[Endoleak, a specific complication of the endovascular treatment of aortic aneurysms]. / Le cas clinique du mois. Les endofuites, une complication spécifique du traitement endovasculaire des pathologies aortiques.

Endoleaks represent the most common complication of endovascular aortic aneurysm repair. With the increasing use of endovascular techniques for aortic aneurysm repair, the prevalence of endoleaks has risen. While maintaining pressurization of the aneurysm sac, endoleaks expose to persistent risks of an evolution towards rupture. Long-term surveillance with imaging studies is necessary to reduce the incidence of these specific complications that may require intervention. The objective of this article is to draw the attention to the possible occurrence of these complications and to report the elements of diagnosis and treatment.

[Exogenous lipoid pneumonia: a simple diagnosis?]. / La pneumonie lipidique exogène: un diagnostic simple?

Exogenous lipoid pneumonia is a poorly known pathology. It results from aspiration of mineral, vegetal or animal oily substances. It is usually iatrogenic and clinical presentation is not specific. Main investigations which allow the diagnosis are: tomodensitometry which is the reference diagnosis modality, chest X-Ray which may be used for follow-up and MR which may contribute to the diagnosis. The treatment is not systematized. Stopping intake of the causal agent is essential. Some patients are treated with success by broncho-alveolar lavage, corticotherapy and oxygenotherapy. An exogenous lipoid pneumonia must be considered in all cases of non resolving pneumonia.

Ruptured hepatocellular carcinoma following transcatheter arterial chemoembolization.

Transcatheter arterial chemoembolization (TACE) is known to be an effective palliative treatment in unresectable hepatocellular carcinoma (HCC). Although TACE can control tumour growth and palliate the patients, complications of TACE with significant morbidity are well known and adversely affect the outcome of patients. Necrotic tumor rupture is a serious complication of TACE and has a high mortality rate. We report a case of ruptured HCC followingTACE in a 78-year-old male patient who subsequently developed peritonitis and pneumoperitoneum. This case gives us the opportunity to underline the importance of such complications and demonstrates the utility of CT imaging for diagnosis and management of patients with ruptured HCC.