[Cardiac hydatid cysts: report of 10 cases]. / Kyste hydatique du coeur. A propos de 10 cas.

Authors report 10 observations of cardiac hydatid cyst collected to cardiovascular unit of Ibn Rochd hospital in Casablanca during last 7 years. Clinical investigation included in all cases chest X ray, ECG and ultrasonography (US). A computed tomography (CT) scan was performed in 6 cases, magnetic resonance imaging in four cases, transoesophageal US in two cases. Examination for other hydatic sites was realized in all cases, and brain CT was performed in 5 cases. The hydatid cyst was variably localized in the left ventricle in 6 cases, the pericardium in 4 cases, the interventricular septum in 2 cases, the right auricle in 2 cases and multiple locations in one case. The existence of other cardiac hydatid sites was found in 7 cases. Seven patients have been operated (2 cases to closed heart). Outcome was favorable in 6 cases with a mean of three years survey. Two patients died and 2 others have been lost of view. The diagnosis of the cardiac hydatid cyst has benefits from the combination USCT scan that allowed a precise topographical inventory, reducing the need for MRI to the complicated cases and to the rare cases of inconclusive results by US-CT scan.

Traumatic aneurysm of the bifurcation of the abdominal aorta in an infant. A case report.

Post-traumatic aneurysms are extremely rare in the infant population. We report a case of delayed abdominal aortic aneurysm that appeared in a 5-year-old female, admitted 5 months previously with contusions to the abdomen.

[Spinal ischemia after biiliac aneurysm surgery related to Behçet's disease diagnosed two years later]. / Ischémie médullaire après chirurgie d'un anévrysme bi-iliaque rattaché 2 ans plus tard à une maladie de Behçet.

A 26-year-old woman underwent bypass surgery for biiliac aneurysm of unknown origin. The aorta was cross clamped below the renal arteries to insert a tube graft between the infra-renal aorta and the external iliac arteries with implantation of the internal iliac arteries on the prosthesis. Due to leakage from the posterior area of the proximal anastomosis, the proximal suture was redone. Total cross clamping lasted 65 minutes. No blood pressure drop was noted during or after the procedure. Postoperatively, the neurological examination revealed paraplegia with mild sensorial deficit and fecal and urinary incontinence. The fecal and urinary deficit resolved three months later. Nearly complete motor recovery was noted at the 18(th) postoperative month. The patient then presented oral and genital ulceration at 22 months postop leading to the diagnosis of Behçet's disease. Several risk factors have been suggested to explain spinal ischemia after abnormal aortic surgery: anatomic variablility of spinal perfusion, duration of aortic cross clamping, and intra- or postoperative episodes of hypotension. Thrombotic damage to the arterial system due to Behçet's disease could also perturb spinal blood supply and reproduce one of the mechanisms incriminated in ischemic spinal lesions occurring during aortic surgery for atheromatous aneurysm.

[Behçet's disease revealed by bilateral femoral aneurysm]. / Maladie de Behçet révélée par un anévrysme fémoral bilatéral.

Behçet's disease is a chronic vascularitis characterized by recurrent ulcers of the mouth and genitalia and iridocyclitis. Vascular complications involving venous thrombosis and arterial lesions are rare. We report a case of Behçet's disease in 30 year-old man revealed by a voluminous right femoral aneurysm and a thrombosed aneurysm of the left iliofemoral trunk. Disease exacerbation was marked by oral ulceration and ocular lesions that delayed surgical cure for 7 days. After surgical resection of the aneurysm, a femoro-femoral bypass was constructed with a polytetrafluoroethylene graft. The left iliofemoral aneurysm was left intact. After 4 years of regular follow-up, there have been no surgical complications. The timing of surgery in patients with a voluminous aneurysm is debated during phases of active disease.

[Hydatic disease of the heart presenting with pericardial effusion. A case report]. / Epanchement péricardique révélateur d'une hydatidose médiastinale. A propos d'un cas.

The authors report a rare case of multiple mediastinal hydatid cysts which ruptured in a 48 year old man who presented with a pericardial effusion. The diagnosis was confirmed by 2D echocardiography, completed by CT scan and magnetic resonance imaging. The patient was operated as a semi-emergency and the outcome was good. This case underlines the rare pericardial involvement and the severity of the complications of cardiac hydatid disease.

[Mediastinal malignant schwannoma disclosed by pericardial tamponade in von Recklinghausen disease]. / Schwannome malin médiastinal révélé par une tamponnade péricardique au cours de la maladie de von Recklinghausen.

The authors report a case of a 47-years-old patient with Von Recklinghausen's disease. He was admitted with pericardial tamponade. 2D echocardiography showed, in addition to the compressive pericardial effusion, an enormous intrapericardial tumor compressing the left cardiac cavities. The patient died soon after pericardial drainage. The post-mortem examination revealed the diagnosis of malignant schwannoma of the left costo-vertebral gutter with an anterior intrapericardial development. A review of the literature showed that malignant schwannomas are seldom localized in the mediastinum, are associated with Von Recklinghausen's disease in 2 to 13% of cases, and have a poor prognosis. Pericardial tamponade is an exceptional presenting sign of mediastinal malignant schwannoma.