Cardiac echinococcosis is a rare manifestation of cystic echinococcosis (CE) caused by the tapeworm Echinococcus granulosus Among all patients suffering from CE, only 0.5%-2% exhibit a cardiac involvement. In addition, during the past years the number of CE cases reported in Western Europe remained roughly unchanged. However, we postulate that cases of CE in Western Europe will increase due to a growing number of refugees coming from endemic areas such as Southern Europe, Eastern Europe and the Middle East. Importantly, although cardiac echinococcosis is rare the disease can lead to many clinical complications, for instance acute heart failure and life-threatening arrhythmias. With respect to the increasing relevance of cardiac echinococcosis in Western Europe and the danger of fulminant disease courses, here we review diagnosis strategies and treatment options of the disease. Diagnosis of cardiac echinococcosis requires a detailed evaluation of the patients' case history, specific laboratory analyses and radiological imaging methods. Ultrasound, MRI and CT are key imaging tools for diagnosis, therapy control, prognosis estimation and disease course control. For the therapy of cardiac echinococcosis, a combination of surgical removal and drug treatment should be applied to symptomatic as well as asymptomatic patients. The complete surgical removal of the cyst(s) is the major prognosis factor of the cardiac manifestation of CE.
Percutaneous nephrolithotomy (PCNL) is one of the most common treatment options in the management of kidney stones in children. While colon perforation during PCNL is reported as a rare complication in adults, there are scarce data regarding colon perforation during pediatric PCNL. We report the successful management of colon perforation occurring during PCNL and of a renal stone in a 6-year-old child. Moreover, we describe the procedure to be followed for colon perforation in children.
The giant hyperplasia of the prostate is extremely rare pathology of prostate gland. Here, we report the successful removal of the 9th heaviest prostate ever reported in the literature.
A young woman presented with severe heart failure symptoms 4 years after percutaneous device closure of an atrial septal defect (ASD). There was residual left-to-right shunting, and the device was obstructing the inferior caval vein and tricuspid valve flow. Intraoperatively, the ASD was shown to be an inferior sinus venosus defect, and reconstruction of the mitral valve and the posterior wall of the left atrium was required. This case emphasizes the importance of appropriate patient selection for interventional ASD closure and demonstrates that patients with less-than-optimal results should be referred for surgical correction early, before the device produces secondary damage to atrial structures and atrioventricular valves.
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