[Abnormal x-ray finding after central venous catheterization]. / Radiologisch auffälliger Befund nach Anlage eines zentralen Venenkatheters.

Central venous catheter placement can cause a variety of complications, such as catheter fracture, loss of the guide wire and embolization. In the case reported a large bore central venous catheter was used in a 32-year-old patient undergoing surgery for vertebral body fracture of the thoracic spine. After a complication-free surgical procedure the post-operative x-ray showed an abnormal finding. A piece of the guide wire was suspected to have been left in the patient. However, this possibility could be ruled out by the anesthesiologist who inserted the catheter. With an additional x-ray and CT scan of an identical catheter it could then be demonstrated that the abnormal finding was caused by polyurethane pins which are integrated in the catheter.

[Fibrodysplasia ossificans progressiva. Anesthetic management of a 2-year-old child]. / Fibrodysplasia ossificans progressiva. Anästhesiologische Versorgung eines 2-jährigen Jungen.

Fibromyalgia ossificans progressiva (FOP) is a severely disabling disorder of connective tissue characterized by congenital malformation of the toes, fingers and vertebrae associated with progressive ossification of striated muscles. Anesthetic management of these patients involves preferably general anesthesia as local or regional anesthesia should be avoided due to possible heterotopic ossification. Airway management is determined by the age of the patient and the progression of the disease. Only a few cases in the literature have reported the anesthetic management of FOP patients and to our knowledge only one case has been published on pediatric patients. In adult, cooperative patients awake fiberoptic intubation is recommended, as ankylosis of the temporo-mandibular joint is the most important clinical feature for anesthesia. As demonstrated and discussed in this case report of a 2-year-old boy, fiberoptic intubation after induction of general anesthesia should be preferred in pediatric patients. Puncture of a vein should be non-traumatic, i.m. injections strictly avoided and careful positioning and padding are needed. Every effort should be made to avoid situations stimulating new heterotopic ossification due to its substantial effect on the quality of life of FOP patients.

[Cardiac perforation after vertebroplasty]. / Palacos im Herzen.

For more than 20 years percutaneous vertebroplasty has been used in the minimally invasive treatment of vertebral fractures. We report on a patient with embolisation of bone cement into the pulmonary artery and the right ventricle, which was perforated. The final diagnosis was delayed due to a combination of complications, previous disorders as well as a second embolisation.