[Traumatic arterio-venous fistula. Experience with 9 cases]. / Fistules artério-veineuses traumatiques. Expérience de 9 cas.

Traumatic arteriovenous fistulas (TAF) are rare forms of vascular injuries. The authors report an experience of nine new cases. Three of them result from a minor traumatism, while the six others are iatrogenic. The symptoms and the physical examination are very helpful in the diagnosis. Selective arteriography is the most useful paraclinical examination to confirm the affection and for the choice of the mode of therapy: surgery, selective arterial embolization, alone or used with surgery according to the characteristics and the location of the fistula.

[Skin lesions due to Mycobacterium marinum: surgical ablation. Apropos of a case of false paronychia]. / Lésions cutanées du Mycobacterium marinum: piège chirurgical. A propos d'un cas de faux panaris.

A Mycobacterium marinum panaris-like cutaneous injury was observed in a 5-year old child. Such an affection may require surgical advice. Lack of its knowledge may lead to serious therapeutic mistakes and complications. The authors emphasize the epidemiologic, clinical and paraclinical data allowing the diagnosis and leading to the right treatment. They also point out the place of surgical therapy in these lesions.

[True hermaphroditism. Late diagnosis. Surgical treatment and a 15-year follow-up]. / Hermaphrodisme vrai. Diagnostic tardif. Traitement chirurgical et suivi de 15 ans.

True hermaphroditism is an usual cause of ambiguous genitalia. In some social areas, the diagnosis is often late and raised as pubertair abnormally. We report a case of a 12 years old Sicilian child, seen in 1975, raised as a boy and whose the main complain was a gynaecomastia. Clinical and paraclinical investigations revealed a small testicle on the one side and on ovary with an uterus and an obturated tube on the opposite side. A small recurvated penis, partially adherent to the scrotum is noticed. A structure embryologycally close to a vagina is also found behind the bladder. Cytogenetic structures showed a mixte karyotype: mosaicim 46 XX/46 XY with a ratio of a 80/20. Hormonal assessment showed a normal level of estrogen while testosterone is below the inferior threshold. A surgical treatment is carried out in three steps: removal of the internal female organs and testicular prosthesis replacement in the one side after castration, reconstruction of the recurvated penis and replacement of the other testicular prosthesis, and finally construction of the anterior urethra. Since the very first step of the surgical management and adjuvant hormonotherapy (testosterone) is administrated in order to decrease the gynaecomastia but also to allow the normal growth of the male organs. We discuss the benefice of a such therapeutic option in the true hermaphroditism lately diagnosed recording to organic and psychological data. We also point out the difficulty in therapeutic choice, mainly when the patient has raised as a boy. The follow-up in this case in 15 years.

[Pancreatitis and choledochal cyst]. / Pancréatite et kyste du cholédoque.

A six years old girl was rushed to hospital with an acute abdomen. Because of the age of the patient, the clinical examination and the usual biology we diagnose an acute appendicitis. The fortuitous measuring out of the pancreatic enzymology allows us to correct our first diagnostic into the one of pancreatitis with angiocholitis. The check-up shows a congenital choledochal cyst with an abnormality of the choledochus-Wirsung junction explaining the physiological pathology presented. The surgical operation was made up of an cystectomy with cholecystectomy and hepatico-jejunostomy according to an Y shaped loop from Roux. Pancreatitis diagnostic is unusual in childhood, there is a good reason to suspect in those circumstances the existence of a choledochal cyst.