Four pathways for hydatid pulmonary embolism.

INTRODUCTION: Hydatid pulmonary embolism (HPE) is rare but remains an etiology that needs to be considered and kept in mind, especially in endemic areas, as regards nonthrombotic embolism. METHODS: Between 2000 and 2014, 10 patients were treated in our department for the presence of hydatid material in the pulmonary arterial circulation. Through these 10 cases, we try to assess the radioclinical characteristics and results of the surgical treatment. RESULTS: The study included six men and four women, average age 28 years. Discovery of HPE was made following the exploration of cardiorespiratory symptoms in nine cases and was incidental in a single patient. Computed tomography angiography (CTA) of the chest directly visualized the hydatid material in the pulmonary arteries in nine cases. Surgery consisted of an embolectomy under cardiopulmonary bypass in nine cases. This embolectomy was preceded by the treatment of an embolic hydatid cyst (HC) in seven cases (HCs of the right heart chambers in six cases and a liver HC ruptured in the inferior vena cava in one case), whereas for only one patient, who presented a HC pedunculated in the right ventricle and protruding into the pulmonary artery, the cure of the cardiac location was sufficient. Only one patient died on the third postoperative day. CONCLUSION: Endoluminal hydatid involvement of pulmonary arteries is extremely rare. CTA chest has an important contribution to the positive diagnosis. Treatment is surgical when the patient's condition allows it.

Catamenial pneumothorax revealing diaphragmatic endometriosis: a case report and revue of literature.

Catamenial pneumothorax (CP) is a rare entity of spontaneous, recurring pneumothorax in women. We aim to discuss the etiology, clinical course, and surgical treatment of a 42-year-old woman with CP. This patient had a right-sided spontaneous pneumothoraces occurred one week after menses. She had under-gone video-assisted thoracoscopic surgery (VATS) because of a persistent air leak under chest tube. VATS revealed multiple diaphragmatic fenestrations with an upper right nodule. Defects were removed and a large part of the diaphragm was resected. Pleural abrasion was then performed over the diaphragm. Diaphragmatic endometriosis was confirmed by microscopic examination. Medical treatment with GnRH agonists was prescribed, and after recovery, the patient has been symptoms free for 20 months.

Cystic Benign Metastasizing Leiomyoma of the Lung Mimicking Hydatid Cyst.

A 60-year-old woman, with history of a resected uterine benign leiomyoma, is operated for a cystic lesion in the left lung, mimicking an hydatid cyst, and confirmed histologically as Cystic Benign Metastasizing Leiomyoma.

Right main bronchus rupture from blunt chest trauma in a child.

We report the case of a 6-year-old boy with right main bronchus avulsion after blunt chest trauma. Reimplantation of the right main bronchus at the carina was performed via a right posterolateral thoracotomy, with satisfactory long-term morphological and functional results.

Cardiac herniation after left intrapericardial pneumonectomy.

Postoperative cardiac herniation is a rare fatal complication that requires urgent surgical reduction and closure of the pericardial defect. Cardiac herniation occurred 8 h after a left intrapericardial pneumonectomy. Although the patient was completely asymptomatic, acute hemodynamic failure with electrocardiographic changes occurred. Chest radiographs were not helpful in showing cardiac herniation. The patient was immediately brought back to the operating room. Cardiac herniation was found to be caused by a pericardial defect, and the heart was strangulated at the atrioventricular groove level. The heart was repositioned, but hemodynamic instability inherent to ischemic strangulation lesions persisted despite extracorporeal membrane oxygenation.

A case of huge solitary fibrous tumor with hypoglycemia.

We report the case of a 64-year-old man with a huge solitary fibrous pleural tumor who presented with breathlessness and recurrent severe symptomatic hypoglycemia. The tumor was safely removed in toto via a median sternotomy. The patient had an uneventful postoperative recovery and no recurrent hypoglycemia.