[Pleuropericardial cyst rupturing into the pericardium causing tamponade]. / Kyste pleuropéricardique fistulisé dans le péricarde avec tamponnade clinique.

Pleuropericardial cysts of the mediastinum are rare lesions, usually congenital but exceptionally acquired. They are often asymptomatic, but complications can occur. We report below the case of a 35-year-old man who presented with an acquired right-sided para-tracheal mesothelial cyst that ruptured into the pericardium and was responsible for clinical tamponade. Although the majority of mesothelial cysts are asymptomatic, only a strict clinical and radiological follow-up can provide an indication for surgical resection. This should be reserved for symptomatic patients or for those facing an uncertain diagnosis.

[Spontaneous bilateral chylothorax revealing a mediastinal and abdominal lymph node tuberculosis]. / Chylothorax spontané bilatéral révélant une tuberculose ganglionnaire médiastinale et abdominale.

Spontaneous chylothorax is a rare condition, lymph node tuberculosis is an exceptional etiology of chylothorax, we report an exceptional case of a patient with mediastinal and abdominal lymph node tuberculosis presenting with spontaneous bilateral chylothorax treated successfully by symptomatic medical treatment and antibacillary.

Iatrogenic pneumothorax: experience of a Moroccan Emergency Center.

The incidence of iatrogenic pneumothorax (IPx) will increase with invasive procedures particularly at training hospitals, that is why we have made a retrospective study of the common diagnostic or therapeutic causes of IPx and its impact on morbidity. From January 2011 to December 2011, 36 patients developed IPx as emergencies, after an invasive procedure. Their mean age was 38 years (range: 19-69 years). Of the patients, 21 (58%) were male and 15 (42%) were female. The purpose was diagnostic in 6 cases and therapeutic in 30 cases. In 8 patients (22%) the procedure was performed due to underlying lung diseases and in 28 patients (78%) for other diseases. The procedure most frequently causing IPnx was central venous catheterization, with 20 patients (55%), other frequent causes were mechanical ventilation in 8 cases (22%) (of whom we reported 3 cases of bilateral pneumothorax), 6 cases of thoracentesis (16%) and 2 patients had life-saving percutaneous tracheotomy. The majority of our patients were managed by a small chest tube placement (unilateral n=30, bilateral n=3). The average duration of drainage was 3 days (range: 1-15 days), sadly one of our patients died of ischemic brain damage 15 days after tracheotomy. At training hospitals the incidence of IPnx will increase with the increase in invasive procedures, which should only be performed by experienced personnel or under their supervision.