[Chemical peritonitis after iatrogenic rupture of a dermoid cyst of the ovary treated by coelioscopy. Apropos of a case and review of the literature]. / Péritonite chimique après rupture iatrogène d'un kyste dermoïde de l'ovaire traité par coelioscopie. A propos d'un cas et revue de la littérature.

Dermoid cyst is the most frequent benign ovarian tumor. Its intraperitoneal rupture may lead to a peritoneal reaction known as chemical peritonitis. It is a rare but a potentially dangerous issue. Its treatment may need one or more reoperations. We report here the case of a patient operated on in emergency for a torsion of an ovarian dermoid cyst, with peritoneal spillage of its content during coeliosurgery. The prolonged contact between the sebaceous material and the peritoneum has led to a chemical peritonitis. Two more laparoscopic interventions, associated with a systemic anti-inflammatory treatment, were necessary to relieve symptoms. We propose the following attitude to avoid this complication: (1) puncture and drainage of the cyst with a trocar; (2) extraction of the cyst in an endobag, and (3) abundant washout of the peritoneal cavity.

[Diagnosis and treatment of mastodynia]. / Diagnostic et traitement des mastodynies.

Breast pain or mastalgia is a frequent complaint and it may represent various pathological conditions. After a thorough evaluation and reassurance of the patients, only those whose symptoms are severe enough to alter their life-style still require therapy. In some cases it will be indicated to modify or to stop an oral contraception or to adapt a hormone replacement therapy. Those women still resistant to treatment may experience relief from evening primrose oil supplements, bromocriptine, danazol, some progestins, tamoxifen or GnRH analogues. Therapy of non cyclic breast pain is made according to the underlying pathology. If no substrate is present, treatment is the same as for cyclical mastalgia but the response is diminished.

[Evaluation of tumor extension in invasive cancer of the uterine cervix. Diagnostic evaluation of cervix cancer]. / Bilan d'extension tumorale lors de cancer invasif du col utérin. Bilan diagnostique et cancer du col.

Cancer of the uterine cervix accounts for approximately 30% of deaths from malignancies in gynecology and this rate has remained unchanged for more than 40 years. The most important prognostic factor is the extent of the disease at the beginning of treatment. There is, however, a discrepancy of some 50% between clinical and postoperative staging. The aim of this study was to evaluate different diagnostic investigations leading to the preoperative classification (FIGO) of 261 patients with cervical cancer. Data of presurgical clinical and radiological examinations were compared with postoperative histopathological findings. Rectovaginal palpation and computerized tomography (CAT) both showed a positive predictive value of 60%. The performance of CAT and lymphography in the diagnosis of lymph node metastasis was poor with positive predictive values of 36.3 and 20%, respectively. In the absence of parametrial infiltration on palpation, cystoscopy and rectoscopy are superfluous since they are always normal. Urography, because of the possibility to show the topographic anatomy of the urinary tract, was justified in all cases. The value of surgical staging and more recent techniques such as sonography and magnetic resonance is discussed.