European Society of Anaesthesiology.

y The SNAP-2: EPICCS collaborators are listed in Supplementary material. AbstractBackground: Decisions to admit high-risk postoperative patients to critical care may be affected by resource availability. We aimed to quantify adult ICU/high-dependency unit (ICU/HDU) capacity in hospitals from the UK, Australia, and New Zealand (NZ), and to identify and describe additional 'high-acuity' beds capable of managing high-risk patients outside the ICU/HDU environment. Methods: We used a modified Delphi consensus method to design a survey that was disseminated via investigator networks in the UK, Australia, and NZ. Hospital-and ward-level data were collected, including bed numbers, tertiary services offered, presence of an emergency department, ward staffing levels, and the availability of critical care facilities. Results: We received responses from 257 UK (response rate: 97.7%), 35 Australian (response rate: 32.7%), and 17 NZ (response rate: 94.4%) hospitals (total 309). Of these hospitals, 91.6% reported on-site ICU or HDU facilities. UK hospitals

Post-pancreatitis pseudoaneurysms are not uncommon. They have a high associated mortality due to a propensity to rupture. Current standards of treatment advocate immediate intravascular interventions. We describe two cases of alcohol-related post-acute pancreatitis pseudoaneurysms arising from the second-order branches of the superior mesenteric artery (SMA) that were endoluminally inaccessible. Both cases were successfully treated with percutaneous thrombin injection into the pseudoaneurysm sac under ultrasound guidance. We suggest that endoluminally inaccessible pseudoaneurysms that are percutaneously accessible can be expeditiously treated with percutaneous thrombin injection. Further, due to the efficaciousness of this procedure, it could be considered as a first-line minimally invasive therapeutic option.

Wilms' tumour (nephroblastoma), the most common abdominal malignancy of childhood, occurs primarily as a malignant renal tumour. Extrarenal Wilms' tumour is rare with occasional reports from the Indian subcontinent. The various locations of extrarenal Wilms' tumour include retroperitoneum, uterus, skin and thorax. In this report we will discuss the imaging features highlighting the imaging differential diagnosis in a case of retroperitoneal (extrarenal) primary Wilms' tumour.

We report a case of isolated myocardial hydatid arising from anterolateral wall of left ventricle (LV) in a 50-year-old female, who presented with progressive exertional dyspnoea for 11 months. Physical examination was unremarkable. Chest radiograph revealed normal lungs and a well defined, homogenous left paracardiac mass. Its medial border was inseparable from left cardiac border. Echocardiography revealed a multicystic mass abutting the LV wall [Table/ Fig-1]. There was mild mitral stenosis (MS) with moderate mitral regurgitation (MR). Ejection fraction was 69% with no regional wall motion abnormality. TLC was 8,500/mm 3 with 1.2% eosinophils. Indirect haemagglutination test for hydatid disease was positive. History of contact with livestock or pet animals was negative.On a 256-slice-dual source scanner (Somatom Definition Flash, Siemens, Germany), initially an ECG triggered coronary scan using prospective gating was done with 80ml 400mg % non-ionic iodinated contrast (Iomeron 400 TM ) at a rate of 5.5 ml/sec followed by saline bolus of 40 ml at same rate. This was immediately followed by another scan of entire chest for cyst morphology using standard chest parameters.The radiation dosages delivered to the patient by the two scans were 1.274 mSv & 2.45 mSv respectively.Data was post-processed to make MPR, MIP and VRT images of coronaries as well as standard images for chest. These revealed a 7.8cm x 6.9cm x 5.8cm size (volume 341 cc), oval, non-calcified, multicystic mass with honeycomb appearance arising from myocardium of anterolateral wall of LV [Table/Fig2a]. Interventricular septum and posterior wall showed normally enhancing myocardium but the myocardium of anterolateral wall of LV was not discernable from the cyst wall [Table/ Fig-2b]. All three coronary arteries were normal and the LAD showed [Table/ Fig-3a,b] no displacement or extrinsic compression by the cyst. Pulmonary arteries and both lungs were normal [Table /Fig-3b]. Since all necessary information was available catheter coronary angiography was not performed. Liver is the most common organ to be involved in this condition. Cardiac hydatid, seen in only 0.5 to 2% cases, is a rare entity because of myocardial contractility. Larvae reach the myocardium through coronary circulation. Among various locations of cardiac hydatid, due to its rich coronary arterial supply Left ventricle (LV) myocardium is the most common site of involvement followed by interventricular septum and right ventricle. Rare locations include pericardium, right atrium and left atrium. A 50-year-old woman presented with dyspnoea for 11 months, chest X-ray showed a well defined, homogenous left paracardiac mass, which is not separable from left heart border. Transthoracic echocardiography revealed a complex multicystic mass lesion abutting antero-lateral wall of left ventricle. Contrast enhanced computed tomography showed a well-circumscribed multicystic mass lesion with honeycomb appearance arising from myocardium of anterolateral wall of left ventricle. Indirect haemagglutina...