Objective -In this paper, we present the case of the sudden cardiac death of an apparently healthy 15-year-old adolescent, as well as the autopsy findings, with histopathology. Case report -A 15-year-old boy was found unconscious in his brother's room. The boy had not been diagnosed with any disease and was apparently healthy. Preliminary autopsy findings indicated the predominance of cardiac pathology in relation to his death. All the cardiac cavities were dilated and enlarged. The trabeculae were more pronounced and thicker, with deepened spaces between them. In the anterior wall and almost the entire upper half of the posterior wall of the left ventricle, as well as the interventricular septum, with almost the entire thickness of the wall, the myocardial tissue was densely imbued with fibrous tissue. Microscopic analysis of cardiac sections showed large fields of hypocellular (scarring) fibrosis, as well as smaller fibrosis focuses of moderate cellularity, with fibroblasts, fibrocytes, and lymphocytes present. Toxicological analysis of blood taken from the femoral vein during autopsy was also performed, and the results showed that there were no traces of alcohol or psychoactive substances. Conclusion -Myocarditis is not uncommon in the pediatric population and has a relatively good prognosis, with most cases resulting in complete recovery. Extensive chronic inflammation with severe fibrosis in an apparently healthy boy leading to death makes our case particularly significant.
Introduction Throughout history, various types of conjoined twins have been described, many of whom lived until adulthood. The anomaly includes several varieties, with parapagus being one of the rarer forms of conjoined twins. The aim of this paper was to present a rare case of conjoined twins-parapagus type. Case outline In this paper we present autopsy and radiologic findings in male 40-week-old parapagus twins from a monozygotic pregnancy, with multiple anomalies in different systems of organs and musculoskeletal systems. Parapagus twins have a side-to-side connection with shared pelvis and can be defined as one of three subtypes. In our case, it was a dithoracic parapagus subtype, with four upper and three lower limbs (tetrabrachius tripus), where the presence of the third bizarre-looking lower limb made the case even more unusual among the rare type. Both parents were drug addicts with a history of sedative abuse. The mother had regular sonographic examinations during pregnancy. Conclusion Adequate early prenatal diagnosis of conjoined twins and possible termination of such a pregnancy are the key reasons for rare occurrence of such cases. Failure to recognize a pathological pregnancy and its maintenance until the delivery, despite regular gynecological examinations, is why our case is unique in comparison to contemporary literature.
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