Extensive hydatidosis of the femur and pelvis with pathological fracture: a case report.

BACKGROUND: Hydatid cysts caused by Echinococcus sp can produce tissue cysts anywhere in the body. Skeletal cystic lesions are rare, yet because of their unusual presentation diagnosis can be missed. CASE REPORT: We report a case of extensive hydatidosis of the femur with pathological fracture and involvement of the pelvis bone, without involvement of abdominal viscera, in a 51-year-old woman. The patient presented with swelling and deformity of the upper and middle third of the left thigh. The diagnosis was confirmed clinico-radiologically and the patient was treated with hindquarter amputation and chemotherapy. The patient died of sepsis and extensive bedsores one month after surgery. CONCLUSIONS: Orthopedic surgeons should be alert to this morbid condition and this disease should be suspected in cystic lesions affecting any organ of the body in pathological fractures with non-union, especially in endemic areas of the world. Early diagnosis helps in eradication and salvage of the bone; misdiagnosis and delayed diagnosis are always fraught with the danger of amputation, recurrence, and sepsis.

Unusual cause of haemorrhage from surgical wound in a child.

Haemorrhage from a surgical wound can be from many potential sources such as injury to vessel, muscle and bone; bleeding disorders; incomplete haemostasis; pseudoaneurysm; and neovascularisation. We report an unusual cause of haemorrhage from the surgical incision in a 9-year-old child. We emphasize that a high index of suspicion is required for early diagnosis, and pseudoaneurysm and neoangiogenesis should be considered in the differential diagnosis of soft tissue masses resulting from direct, blunt trauma even in children.