[Split-cord malformation (diastematolmyelia) presenting in two adults: case report and a review of the literature]. / Diastématomyélie révélée chez l'adulte: étude de deux cas et revue de la littérature.

INTRODUCTION: Split cord malformation (SCM) is an uncommon developmental anomaly characterized a cleft spinal cord. In type I, each of the hemicords is contained within an individual dural tube whereas in type II there is a common dural tube housing both hemicords. Commonly diagnosed in childhood, adult presentation is exceptional. METHODS: We report the case of two women whose type II SCM was discovered at the age of 40 and 54 years. RESULTS: The first patient complained of chronic lombar and radicular chronic pain with dysuria. Physical examination revealed a radicular syndrome with abolition of the left Achille reflex and a lombar hair tuft. MRI showed a disc herniation at the L5-S1 level, with a partial SCM at the level of the L2 vertebra, spina bifida and tethered cord. The second patient complained of lombar pain with perineal irradiation for 6 years. Physical examination showed a lombar cutaneous angioma. MRI revealed a thoraco-lombar SCM at the T12 to L1 level, with spina bifida. No spur could not be identified in either patient. No further surgical treatment was given. CONCLUSION: Based on these two observations, we propose a review of literature reporting 90 cases of adult SCM.

[Aneurysm of the superior mesenteric vein: imaging findings]. / Anévrisme de la veine mésentérique supérieure: apport de l'imagerie.

The authors report two uncommon cases of incidental superior mesenteric vein aneurysm in two asymptomatic women. Patients underwent ultrasonography, CT and MR angiography. The etiology, clinical features and treatment are discussed along with a review of to the literature.

[Intestinal pneumatosis. Right colon cystic form with linear aspect on scan]. / Pneumatose intestinale. Forme kystique colique droite d'aspect linéaire au scanner.

INTRODUCTION: Digestive pneumatosis corresponds to the presence of air in a wall of digestive tract. It is common to oppose primary cystic-type pneumatosis, involving the left colon, with linear-type pneumatosis that may affect the whole of the digestive tract. OBSERVATION: In a 41 year-old man presenting with Sharp's syndrome, abdominal pain occurred revealing an isolated right colon pneumatosis. Although abdominal tomodensitometry showed a strictly linear pneumatosis, colposcopy revealed voluminous cysts. CONCLUSION: With this case report, the limits of tomodensitometry in distinguishing linear from cystic forms are apparent. The importance of avoiding surgery is underlined. Our patient presented with a pneumo-peritonitis only requiring medical treatment since this disease generally regresses spontaneously.

[Mechanical small bowel obstruction due to bezoars: correlation between CT and surgical findings]. / Occlusion mécanique du grêle avec bézoard: apport du scanner et corrélation chirurgicale.

PURPOSE: To evaluate the correlation between computed tomography (CT) and surgery, for the diagnosis of bezoar in small bowel obstruction. To analyze the predisposing etiologic factors in this population. PATIENTS AND METHODS: We reviewed retrospectively between 1994 and 1999, 12 patients whose final diagnosis was small bowel obstruction with bezoar. All patients underwent helical CT scan before treatment. Eight patients were treated by surgery and 4 recovered with gastric aspiration. RESULTS: Small bowel obstruction was diagnosed by CT which always demonstrated a transition zone with ovoid intraluminal mass outlined by the bowel wall. The mass consisted of a mixture of soft tissue and internal gas bubbles like feces, suggesting bezoar. Surgery confirmed small bowel obstruction and presence of bezoar. Predisposing factors were: partial gastrectomy (2/12), post surgical adhesions (7/12), Meckel diverticulum (1/12) and dietary factors. CONCLUSION: We agree with the authors of the few prior CT reports and suggest that the characteristic CT appearance of mottled gas pattern is pathognomonic of bezoar with an excellent correlation in our population.