Patients with parastomal recurrence have poor prognosis and pose a great challenge to the surgeons. Surgical resection is the only curable choice. Treating

Background: Vitamin D (VD) insufficiency is present in chronic pancreatitis (CP), leading to increased cardiovascular risk, bone complications, impaired quality of life, and increased mortality. This study aimed to determine the prevalence of VD deficiency in patients with CP and to assess its relationship to CP progression and associated cardiovascular complications. Methods: Seventy patients were enrolled and evaluated for pancreatic exocrine insufficiency by fecal elastase-1, CP severity by M-ANNHEIM classification, cardiovascular risk by 10-year risk mortality scores (SCORE and FRS), and for arterial stiffness using pulse wave velocity (PWV) at a. carotis and a. femoralis. Determination of 25-hydroxyvitamin D was performed by an LC-MS/MS method. Resting energy expenditure was calculated using the Harris–Benedict formula. Results: Mean VD levels were 37.86 ± 24.36 nmol/L (range 3.854–99.874 nmol/L); only five patients were in sufficiency status. VD levels correlated significantly with body mass index (BMI) and resting energy expenditure. In patients with severe structural changes, we observed lower VD levels regardless of etiology (p < 0.01). VD levels were lower in patients with pancreatic exocrine insufficiency (PEI), p < 0.05. Patients with mild CP by M-ANNHEIM had lower levels of VD compared to moderate and advanced CP, p < 0.05. At a cut-off of VD 11.95 nmol/L, we verified pancreatic lithiasis with 89.4% sensitivity, 83.3% specificity, and AUC of 0.826 ± 0.113 (95% CI, 0.61–1). VD status worsened with the increase in the 10-year risk mortality by both SCORE and FRS and PWV, p < 0.05. Conclusions: Most of our patients with CP were VD insufficient. Monitoring of nutritional status in patients with CP is mandatory to prevent the development of malnutrition complications and the associated morbidity and mortality.

Boerhaave's syndrome is a rare critical condition manifesting as transmural esophageal rupture. It is usually associated with forceful emesis and increased intraesophageal pressure. Immediate aggressive surgical intervention is imperative in such cases. We present a patient with a late diagnosis of Boerhaave's syndrome who was successfully treated in our department. We performed a subtotal esophageal resection, esophagostomy, gastrostomy, pyloroplasty by Heineke-Mikulicz, debridement, bilateral early decortication of the lung, and cleaning of the pleural cavities and mediastinum.

The development of a late fistula between a native unremoved corrosively altered oesophagus and the right lung with subsequent chronic lung abscess formation 34 years after retrosternal colo-oesophagoplasty is an extremely rare complication. According to our review of the English-language literature, such a case has not been described so far. We present a 50-year-old man with complaints of dry cough, periodic epigastric postprandial pain, regurgitation of food and halitosis, which started about seven years ago. Transthoracic right-sided subtotal oesophagectomy and resection of the sixth lung segment were performed. Diagnostics and surgical treatment are discussed.

Cholecystoenteric fistulas are a rare complication of chronic gallstone disease. If not diagnosed on time, they can cause several complications such as gallstone ileus, gastric outlet obstruction (Bouveret syndrome), cholangitis, or liver abscess. We present a case of a patient with chronic calculous cholecystitis, who was admitted due to unspecific abdominal discomfort and impaired liver function with increased cholestatic liver enzymes. We found a stone in the distal part of the common bile duct with the papilla orifice located in a duodenal diverticulum and a cholecystoduodenal fistula as an additional finding, which at that point was uncomplicated. After successful endoscopic therapy of the choledocholithiasis, the patient was referred for laparoscopic cholecystectomy and treatment of the fistula. During follow-up, the patient was in an excellent overall condition.

An inflammatory fibroid polyp (Vaněk’s polyp) is a rare, benign, mesenchymal polyp originating from the submucosa of the gastrointestinal tract. Symptoms are non-specific and depend on the tumor size and location. Despite their benign nature, these tumors can mimic other malignant conditions, making an accurate diagnosis crucial for appropriate management. Histologically, they are submucosal lesions composed of spindle-shaped or stellate stromal cells, stroma with thin-walled vessels around which spindle-shaped cells are arranged similar to onion skin, an eosinophil-rich inflammatory infiltrate, and minimal mitotic activity. In this article, we present the case of a 63-year-old woman with a giant benign inflammatory fibroid polyp of the stomach. We performed distal esophageal resection, total gastrectomy, and omentectomy, as the passage was restored with a transmesocolic termino-lateral esophago-jejunal Roux-en-Y anastomosis. We also present a brief literature review on this topic.