Cystic rectal duplication: a rare cause of neonatal intestinal obstruction.

A case of cystic rectal duplication revealed on day 2 of life by a low intestinal occluding syndrome is reported. Radiologic imaging (ultrasonography, cystography, rectography) showed a large, retrorectal liquid formation in the pelvis and abdomen, with pelvic compression of the terminal alimentary canal and lower urinary tract. Magnetic resonance imaging demonstrated a liquid formation with clearly defined edges and no medullary involvement, thus ruling out the possibility of a previous meningeal hernia. Biological markers were within normal limits. On day 4, a 9 x 6-cm cystic rectal duplication was removed, followed by a temporary colostomy. Pathologic examination demonstrated typical rectal architecture with ciliated cells. Radiologic and clinical findings at 2-month follow-up were reassuring. This case report is exceptional for the following reasons: (1) As a rule, rectal duplications are relatively rare (70 cases reported in the literature); (2) The means of disclosing a neonatal rectal duplication is unusual (4 cases reported in the literature); (3) The volume of the malformation was considerable; and (4) Heterotopic ciliated epithelium was present.

Congenital extra-hepatic portocaval shunt. Concerning a case of antenatal diagnosis.

The authors report a case of congenital extra-hepatic portocaval shunt in a two-year-old girl. While pointed out antenatally by ultrasound and suspected by a follow-up ultrasound at the age of two years, this anomaly could be confirmed only by coupled ultrasound scanning and color Doppler, which allows for dynamic anatomic and morphologic evaluation. Comments concern mainly the embryologic hypothesis and the clinical tolerance of this malformation (because no therapeutic measures were adopted).

[Clinostatic variations of the lumbosacral spine and obstetrical mechanics]. / Variations clinostatiques de la colonne lombo-sacrée et mécanique obstétricale.

An X-ray study of the lumbar spine after childbirth in 2 groups of patients (one control group and one group with engagement dystocia) picked up one difference between the groups. The patients who gave birth spontaneously, presented with hyperlordosis which was relieved when lying down. In contrast, the patients who had presented engagement dystocia, presented with hyperlordosis which was aggravated when lying down.

[Vesico-ureteral reflux. Ultrasonographic aspect of endoscopic treatment (excluding follow-up)]. / Reflux vésico-urétéral. Aspect échographique du traitement endoscopique (en dehors de la surveillance).

Thirty four children, mean age 6 years, with reflux of 56 ureters were treated by an endoscopic approach. The technique, a recent innovation, attempts to reinforce the intravesical trajectory of the ureter by the injection of a Teflon disk below the vesical mucosa at the ureteral meatus level. The Teflon disk used is radiotransparent but could always be detected by ultrasound imaging, whatever its size, as a very reflecting image with a posterior cone shadow.

[Anuria in an infant caused by an intrapyelic mycelial bezoar in a solitary kidney]. / Anurie du nourrisson par bézoard mycélien intrapyélique sur rein unique.

A 4 month-old premature infant having received prolonged intensive care for necrotizing enterocolitis and Pseudomonas infection, developed anuria with intrapyelic fungus ball developed in a congenital single kidney. Review of the literature found 19 similar cases and emphasized the difficulty of an early diagnosis and the usefulness of renal ultrasonography for its detection. Moreover the opportunity to treat premature neonates carrying candida albicans with IV amphotericin B and flucytosine before the occurrence of an uneasy treatable urological obstacle in discussed.

[X-ray computed tomography in purulent pleurisy]. / Apport de la scanographie au cours des pleurésies purulentes.

Complementary CT scan imaging during investigation of 18 cases of empyema showed it to be an essential examination, since it established the diagnosis in all cases, determined possible extension of the infectious process and possible causal lesion, defined the most effective approach for percutaneous drainage and evaluated efficacy of the later.

[Radiographic aspect of enterocystoplasties using the Kock technic]. / Aspect radiographique des entéro-cystoplasties selon la technique de Kock.

Normal radiologic images obtained during postoperative review examinations of patients with bladder epithelioma, treated by cystectomy and continent enterocystoplasty using the recently introduced Kock's technique, are described and a programme of radiologic follow up of these patients proposed.