[Iatrogenic gas embolism after use of hydrogen peroxide in the treatment of lung hydatid cyst: a report of 2 cases]

Echinococcus disease in endemic in our country. Surgical resection of the hydatid cyst with the use of a protoscolicidal solution in the operative field remains the standard treatment. The degradation of hydrogen peroxide results in considerable amounts of gaseous oxygen witch has proven protoscolicidal properties. This gas can enter the circulation and determine sever embolism. We report two cases of severe oxygen embolism with neurological signs during surgical treatment of thoracic hydatid cysts. We report 2 cases of embolic events with neurological signs. The first, during a pleural cleaning with hydrogen peroxide after cystectomy of a pulmonary hydatic cyst at the right upper lobe. The second case, after a pleural washing during the treatment of hepatitic hydatidosis complicated by a ruptured cyst in the thorax. The most important diagnostic criterion is the patient's history, because the clinical suspicion of embolism is based on the initial neurologic or cardio-respiratory symptoms and the direct relation between these symptoms and the use of hydrogen peroxide and imposes appropriate treatment before further examination including brain imaging. The treatment with hyperbaric oxygen in the first line treatment, thus, transfer to a hyperbaric oxygen facility should be accomplished without delay. The possibility of such serious complication leads us to use hydrogen peroxide with great care or to use other protoscolicidal solutions

Endoscopic thoracic sympatecomy for hyperhidrosis

Hyperhidrosis is a benin affection representing a social and professional problems and occupational handicaps in young patient. Endoscopic thoracic sympathectomy thus provides a radical treatment for severe palmar and axillary hyperhidrosis. We describe the technique used in our institut and present results. From 1995 to 2002, 32 patients were operated on for hyperhidrosis. There were 17 mens and 15 women raging in age from 15 to 32 years. The intervention consisting on destruction by eJectrocoaguJation to the sympathetic trunk. There was no major complication and the mean postoperative hospital stay was 2 days. The disappearance of the palmar sweating was immediately after operation. 7 patients complained of compensatory sweating. Endoscopic thoracic sympathectomy for hyperhidrosis is a safe effect technique for treating palmar and axillary hyperhidrosis. Compensatry sweeting represent the major that necessite a preable information

Primary mediastinal seminoma. Report of three cases

Primary mediastinal seminomas [PMS] are rare tumors that are morphologically similar to their testicular counterparts but may have different biologic behavior due to their particular anatomical location. New cases report of PMS. Three new cases of primary mediastinal seminoma are presented. The patients were men aged of 16, 33 and 47 years. Their clinical symptoms included cough, dyspnea, chest pain and superior vena cava syndrome. None of the patients had a previous history of testicular neoplasm or tumor elsewhere. Mediastinoscopie biopsy was performed and histological examination results revealed a seminoma. Immunohistochemical showed membranous staining with placental alkaline phosphatase in the three cases. Chemotherapy has largely replaced surgical resection and radiotherapy as the initial treatment in patients with mediastinal seminoma

[Primary hydatidosis of the chest wall. Report of 5 cases]

Hydatidosis is an endemic affection in Tunisia. Bone echinococcosis is a relatively rare entity accounting for only 0.5-2% of all hydatid cysts in humans and chest wall is an uncommon site for the disease. Report of a new case. We report about this talk 5 cases concerning 2 men and 3 women [mean of age 35,4 years] explored for parietal mass [4 cases], or chest pain [1 case]. Diagnosis was suspected on radiologic findings in all cases. All patients underwent surgery. Medical treatment was associated in 2 cases. Histopathology of resected specimen confirmed diagnosis of echinococcosis. No recurrence was observed during follow-up period

[Pulmonary inflammatory pseudotumor: difficulties in diagnosis and prognosis]

Inflammatory pseudotumors are uncommon benign lesions of the lung of unknown origin, that may show aggressive behavior. Although pseudotumors constitute less than 1% of all lung tumors, they are reported to be the most common cause of solitary lung masses in children. Complete resection, when possible, is safe and leads to excellent survival. The case presented here highlights difficulties in clinical and histologic diagnosis

[Endobronchial hamartoma revealed by hemoptysis]

Hamartoma is the most frequent benign tumor of the lung. Its endo bronchial location is rare. We report two cases of endo bronchial hamartoma occurring in 2 men aged 68 and 60 years respectively. The two cases were revealed by hemoptysis. Bronchial fibroscopy showed a bud respectively in the left stump and in the lower left bronchus. Treatment consisted in a pneumonectomy and a lower lobectomy. A histological examination confirmed the diagnosis of endo bronchial hamartoma. Diagnosis of endobronchial hamartoma before surgery is difficult. Pulmonary resections are often necessary because of parenchyma lesions caused bronchial obstruction

Acute Arterial ischimia by tumoral embolism after lung resection: report of two cases and literature review

From January 1984 to December 1999 we operate in our institution, 465 patients affected by lung cancer. In the early post-operative period we observe two arterial peripheral embolic events. Treatment consist in surgical embolectomy by fogarthy sond under femoral way. We don't observe post-operative complications or any functional sequelae. For the two patients tumoral character of the embalm was confirmed this work confirm the need of pre-operative precautions to avoid this complication they way be severe when indiagnosed or treated latterly