[Pulmonary textiloma revealed by hemoptysis 12 years after thoracotomy]. / Textilome pulmonaire révélé par une hémoptysie 12 ans après thoracotomie.

INTRODUCTION: Pulmonary textiloma or retained surgical sponge is rare but can have detrimental consequences. Its diagnosis is difficult, even when using computerized tomography (CT) scan and is always a medical and legal problem. EXEGESIS: We report the case of a 46-year-old man with a history of pulmonary tuberculosis diagnosed by thoracotomy in 1986, who was admitted to hospital for hemoptysis. CT scan showed the existence of a pulmonary lesion. Clinical, radiological and fiberoptic endoscopy features mimicked an abscess or bronchiectasis. The patient underwent left inferior lobectomy. Anatomical findings led to the diagnosis of textiloma. CONCLUSION: This case shows the difficult in diagnosing pulmonary textiloma, even when using CT scan. Textiloma should be considered when an atypical pulmonary mass is found in a patient with past history of thoracotomy.

[Aneurysm of the iliac artery in an elderly subject. Role of treatment with covered endoprosthesis]. / Anévrysme de l'artère iliaque du sujet âgé. Place du traitement par endoprothèse couverte.

BACKGROUND: Coated stents can be an alternative to open surgery for arterial aneurysms, particularly in patients with high operative risk. CASE REPORT: A 90-year-old man with advanced stage cardiopathy developed a 52 mm aneurysm of the iliac artery. Perioperative imaging (arteriography with marked catheter, CT-scan and endovascular ultrasonography) provided a precise description. The material used (PTFE coated thermal memory endoprosthesis, balloon in the hypogastric) provided effective exclusion. DISCUSSION: Endovascular treatment can be a useful alternative to open surgery for arterial aneurysm in the very elderly.

[Multi-plane transesophageal echocardiography in cardiac angiosarcoma. Apropos of a case]. / Apport de l'échocardiographie transoesophagienne multiplan dans l'angiosarcome cardiaque. A propos d'un cas.

The authors report the case of a right atrial angiosarcoma extending to the right ventricle, presenting with a massive pericardial effusion, in a 30 year old man. The patient underwent surgical ablation of the tumour with right atrial reconstruction, tricuspid valvuloplasty, plicature of the right ventricle and a right coronary artery bypass graft with complementary chemotherapy. This case illustrates the decisive contribution of multiplane transoesophageal echocardiography in the preoperative investigation, providing accurate information about the site and extension of the tumour, and even about the malignant character of the pathology. Magnetic resonance imaging, though useful, did not provide any further information in this case. Unfortunately, thoracic CT scan, performed 15 days after surgery, showed the presence of pulmonary metastases, confirming the very poor prognosis of these tumours.

[Spontaneous rupture of the ascending aorta disclosing inflammatory arteritis]. / Rupture spontanée de l'aorte ascendante révélatrice d'une artérite inflammatoire.

The authors report the case of a 74 year old man with no known medical history who died of spontaneous rupture of the thoracic aorta due to giant cell arteritis. The description of the macro and microscopic lesions confirmed the severity of the disease of the large arteries and explained the cause of death. The authors emphasize the clinical features of this case and discuss its place in the classification of aortitis. The type, incidence and severity of the aortic disease in inflammatory arteritis are also analysed. Spontaneous rupture of the aorta without dissection or aneurysm formation does not seem to have been previously reported and could be the mechanism of some cases of sudden death.

[Incomplete spontaneous rupture of the supravalvular aorta complicated by pericarditis and aortic insufficiency]. / Rupture spontanée incomplète de l'aorte sus-sigmoïdienne compliquée de péricardite et d'insuffisance aortique.

The natural history of an incomplete spontaneous rupture of the ascending aorta over a 4-year period is reported. The initial presentation was subacute pericarditis which regressed spontaneously. Aortic regurgitation developed on the 100th day of the disease and was perfectly well tolerated haemodynamically for 4 years. This favourable course was interrupted by type I aortic dissection. The post-mortem examination provided an explanation for the peculiar development and course of the aortic regurgitation: it was due not to the usual prolapse of the cups but to displacement of the left posterior commissure by the retractile fibrosis arising from the lower lip of the spontaneous rupture.

[Diffusion of cefotiam into ascitic fluid]. / Etude de la diffusion du céfotiam dans le liquide d'ascite.

The large apparent volume of distribution of cefotiam (reported by Fourtillan et al. [4]), prompted an investigation of cefotiam diffusion into ascitic fluid. Eight patients with non-infected ascites were each given a single intravenous bolus of 2 gr cefotiam. Samples of blood and ascitic fluid were collected 0.5, 1, 2, 3, 4, 6 and 8 hours after the injection. Plasma and ascitic fluid concentrations of unchanged cefotiam were determined using HPLC. Peak concentration in ascitic fluid averaged 18 micrograms/ml and was reached at two hours. Concentrations were still high (approximately 13 micrograms/ml) at 8 hours, leading to further assays 12 and 24 hours after the injection in three subjects. Cefotiam concentrations achieved in ascitic fluid seem adequate for the treatment of infected ascites, given the antibiotic's MICs for the organisms most commonly involved.