[Chloral hydrate poisoning]. / Intoxication à l'hydrate de chloral.

The intentional ingestion of 5 g of chloral hydrate by a 67-yr-old man resulted in cardiac arrhythmia including tachyarrhythmia and polymorphic ventricular extrasystoles. As the ingested agent was unknown at admission, the patient was treated among others with sodium lactate, a non validated therapy of arrhythmia caused by chloral hydrate overdose. The discontinuation of arrhythmia was in favour of a beneficial effect of this treatment which remains to be confirmed. This unusual therapy is the original point of this case report which allows to question the so-called innocuousness of chloral hydrate, to remind the conventional treatment of the arrhythmias caused by this agent, the place of beta-adrenergic blockers, as well as the therapeutic difficulties when the causative agent remains unknown.

[Post-traumatic pneumatocele and hemato-pneumatocele of the lung. Apropos of 3 cases]. / Pneumatocèles et hémato-pneumatocèles post-traumatiques du poumon. A propos de 3 observations.

Pneumatocele and haemato-pneumatocele are air or air/fluid cavitary lesions which develop in the lung parenchyma after thoracic trauma. The formation of this lesion requires a direct violent impact on the pliable lung wall which explains its frequency in young adults. They are preferentially localised in the lung bases. The importance of associated lesions often marks the pneumatocele. Though rarely described, its frequency is certainly underestimated. If haemoptysis is the most frequent clinical sign it is the chest x-ray which demonstrates the early abnormality in the form of a rounded translucent image with a fine contour and variable diameter. The existence of a fluid level suggests the presence of blood (haemato-pneumatocele). The differential diagnosis with a localised pneumothorax, a diaphragmatic hernia and a pre-existing cystic lesion is easy as a rule but an evacuated pulmonary haematoma may lead to the discussion, especially as the mechanism of their formation may be the same. In isolation their clinical implications are minimal, their evolution favourable and after several weeks with a restitution of the integrity of the pulmonary parenchyma the absence of therapeutic intervention is justified.