Double popliteal artery of congenital origin.

An exceptional unilateral right double popliteal artery was discovered by chance. After a review of the possible causes of embryological developmental abnormalities, the most likely hypothesis is that of persistent sciatic artery.

[Diagnostic and therapeutic problems of aorto-enteric fistulas caused by aortic prostheses. 5 surgical cases of which 4 were successful]. / Problèmes diagnostiques et thérapeutiques des fistules aorto-digestives par prothèse aortique. A propos de 5 cas opérés dont 4 avec succès.

The clinical characteristics, surgical treatment and therapeutic results, were surveyed in 5 cases of aorto-enteric fistulas observed in 650 abdominal aortic reconstructive operations in ten years. The fistula concerned the duodenum in two cases, the jejunum in one and the ileum in two cases. Two patients were treated by removal of the prosthesis and an axillofemoral bypass, one by an axillofemoral shunt only and the two others by repair of the graft. One patient died a few days after the operation, another eighteen months later. The prognosis of aorto-enteric fistulas after aortic reconstructive surgery is often bleak. It should be improved by an early diagnosis, supported by anamnestic history and an upper endoscopy. An aggressive surgery, whose modalities are discussed, gives maximum chances of success.

[An unusual cause of hepatic abscess]. / Une cause insolite d'abcès hépatique.

We report the case of a liver abscess resulting from the intra hepatic migration of a toothpick coming from the stomach.

[A rare etiology of acute occlusion of the small intestine: anisakiasis. Review of the literature apropos of a case]. / Une étiologie rare d'occlusion aiguë du grêle: l'anisakiase. Revue de la littérature à propos d'un cas.

The authors report a case of acute small bowel occlusion related to anisakis. This parasitis is due to ingestion by man, an unusual host, of a nematode of "anisakis" type at larva stage, a parasite to be found in numerous species of raw or home-processed fish. The parasite whose symptomatology is aspecific, can be located on the whole digestive tube. Diagnosis suggested by medical inquiry along with eosinophily, can be confirmed by serology and discovery of the parasite after anatomo-pathologic analysis. Medical treatment consisting in associating anti-parasite medicines with corticoids in certain cases, is recommended in diffuse forms and allergic signs of disease. Surgical complications make the laparotomy necessary for appropriate diagnosis and curing of the patient. Increasing frequency of this pathology shows the importance of prophylactic measures such as: abstaining from raw or home-processed fish, cooking fish at a temperature of 60 degrees C, deep-freezing fish at a temperature of -20 degrees C for 24 h at least, before eating it raw.

[False aneurysm of the superior mesenteric artery complicating a pancreatic pseudocyst. Report of a case and review of the literature]. / Faux anévrysme de l'artère mésentérique supérieure compliquant un pseudo-kyste pancrétique. Rapport d'un cas et revue de la littérature.

The authors report a case of a pancreatic pseudocyst complicated by a false aneurysm of the superior mesenteric artery. The diagnosis was made possible thanks to the evocative images of echography and C.T. scanning permitting to perform on time the arteriography. The surgical treatment consisted on the exclusion of the false aneurysm, which necessitated a distal bypass to revascularise the intestinal tract, and the drainage of the pseudocyst by a Roux-en-Y loop. A review of literature is made.

[False aneurysm of the superior mesenteric artery complicating a pancreatic pseudocyst]. / Faux-anévrisme de l'artère mésentérique supérieure compliquant un pseudokyste pancréatique.

The authors report a case of false aneurysm of the superior mesenteric artery, complicating acute pancreatitis. They insist on the sonographic signs of "the cyst within a cyst"; the presence of a cystic lesion located within a larger mass an US Scanning is highly suggestive of a false aneurysm included in a pseudocyst. They demonstrate the correlation between US Scanning, CT Scan and arteriogram.

[Post infarction septal perforation. Is the early operation benefical?]. / Perforation septale post-infarctus. L'intervention très précoce est-elle bénéfique

A case is reported of a ruptured septum in a man of 74 which was operated on after 48 hours; the authors recall the development of ideas on the surgical treatment, and also the advantages which may be expected from counterpressure from an intra-aortic balloon. If this is not available, it seems to them that the operation must be carried out even more swiftly, within the first few hours, if damage to the myocardium and the consequences of prolonged shock, are to be avoided.