Renal and perirenal abscesses are very rare in children. They can be present as an acute emergency condition or insidiously as a chronic disease. The diagnosis is not so obvious, and it is a big challenge, especially when it can simulate a kidney tumor. The treatment can be conservative, preferably with targeted antibiotics, or surgical, consisting primarily of drainage. This publication aims to present a clinical case in which both diagnosis and treatment were a big challenge for the entire treatment team. A 10-year-old male patient was admitted to the hospital because of mild abdominal pain and a temperature of 37.5 °C. The symptoms lasted for a week. In the computed tomography (CT), the lesion’s dimensions were 11.1 × 8.2 × 25 cm, and inflammation, abscess, cyst, and abdominal tumor have been suggested. The decision about surgical treatment was made. An enormous abscess near the right kidney was localized. The patient’s condition stabilized after surgery. Unfortunately, due to persistent purulent reservoirs, a second laparotomy was necessary. During the extensive diagnostic cystourethrography performed, vesicoureteral reflux was visualized. In conclusion, though a perinephric abscess is very rare in children, it should be taken into consideration in patients with non-specific abdominal symptoms. The imaging using ultrasound and CT scan with contrast enhancement is crucial to recognize and properly treat the condition. In terms of a small abscess, the only antimicrobial treatment using antibiotics of a broad spectrum can be considered. However, the drainage of an abscess, either percutaneous or open, should be used. For the large abscess, the open drainage seems to be a primary method of treatment. The importance of cooperation in a multidisciplinary team is crucial, as the diagnosis and treatment of underlying causes are essential.

Introduction: The aim of the work is to present the possible struggles that a doctor of the Hospital Emergency Department for adults may encounter when admitting a pediatric patient with a head injury. Head trauma is the most common cause of death or permanent injury in the pediatric population. The lack of experience in dealing with a minor patient, as well as the lack of knowledge of anatomical and physiological differences make it necessary to introduce simple algorithms. It helps to facilitate decision-making proces while facing this challange. Methods: The paper discusses the recommended management of a pediatric patient with the head injury treated by a team with limited experience in the field, based on a review of the literature - available studies and publications from the last 15 years - as well as the authors’ own experience. Result: In case of the pediatric head trauma there is a need to develop a patient examination scheme, paying attention to the specific anatomical and physiological differences resulting from the patient's age. It i salso recommended to introduce an algorithm that allows to limit and reasonably use imagining – mostly CT scan – in pediatric patients ( CHALICE, CATCH and PECARN algorithms). The article also recommends methods of management in the case of particular types of craniocerebral trauma.

Introduction: Gastroschisis is a common developmental anomaly of the abdominal front wall. The aim of surgical management is to restore the integrity of the abdominal wall and to insert the bowel into the abdominal cavity with the use of the primary or staged closure technique. Aim: The aim of this paper is to analyze our 20 years of experience surgically treating gastroschisis with primary and staged closure, to compare the postoperative course for these techniques, and to identify factors that influence the course and early results of treatment. Methods: The research material consists of a retrospective analysis of the medical history of patients treated at the Pediatric Surgery Clinic in Poznań over a 20-year period from 2000 to 2019. A total of 59 patients were operated on (30 girls and 29 boys). Surgical treatment was performed in all cases. Primary closure was performed in 32% of the cases, whereas staged silo closure was performed in 68% of the cases. Results: Postoperative analgosedation was used for 6 days on average after primary closures and for 13 days on average after staged closures. Generalized bacterial infection was present in 21% of patients treated with primary closures and in 37% for staged closures. Infants treated with staged closure began enteral feeding considerably later than those treated with primary closure (day 22 vs. day 12). Conclusions: It is not possible to clearly indicate which surgical technique is superior based on the results. When choosing the treatment method, the patient’s clinical condition, associated anomalies, and the medical team’s experience must be taken into consideratio