ABSTRACT
Hydatid disease is a major health problem. Multiorgan involvement including the heart and the liver is a very rare presentation. Management of multivisceral hydatidosis through a sole incision should be considered when possible. Median sternotomy is considered in our case.
ABSTRACT
The intrathoracic sewing needle is an exceedingly rare condition mildly documented in the literature. Given the needle's tendency to migrate, it must be removed as soon as possible, and the minimally invasive technique should be tried first.
ABSTRACT
INTRODUCTION: Rupture of the pericardium complicating blunt thoracic trauma may lead to cardiac luxation if not early recognized and appropriately surgically treated. This condition is exceedingly rare and carries a high mortality rate. CASE PRESENTATION: A 37-year-old man presented with severe multiple injuries following a road traffic crash, including blunt trauma to the thorax and abdomen. He was in a hemodynamically stable condition. The chest radiograph and CT scan revealed a leftward heart herniation through a pericardial tear, there were also non surgical hepatic and splenic lesions. The diagnosis of left cardiac luxation with no associated valvular lesions was made. Surgical exploration via a midline sternotomy revealed a protruding heart herniating into the left pleural cavity through a large tear (15 cm) of the left pericardium. Sutures with Teflon felt pledgets were performed. The postoperative chest radiograph was normal and the postoperative course was uneventful. DISCUSSION: Post traumatic heart luxation diagnosis is clinically difficult because the scarcity of signs and lack of specificity. Chest X ray can be suggestive, and specific findings can only be detected by computed tomography, which is the most sensitive diagnostic method. Surgical management in this condition is mandatory to avoid fatal complications such as great vessels strangulation. It consists of replacing the heart in the pericardial sac and repairing the pericardial tear. CONCLUSION: Despite its rare occurrence, trauma surgeons must be aware of cardiac luxation. Any suspicion of such a diagnosis would warrant surgical exploration to avoid fatal complications.
ABSTRACT
Hydatid disease is one of the most widespread and endemic infections causing a substantial health and economic burden. The liver and lungs remain the most affected viscera. We report the case of a 41-year-old man with an atypical presentation: a hydatid cyst of the liver with a massive extension to the mediastinum through the esophagus hiatus. This patient underwent a single-stage surgical session to treat the mediastinal and abdominal parts of the cyst through a unique thoracic route.
