A 16-year-old girl with an asymptomatic large splenic cyst. The disease was discovered by an accidental ultrasound of the abdomen due to a urinary infection. The patient was followed up conservatively for 3 years, and after the gradual enlargement of the cyst, laparoscopic surgery was indicated. The operation and postoperative follow-up for a period of 6 months is satisfactory.

Introduction: The role of Radio frequent Generator (RF) has been extended from simple tumor ablation to routine hepatic resection. RF energy precoagulates the tissue and thus allows the closure of small blood vessels and bile ducts. The development of surgical techniques and modern technological advances have enabled liver resections to be significantly surgically better controlled in the sense of bleeding, and are more successful and safer for patients. The RF generator has its advantages and disadvantages and as such can be equally used in resective liver surgery. Aim: Display the intraoperative and postoperative complications among patients that had been subjected to liver resection using a RF generator (RF resection), compared to those that had been subjected to liver resection without the use of RF generators (classical liver resection methods of CC resection). Material and methods: The study included 60 patients of both sexes which had resective operative surgery or metastasectomy on the liver due to the basic process. The study was conducted at the Clinic for General and Abdominal Surgery of the Clinical Center of the University of Sarajevo in a four-year period. The study was designed as a comparative study of outcome and postoperative complications of surgical treatment, i.e. resective liver interventions using two operating techniques (RF–liver resection and Classical resection techniques on the liver). Results: The highest number of surgical procedures was due to colorectal cancer. A slightly smaller number was performed due to primary liver cancer and gallbladder cancer. The highest number of surgical interventions remain on non-anatomic resections. Smaller number remains to large resective operations. The length of hospitalization was significantly correlated with blood loss (r = 713 p = 0,000) and the average hospitalization time ranged from 10.5 to 53.3 days. Conclusion: We have shown that the use of RF generators does not significantly reduce intraoperative and postoperative complications. There is a justification for using both techniques for resection on the liver. The resective liver operation depends mostly on the personal stance and the surgeons training.

INTRODUCTION Liver is made up of functionally indipendent parts or segments, and segmentation is based on course and ramification of blood vessels and bile ducts whereby each segment represents separate territory of the liver. Most severe complication is a postoperative liver insufficiency that demands complex treatment, is followed by high mortality and demans specific treatment including liver transpaltation. MATERIALS AND METHODS Study was designed as retrospective and included patients who underwent liver resection at Clinic for abdominal surgery of Clinical Centre University Of Sarajevo (CCUS) during period 2010-2012. The study included 44 patients at the Clinic of abdominal surgery. RESULTS There were 6 (13.6%) hepatocellulare carcinomas, also 6 (13.6%) echinococcus cysts, the rest (72.8%) were different liver tumors. In the study group, following complication have been percepted; biliary leak (defined as the level of bilirubine in drainage fluid exceeding 5.0 mg/dl (> 85 micromol/l) more than 7 days), postoperative hipoalbuminemia, the need for reintervention as well as letal outcome. Complications were percepted in 7 patients (15.9%). In patient with no complication the lenght of hospitalization was 8-12 days while in thoose with complications hospitalization was prolonged to max 25 days. CONCLUSION Majority of resections have beed done due to metastatic tumors, slightly lower number due to primary tumor (hepatocellulare carcinoma). Postoperative complications correlated with older age, comorbidity and higher blood loss during operation. One of the most often complications in our casuistics was biliary leak.

INTRODUCTION Polytrauma is defined as an injury where they are affected by at least two different organ systems or body, with at least one life-threatening injuries. Given the multilevel model care of polytrauma patients within KCUS are inevitable weaknesses in the management of this category of patients. OBJECTIVE To determine the dynamics of existing procedures in treatment of polytrauma patients on admission to KCUS, and based on statistical analysis of variables applied to determine and define the factors that influence the final outcome of treatment, and determine their mutual relationship, which may result in eliminating the flaws in the approach to the problem. MATERIAL AND METHODS The study was based on 263 polytrauma patients. Parametric and non-parametric statistical methods were used. Basic statistics were calculated, based on the calculated parameters for the final achievement of research objectives, multicoleration analysis, image analysis, discriminant analysis and multifactorial analysis were used. From the universe of variables for this study we selected sample of n = 25 variables, of which the first two modular, others belong to the common measurement space (n = 23) and in this paper defined as a system variable methods, procedures and assessments of polytrauma patients. RESULTS AND DISCUSSION After the multicoleration analysis, since the image analysis gave a reliable measurement results, we started the analysis of eigenvalues, that is defining the factors upon which they obtain information about the system solve the problem of the existing model and its correlation with treatment outcome. CONCLUSION The study singled out the essential factors that determine the current organizational model of care, which may affect the treatment and better outcome of polytrauma patients. This analysis has shown the maximum correlative relationships between these practices and contributed to development guidelines that are defined by isolated factors.

Polytrauma is defined as injury that have affected at least two different organ systems or organs, with at least one of them is life-threatening. It as a sum of severe anatomical and functional impairments, whose evolution is difficult to predict and often questionable outcomes. According to statistics obtained from MTOS (Major Trauma Outcome Study) and TARN (Trauma Audit Research Network) totals up to 10% of all hospitalized injuries. Accompanied by a high mortality rate, especially in the population of young and middle-aged, which in the levels of the organization of our health service is 25-35%. The causes of polytrauma are numerous, and the most common consequence of road accidents, falls, violent crimes with the actions and use of weapons, natural disasters, wars, mining accidents etc. The mortality rate in polytrauma depends on many factors related to all levels of care polytraumatised person in the organization of the health system. According to data from the NTDB ACS for 2004. mortality rate in polytrauma was 18,04% (with ISS value 16-24, mortality rate was 6,21%, and with ISS value >24 mortality rate was 33,05%). TARN data it has about 17,7%. The aim of our study is to make the quantification of polytrauma in a five-year period (2000. to 2004.) taken care of at the Clinical Center University of Sarajevo, to process data received by multiple scoring for each individual patient and to calculate and display total mortality rate in the sample with the comparison of results from the MTOS and TARN baseline norms.