We report an 80-year-old man with a descending thoracic aortic aneurysm and recent pancreaticoduodenectomy for pancreatic adenocarcinoma. 18F-FDG PET/CT performed for elevated inflammatory markers demonstrated a hypermetabolic hepatic lesion, subsequently diagnosed as a liver abscess, and intense periaortic uptake with new periaortic soft-tissue thickening and aneurysm enlargement compared with prior CT. One month later, CT for chest pain showed further aneurysm enlargement and progressive mural abnormalities, raising suspicion of an infected aneurysm, although inflammatory aneurysm remained a differential diagnosis. This case highlights the potential value of 18F-FDG PET/CT in detecting metabolically active aneurysmal wall disease associated with rapid aneurysm progression.

Thoracoscopic intercostal nerve cryoablation is increasingly used as an adjunct to the Nuss procedure for pectus excavatum to reduce postoperative pain, yet detailed stepwise descriptions remain limited. This video tutorial presents a practical, structured description of the operative technique with emphasis on reproducible procedural steps. The patient is placed supine with both arms elevated, and single lung ventilation is established, commencing with the left-sided procedure. Thoracoscopic access is obtained through small lateral ports, followed by carbon dioxide insufflation to improve visualization. The thoracoscope is introduced to identify the third to eighth intercostal spaces. A cryoprobe is inserted through a lateral intercostal access point and positioned directly onto the intercostal nerve along the inferior border of each rib. A palpation instrument is used to retract the lung and facilitate safe exposure of the target nerve. Once correct positioning is confirmed, a controlled freezing cycle is initiated to achieve targeted nerve ablation, after which complete thawing is ensured before probe repositioning. The process is repeated sequentially for each intercostal level. After completion of cryoablation, an adjunctive intercostal block may be administered, followed by reinflation of the lung under thoracoscopic visualization. After the left-sided procedure is completed, it may be reproduced on the right. Once the right-sided procedure is completed, standard Nuss bar placement is performed. Technical pitfalls related to probe positioning, rib level identification, and tissue protection are highlighted to support safe and consistent application of the technique.

Objective: To summarize the clinical characteristics of pediatric pulmonary echinococcosis (PE). Methods: Case series study. Clinical data of 10 children with PE hospitalized in the Department of Respiratory Medicine and General and Thoracic Surgery at Beijing Children's Hospital Xinjiang Hospital from December 2022 to June 2025 were retrospectively collected, including general information, clinical manifestations, pulmonary imaging findings, laboratory test results, and treatment details. Results: Among the 10 children, there were 7 males and 3 females. Three cases were asymptomatic. Seven cases presented with cough, including 2 cases with chest pain, 1 case with fever, and 1 case with dyspnea. Elevated peripheral blood eosinophil counts were detected in 5 cases. One case initially presented with severe idiopathic thrombocytopenic purpura (ITP). Elevated C-reactive protein levels were noted in 3 cases. Pulmonary CT scans in all 10 children revealed solitary or multiple round or oval cystic fluid-density space-occupying lesions with high-density capsules visible at the margins and uniform density within the cysts. Two cases were complicated by obstructive emphysema, 2 cases by cystic cavities, 1 case by pyothorax. Five children had concurrent hepatic echinococcosis. All 10 children achieved complete intracapsular resection of pulmonary echinococcus cysts. Conclusions: Pediatric PE can be asymptomatic or present with cough, chest pain, and dyspnea. It can initially manifest as ITP. Imaging findings demonstrate solitary or multiple round or oval cystic space-occupying lesions with well-defined hyperdense capsule margins, which may be accompanied by obstructive emphysema.

Sinus of Valsalva aneurysm (SVA) is a rare cardiac anomaly, with autopsy-confirmed fatal cases remaining uncommon. This report presents a rare case of sudden death in a 13-year-old male adolescent caused by rupture of a noncoronary SVA into the right atrium, resulting in acute circulatory dysfunction, with vomiting as the only initial symptom. The cause of death was confirmed through comprehensive forensic autopsy, histological examination, and toxicological analysis. Additionally, a review of relevant autopsy case reports published in the past two decades on PubMed and Web of Science identified 13 cases of SVA-related mortality. We summarized the anatomical origin of aneurysms, gender distribution, clinical manifestations, rupture-associated fatal mechanisms, and pathological features observed in these cases. The findings indicated that in SVA-related fatal cases, the most common rupture sites were the right coronary sinus, left coronary sinus, and noncoronary sinus. The rupture typically occurred into the atrium or pericardium. Chest pain and vomiting were frequently reported as prodromal symptoms. Imaging techniques such as echocardiography and computed tomography were useful in aiding diagnosis. Cardiac pathology in these cases was often accompanied by additional abnormalities, including cardiomegaly, atherosclerosis, inflammation, or congenital defects. This report, in conjunction with the literature review, provides important reference material for forensic autopsy.