[Identification of sentinel lymph node: Comparison between SNOLL and routine isotopic procedure]. / Identification isotopique du ganglion sentinelle : comparaison du SNOLL avec la technique isotopique de référence.

INTRODUCTION: Axillary staging remains the most accurate predictive factor for recurrence risk and survival in patients with invasive breast carcinoma. Sentinel Node Occult Lesion Localization (SNOLL) allows with a single intra-lesion injection both localization of impalpable breast lesion and sentinel node biopsy. Our aim was to compare the efficacy of SNOLL and standard radio isotopic method for sentinel node localization by lymphoscintigraphy. METHODS: This retrospective study enrolled 100 patients treated for breast carcinoma with indication of sentinel node biopsy between may 2017 and January 2019 in breast surgery unit of Montpellier university hospital. RESULTS: SNOLL and standard radio isotopic method were realized in respectively 65 and 35 patients. Failure rates of sentinel node localization were respectively 34% and 11% by lymphoscintigraphy (P=0.02), 17% and 9% intraoperatively and 11% et 6% using radioisotope combined with colorimetric method. DISCUSSION: Failure rate of sentinel node localization is higher using SNOLL. This rate is reduced by additional radioisope migration in the time between isotope injection and surgery and by the use of combined method. SNOLL should therefore be combined with colorimetric method. These results must be confirmed in a larger study.

Acute pelvic pain in females in septic and aseptic contexts.

Acute pelvic pain in women is a common reason for emergency department admission. There is a broad range of possible aetiological diagnoses, with gynaecological and gastrointestinal causes being the most frequently encountered. Gynaecological causes include upper genital tract infection and three types of surgical emergency, namely ectopic pregnancy, adnexal torsion, and haemorrhagic ovarian cyst rupture. The main gastrointestinal cause is acute appendicitis, which is the primary differential diagnosis for acute pelvic pain of gynaecological origin. The process of diagnosis will be guided by the clinical examination, laboratory study results, and ultrasonography findings, with suprapubic transvaginal pelvic ultrasonography as the first-line examination in this young population, and potentially cross-sectional imaging findings (computed tomography and MR imaging) if diagnosis remains uncertain.