[A rare cause of spontaneous hemoperitoneum in adults: ruptured cystic hemolymphangioma]. / Cause exceptionnelle d'hémoperitoine spontané chez l'adulte: hémolymphangiome kystique rompu.

Hemolymphangioma is a benign tumor resulting from the abnormal development of the lymphatic vessels associated with vascular malformations. 50% to 60% of these tumours are present at birth. Cervical forms are most frequent. Abdominales locations are very rare. We report, through a literature review, two cases of patients with cystic hemolymphangioma of the spleen revealed by spontaneous haemoperitoneum admitted to the Emergency Department of Visceral Surgery. The first case is a 50-year old patient and the second is 20-year old man admitted to the emergency department with diffuse abdominal pain associated with dullness to percussion on the dependent side and abdominal distension associated with haemorrhagic shock, pallor, unobtainable pulse, stabilized after a short resuscitation time respectively. All patients underwent complete tumor resection. The diagnosis of cystic hemolymphangioma of the spleen was based on anatomopathological examination of the surgical specimens. Hemolymphangioma is a rare tumor with a favorable prognosis. Some cases of spontaneous regression have been reported, but evolution is usually characterized by slow tumor growth. Malignant transformation never occurs. Treatment is surgical. Prognosis is subjected to complications, quality of the surgical excision and recurrences which are frequent especially after incomplete excision.

[Duodenal leiomyosarcoma revealed by gastrointestinal hemorrhage]. / Léiomyosarcome duodénal: description d'un cas révélé par une hémorragie digestive.

INTRODUCTION: Leiomyosarcomas account for approximately 75% of all gastrointestinal sarcomas but only 8-10% of duodenal malignancies. Pain and bleeding are the principal symptoms. Prognosis of these tumors is difficult to assess. If excision is successful, however, prognosis is usually good. We report the case of a patient with leiomyosarcoma of the duodenum first identified because of gastrointestinal hemorrhage. CASE: We report the case of a 57-year-old women who underwent duodenopancreatectomy for duodenal leiomyosarcoma. Histological and immunohistochemical findings confirmed the diagnosis of low-grade leiomyosarcoma and ruled out a gastrointestinal stromal tumor. DISCUSSION: Duodenal leiomyosarcomas are very rare. Preoperative diagnosis is difficult. The combination of a mass and a hemorrhage must suggest the presence of leiomyosarcoma. Radiological and endoscopic findings may not be conclusive: only histologic examination provided the definitive diagnosis here. Many criteria have been used to assess prognosis; complete resection appears to be the principal prognostic factor and is associated with improved survival.

[Gallbladder volvulus: Two cases]. / Volvulus de la vésicule biliaire: deux cas.

INTRODUCTION: Gallbladder volvulus remains a relatively rare disorder. OBSERVATION: We report two cases, both in men older than 80 years and both diagnosed during surgery. Both patients presented signs of peritonitis (one generalized and the other localized) and severe sepsis. DISCUSSION: We review the literature about gallbladder volvulus to analyze its incidence, etiology, and clinical, radiologic and therapeutic characteristics.