Incidental finding of thymic cyst in a newborn baby.

Thymic hyperplasia is a common finding among newborns, but cyst formation might produce mediastinal symptoms. Lethal outcome is reported when accompanied by massive intrathoracic hemorrhage. The clinical picture in our case was characterized from profuse multiple hemorrhagic foci and respiratory distress syndrome, with an unclear role of the thymic cyst.

Traits of vulnerability in repetitive sexual assaults of mentally disabled people.

The issue of sexual abuse, assault, rape and unwanted pregnancies among mentally disabled women is largely under-reported for many reasons. Several myths prevail including that mentally disabled women offer little interest to sexual predators, together with a negative public attitude and this contributes to the problem. We report the case of a single centre in Albania, where repetitive sexual assaults were perpetrated against three mentally disabled women. Three unwanted pregnancies followed. The issue gained public attention after three criminal abortions were performed secretly with the aim of covering up the story. Charges were raised against the director of the centre and an employee from the nursing staff. Proceedings are still ongoing. We discuss some details from the forensic investigation and consider several systemic weaknesses that have exposed this vulnerable target group to the risk of being severely and repetitively abused. We believe greater staff awareness, and a better medical and legal framework, are indispensable to deter further offences especially where facilities are under-resourced as here.

Pattern of lethal trauma among swimmers colliding with a personal watercraft.

Personal watercrafts (otherwise known as Jet Skis or wave runners) possess powerful propelling engines that enable them to reach high velocities. In overcrowded sea shores, especially due to a diversity of human errors (inexperience, underage operator, alcohol-related errors and lack of training), these vessels might cause severe damage to the operator himself, to swimmers in the whereabouts but to the environment as well. We present three fatal victims that were struck and overrun by personal watercrafts used for recreational purposes. One of them had a deep skull trauma resulting from being hit by the hull of the vessel. The other two cases had an impressive and particular pattern of tissue trauma, with deep parallel cutting wounds due to the contact with the propeller helix. All cases were treated as accidental drowning, because even when rescue operations were immediate, the loss of conscience following the severe blunt trauma inside the water left few chances, if any, to survival.

An unusual lethal gunshot wound to the head.

Atypical gunshot wounds present a challenge for the forensic expert, and sometimes differentiating these from a blunt trauma can be difficult. A careful crime scene investigation can be helpful in finding additional evidence and clarifying the nature of the injuries. We describe a case of an unusual craniocerebral injury that was initially interpreted as a blow from a wooden object. The appearance of the wound lacked the classical characteristics of entrance and exit bullet wounds, but the investigation showed it was due to the ricocheting of a destabilized bullet. Potentially lethal, craniocerebral gunshot injuries are a common occurrence in developing countries even in non-conflict areas, with very bad outcomes even when treated aggressively in specialized neurosurgical facilities. The authors briefly discuss similar cases and opinions in the relevant literature, emphasizing the importance of a rational approach during the reconstruction of the crime scene.

Placenta increta causing hemoperitoneum in the 26th week of pregnancy: a case report.

INTRODUCTION: Placenta increta is a serious complication of pregnancy. We describe a case leading to uterine rupture associated with massive intra-abdominal hemorrhage. CASE PRESENTATION: A 34-year-old Caucasian Albanian woman, gravida 2, para 1, was admitted to the emergency department of our hospital for acute abdominal pain associated with profound secondary anemia. An anatomopathological diagnosis of placenta increta destruens was made. An urgent hysterectomy was performed after resuscitation procedures, applied due to the severe anemia and the abdominal drama accompanying the case. Intra-operatively, a uterus-saving procedure was found to be impossible, and hysterectomy remained the only surgical option. The uterine structures were sent for further microscopic evaluation. On histological examination, deep trophoblastic infiltration of the uterine wall was observed, justifying the surgeon's decision. Our patient received blood transfusions and antibiotics. Her sutures were removed on the eighth postoperative day and she was discharged the following day in a stable condition. CONCLUSION: This case, describing a patient with uterine rupture and massive hemorrhage, illustrates a serious and potentially fatal complication of placenta previa. In such cases, surgery is essential, and hysterectomy may be the only viable option.