of C3435T polymorphism and the risk of colorectal cancer in younger age. There was no correlation between the C3435T and G2677T/A polymorphisms of the MDR1 gene and other clinical parameters., Conclusions: Our findings suggest that T allele carriers of C3435T polymorphism have an increased risk of CRC. However, further studies are needed on a much larger number of patients and genes associated with metabolism and transport of xenobiotics including procarcinogens.

Introduction: Colorectal cancer is one of the most common malignancies. It is the second most common cause of cancer death in men and the third most common in women. The aetiology of colorectal cancer is multifactorial, complicated, and remains the subject of many studies. It has been estimated that only 15-30% cases of colorectal cancer are hereditary. The aim of the study was to determine the relationship between the C3435T and G2677T/A polymorphisms of the MDR1 gene and the risk of developing colorectal cancer., Materials and Methods: The study group comprised 47 women and 60 men with colorectal cancer. The age of patients was 47-83 years. In each case the diagnosis of colorectal cancer was confirmed by histopathological examination. The control group comprised 110 subjects without malignant colorectal cancer. Genetic analysis was carried out using PCR-RFLP., Results: A relationship between the presence of CT and TT genotypes of C3435T MDR1 gene polymorphism and onset of colorectal cancer at a younger age was found. No correlation between C3435T or G2677T/A MDR1 gene polymorphism and other clinical parameters was identified., Conclusions: Further studies are necessary on a significantly greater number of genes and their polymorphisms. Findings from this study may be used as a part of polygenic analysis aimed at explaining the complicated processes responsible for the onset and development of colorectal cancer.

On occasion of the 120th anniversary of the founding of the Polish Association of Surgeons, we present the scientific and educative activities of the West Pomeranian Section of the Association during its 60 years of existence. The aim of this work is to present the profile of Prof. Tomasz Grodzki, one of the founders of the Polish Society of Cardiothoracic Surgeons and head of the Department of Thoracic Surgery at the hospital in Szczecin-Zdunowo. Attention is devoted to his educative and scientific contributions and to the role played by Prof. Grodzki in the development of thoracic surgery in the province of West Pomerania. In cooperation with the Department of Cardiosurgery, Second Clinical Hospital in Szczecin, Professor Grodzki, as head of the Thoracic Surgery Ward at the hospital in Szczecin-Zdunowo, organized the First Founding Congress of the Polish Society of Cardiothoracic Surgeons in April 26-28, 2002.

Bowel obstruction caused by a gallstone is a rare pathology in the abdomen. The high mortality associated with this condition has prompted the authors to present their experience over the past two years against the background of published case reports. This paper presents three different ways of management of gallstone ileus: enterolithotomy; two-stage surgery--enterolithotomy followed by cholecystectomy; one-stage surgery--enterolithotomy combined with cholecystectomy and fistula repair. The authors report on a case which was successfully managed with enterolithotomy only and discuss arguments in favor of each procedure. Enterolithotomy appears to be the safest approach in gallstone ileus, leaving time to qualify the patient for further surgery on the basis of clinical status and symptoms.

A gastrointestinal fistula is a late complication of peptic ulcer disease and forms when gastric resection is inadequate or vagotomy is incomplete or not performed. Such cases are extremely rare and are occasionally reported in the literature. We present a patient with a gastrocolic fistula which developed 7 years after partial gastrectomy due to pyloric stenosis as a sequella of peptic ulcer. Nonspecific clinical symptoms and ambiguous radiographic findings delayed the diagnosis of gastrocolic fistula. The patient was operated; "en bloc" resection of the fistula with partial resection of the transverse colon and stomach supplemented with truncal vagotomy was done. The possible cause of recurrence of peptic ulcer in this patient was that vagotomy was not done during the first surgical intervention. Thus, the gastrocolic fistula became a late complication of the recurrence of peptic ulcer. Diagnostic difficulties in gastrocolic fistulas are presented and surgical management of this complication is discussed.