Objective: To study the clinical profile of patients admitted with polytrauma over a five year period in a general hospital and review the management of abdominal trauma in them. Material and Methods: Medical records of 92 patients were studied retrospectively. The clinical presentation with details of injuries, relevant investigations done and the operative findings were analyzed. Results: Polytrauma was significantnly more common in males than females (P<0.001) and more so in the young age, between 20 and 29 years of age ( P<0.01). Road Traffic Accidents were the predominant cause followed by falls. Surgical operative management was necessary in 38 patients (41%) with abdominal trauma. Overall mortalitety was 4%, that for admitted patients 1% and post-operative mortality 3%. Conclusion: The clinical profile of polytrauma and the management of abdominal trauma in a general hospital are presented. The need for updating the national trauma registry with uniformity in reporting polytrauma in Serbia. 

Women in the age of 70 years admitted to the hospital in severe condition, 4 months after transvaginal hysterectomy. Physical examinaton revealed small bowel loops passing through the anus into the auter spaces. Previous surgery was as follows: Hysterctomia totalis vaginalis, conservatio adnexorum bill, colpoperineoplastica cum myorraphiam mm. levatores any, vaginopexia sacrospinalis sec. Nichols pp. prolapsus utery totalis am. n 4. On that occasion the anterior wall of rectosygmoid colon was damageden size 70x50 mm by that time. The lesions was neither noted nor repaired during. Postoperativne course was uneventful. After 4 mounths, during phisical strain patient felt sudden pain in abdomen, need for passing the bowels, noting the passage of the intestines through the annal appertura immediate reoperation was undertaken. Through medial infraumbilical approad small intestine was mannualy repositioned the lesion of the large intestine was managed by primary suttures Vicryl 000. Drainage of peritoneum performed. Postoperative course un univentful. Intestinal function restored. Wound healed correctly, per primam.

Echinococcus is a zoonosis, parasitic disease, caused by echinococcus granulosus, E. multilocolaris, E. Vogeli and E. oligarthus. The most frequent at humans is a cystic form of the disease caused by E. granulosus, and rarely the alveolar one caused by E. multilocolaris seu alveolaris. It can affect all the organs and tissues. The most affected ones are: liver (70- 80%) and lungs (10-25%), while rarely, at 5% it can be found in spleen, kidneys, brain, heart, pancreas, mussels and skeleton. The only secure treatment of the primary echinococcosis is the surgical one. It should start immediately after the diagnosis is set in order to avoid complications which follow echinococcosis. Several surgical methods are used in practice for live echinococcus treatment: partial pericystectomia, total cystopericystectomia and liver resection. Aim of the work is to show the importance of the echinococcus cyst of liver and treatment methods. The patient presented in the work is Dj.G., female, register number of the disease history 355/14.05.2007., 61 years old, hospitalized at Surgical Clinic because of the surgery of echinococcus cyst on the left liver lobe. Diagnosis was set by abdomen USG, CT of the abdomen, and laboratory analyses. During the surgery, we found a big echinococcus cyst localized in the second and third segment of liver, so we did a liver resection as a bisegmetectomia with total ekstirpacija of the cyst. Postoperative flow passed normally and the patient
was on the eight postoperative day sent to further home care in a generally and locally good state.

Autors reports 20 ten old boy received penetrating vulns thorasic with naif at midle linea.subksifoid area. Patient with angina pectoris, hypovolemic shock end cardiac arrest received at department intensive care Clinic hospital centre Prishtine in Gracanica. In cardiogenic arrest under reanimation is introduction in general endotracheal anestesy and intervention surgery. Maden midle sternotomy and verification laesio pericardii under right cordis longth of 20 mm,hematopericard and vulnus at parietis diaphragmalis right ventricular in area septoapicalis.Past evacuation sangui from pericard heart mobilisation and made compresion phingin.Placement closure laesion with cardiorraphia prolen 0000 sec.Cooley.Lesion right pleurae mediastinalis and placement drain in right torasic cavum and drain mediastine in restrosternal area i aspiration undervother sec. Bilay. Fixation sternum with fillum metalicum sec. Kurschner. Reanimation intensive care all time and past realisation complete haemostasis along linae sutturae heart folow up substitution adecquat failure volumen total sangui plasm and cristolid. Realisation total stability hemodinamic and patient move at department intensive care. Control EKG, echocardiography and cardiac ensims 5 and 10 dely psotoperative show fingins corectly. Not signs ischemic laesaoin and disfunction conducti and arrhythmi. Haert pariets is all corectly viability and cinesy.

Obstructive jaundice presents partial or complete blockade in the gall way towards intestinal tract. This blockade is caused by mechanical obstruction in the extrahepatitic bilioductule system. Etiologic factors which cause obstruction of the extrahepatitic gall ways are numerous. One of the reasons of appearing obstructive jaundice is penetration of the cyst parts or cyst sprout into the gall ways. Echinococcus is zoonosis, parasitic disease, caused by echinococcus granulosus, E. multilocolaris, E. vogeli i E. oligarthus. At humans, cystic form of disease caused by E. granulosus appears most frequently, while the alveolar one caused by E. multilocolaris seu alveolaris appears rarely. Aim of the work is to show the importance of the echinococcus cyst of the liver at the appearing of the obstructive jaundice , penetrating the cyst parts or cyst sprout in the gall ways. The patient presented in the work is E.C., male, register number of the disease history 404/05.06.2007, 20 years old, hospitalized at Surgical Clinic because of the surgery of echinococcus cyst on the left liver lobe. Diagnosis was set by abdomen USG, CT of the abdomen, and laboratory analyses. Echinococcus cyst got complicated by its penetration into the gall ways, and manifested by jaundice, the signs of purulent cholangiitis, and bad general state of the patient, so the surgical treatment is absolutely indicated. During the surgery, after the done pericystectomia, cholendochotomia is done because of the enlarged cholangiitis, where the signs of purulent cholangiitis and 5 cyst sprouts are found and removed. Postoperative flow passed normally. Findings of done secondary cholangiography showed normal structure and transience of gall ways, so the T-drain was removed and the patient sent to further home care in a generally and locally good state.

Ahernia occurs when the contents of a body cavity bulge out of the area where they are normally contained. These contents, usually portions of intestine or abdominal fatty tissue, are often enclosed in the thin membrane that naturally lines the inside of the cavity. Although the term hernia can be used for bulges in other areas, it most often is used to describe hernias of the lower torso (abdominal wall hernias). Hernias by themselves usually are harmless, but nearly all have a potential risk of having their blood supply cut off (becoming strangulated). If the hernia sac contents have their blood supply cut off at the hernia opening in the abdominal wall, it becomes a medical and surgical emergency. Aims of the paper were: 1. to reveal the prevalence of inguinal region hernias (IRH) among all patients being admitted to emergency ward of Surgery Clinic at Gracanica during 2006 and 2. to show treatment efficacy of each surgical methods used. Material and method: Clinical
Center Pristine, Surgery Clinic at Gracanica patients' medical records were analyzed. Prevalence of IRH was monitored during the time frame of 1 year (2006). Basic statistical methods were applied for data analyzing. Results and discussion: During the time observed, 504 patients underwent surgical treatment. Among them, 162 patients (32,14%) were operated on inguinal region hernias. IRHs were more prevalent in males - 146 cases (90,12%) in comparison to 16 cases in females
(9,88%). During the certain time period, IRHs were more prevalent in adults 101 cases (62,35%) than in children 61 cases (37,65%). The vast majority of all operated hernias, belong to group of inguinal hernias 156 cases (96,30%). At the same time, there were only 6 cases (3,70%) of femoral hernias. This observation is in concordance with the data published worldwide inguinal hernias make up 75% of all abdominal wall hernias and occur up to 25 times more often in men than women.
The study, also, revealed incarcerated hernia (part of the intestine or abdominal tissue that becomes trapped in the sac of a hernia) in 6 patients (3,70%) while recurrent hernia was found in 3 patients (1,85%). The most frequently used surgical approaches were: i) Ferrary method in 54 patients (33,33%; ii) Lichtenstein method in 42 patients (25,93%), and iii) Bassini method in 35 patients (22,22%). Postoperative complications were noted in 3 patients (1,85%). Conclusion: Based on the results obtained, one may conclude that efficacy of surgical method used in treatment of IRH is in indirect relation with the number of postoperative recidives the higher the number of hernia recurrences, the lower the efficacy of surgical method is