[Echinococcosis involvement of the heart]. / Echinokokkusbefall des Herzens.

A case report is given of a 37-year-old patient who had echinococcus infestment the heart. Diagnosis was established after drainage of the pericardium, when cysts of a diameter between 0.5 and 3 cm were evacuated. During this procedure the pericardium and the left ventricle were searched and revised extensively and drug therapy with Mebendazole was instituted. In spite of that a new cyst developed in the pericardium and a big cyst in the abdomen, was found which had practically transformed the whole left lobe of the liver into a cyst. Both lesions were removed surgically. It must be emphasized 1) that a very careful search of all organs liable to harbour echinococcus should be performed in patients who have cardiac involvement of the disease, 2) that chemotherapy will not prevent with necessity the development of fertile elements which could not be removed during surgery and 3) that patients have to be followed through several years in order to evaluate the success of therapy.

Temporary cutaneous vesicostomy in pediatric patients.

Cutaneous vesicostomy is useful as a stage in management of various vesical and infravesical disorders in pediatric patients. The underlying problem can often be circumvented by temporary cutaneous vesicostomy and later be approached by reconstructive surgery, intermittent catheterization, or pharmacologic manipulation. In contrast, long-term cutaneous vesicostomy often leads to an unacceptably high rate of complications.

Ureterosigmoidostomy followed by carcinoma of the colon.

Adenocarcinoma of the colon developing as a late complication or ureterosignoidostomy has been reported with increasing frequency. A patient is presented who developed adenocarcinoma of the colon 28 years after ureterosigmoidostomy for bladder exstrophy and 13 years after conversion of the ureterosigmoidostomy to an ileal conduit. The colonic tumor was documented at postmortem examination to be at the ureterosigmoidostomy site. Because of the potential late development of adenocarcinoma of the colon, careful follow-up of patients with ureterosigmoidostomies, particularly those performed in children many years ago, is indicated.

Simultaneous traumatic bladder perforation and disruption of the prostatomembranous urethra.

The simultaneous occurrence of disruption of the prostatomembranous urethra and traumatic perforation of the bladder is seldom diagnosed before operation for the urethral injury. The presence of posterior disruption can make radiological diagnosis of the concomitant bladder perforation difficult. Lack of a palpable bladder a few hours after urethral injury should arouse suspicion of a combined injury. Careful bladder examination is indicated at the time of operation for all cases of posterior urethral injury to eliminate possible bladder perforations and the significant increase in morbidity and mortality associated with their presence.