[Spontaneous rupture of the esophagus diagnosed late. Recovery by directed fistulization]. / Rupture spontanée de l'oesophage vue tardivement. Guérison par fistulisation dirigée.

Spontaneous rupture of the oesophagus is uncommon and is difficult to diagnose in the early stage. Clinical signs are lacking or incomplete, causing a delay in diagnosis and therapy which requires both intensive medical care and surgery. The surgical procedure depends on the time lapse to diagnosis. We report a case diagnosed 16 days after rupture in which directed fistulization led to complete healing.

[Endometriosis and diaphragmatic defect in catamenial pneumothorax]. / Endométriose et brèche diaphragmatique dans le pneumothorax cataménial.

Two cases of catamenial pneumothorax are reported, a rare condition characterized by its sudden occurrence in a female patient between the ages of 30 and 40 years, always at the onset of the menstrual cycle. Its exact origin is unknown, but the frequent co-existence of endometriosis and a defect in the diaphragm suggests that endometriosis may be important in the etiology both of the pneumothorax and the diaphragmatic lesion. Pelvic endometriosis was present in both our patients, one of whom also had diaphragmatic endometriosis. The treatment of the pneumothorax in both our cases consisted of pleural decortication with excellent results so far.

[Isolated pulmonary choriocarcinoma]. / Choriocarcinome pulmonaire isolé.

The author report a case of isolated choriocarcinoma of the lung revealed in a young woman by a tumoral syndrome of the right base with haematoma. The diagnosis of isolated pulmonary choriocarcinoma was based on the lack of previous gynaecological history and tumour, on the singleness of the lung tumour at CT, and on the high initial beta-CGH level (3,300 ng/ml) in the absence of pregnancy. Surgical resection confirmed the diagnosis and lowered the beta-CGH level to 7 ng/ml. The various aetiopathogenic theories put forward and their relations with the prognosis disparity found in the literature are reviewed. The authors compare the prognosis of isolated pulmonary choriocarcinoma in a non-nulliparous woman to that of placental choriocarcinoma.