[Peritoneal and tubal Schistosoma haematobium bilharziasis. Two case reports]. / Bilharziose péritonéo-tubaire à Schistosoma haematobium. A propos de 2 cas.

It is now recognized that eggs of Schistosoma haematobium are most commonly found in the bladder because this parasitic infestation usually affects the urinary tract. However, numerous papers have been published on the occurrence of schistosomiasis of the female genital tract. The frequency of distribution of schistosomal disease of the genital tract has not been estimated because only cases with overt disease are usually considered. The involvement of Fallopian tubes is not rare in endemic areas and may predispose to ectopic pregnancy and infertility. In this paper, we report two cases of Schistosomiasis in black African women due to Schistosoma haematobium localized in the peritoneum and the Fallopian tubes. Our first patient had primary infertility associated with bilateral hydrosalpinx and peritoneal inflammatory reaction. Our second patient had an ectopic pregnancy associated with chronic salpingitis. In the both cases, histological examination showed the presence of schistosomal eggs in the peritoneum and the Fallopian tubes. These cases suggest that bilharziasis should now be considered as a urogenital disease and not only as an urinary tract disease.

[Subcapsular liver hematoma, a HELLP syndrome complication]. / Hématome sous-capsulaire du foie, complication du HELLP syndrome.

The authors report a case of unruptured subcapsular haematoma of the liver in a 31-year-old woman, para 2, in the 34th week of pregnancy, complicated by preeclampsia. Clinical signs of preeclampsia were associated with pain in the right hypocondrium and laboratory findings consistent with a true HELLP syndrome. The diagnosis of subcapsular haematoma was confirmed by tomodensimetry. A cesarean section was carried out but a conservative treatment of the hepatic haematoma was decided. Regular X-ray follow-ups showed the regression of the hepatic lesion. This case confirms recent reports that patients with unruptured capsular haematoma should be treated conservatively but should receive careful monitoring.

[A rare ovarian pseudotumor: massive edema of the ovary]. / Une pseudo-tumeur ovarienne rare: l'oedème massif de l'ovaire.

The authors report a case of massive ovarian edema which declared itself by pain in the abdomen and pelvis and an ovarian mass measuring 13 cm in diameter, occurring in a 22-year-old woman. Since it was not possible to make a diagnosis by any frozen-section examination, histology was carried out on the ovary that had been removed. This showed that the stroma of the ovary had become separated by massive edema preserving the albuginea and the superficial cortex. This case history of massive edema of the ovary shows the characteristics of this ovarian pseudotumour as described in the literature. The principal differential diagnoses of the condition are oedematous fibroma, and myxoma of the ovary. Apart from the fact that torsion of the adnexae can occur in some of these cases, the pathogenesis is still unexplained. When an ovarian tumour is found in a young woman a frozen-section examination must be carried out to make the diagnosis and perhaps avoid oophorectomy, particularly when untwisting a torsion can lead to resorption of the edema.

[Treatment of upper genital infections in women. Multicenter study of the comparative efficacy and tolerance of an amoxicillin-clavulanic acid combination and of a triple antibiotic combination]. / Traitement des infections génitales hautes de la femme. Etude multicentrique de l'efficacité et de la tolérance comparées de l'association amoxicilline-acide clavulanique et d'une triple association antibiotique.

Eighty-two patients with laparoscopically confirmed salpingitis were randomly divided into two groups in a multicentre and prospective trial. Single drug therapy with the amoxicillin-clavulanic acid combination was used in 42 patients (group A). The other 40 patients were given a combination of penicillin, aminoside and metronidazole (group B). For each case a secondary prescription for a tetracycline was discussed. Clinical results were comparable in both groups: sooner (at the end of the hospitalization period) in group A: 10 cured, 30 improved and 2 failures against 9 cured, 30 improved in group B. Later (evaluation after 5 to 8 weeks) a relapse was noted in five patients in group A and included one case of angioedema in group B. It is concluded that amoxicillin-clavulanic acid combination is a satisfactory alternative to the penicillin-aminoside-metronidazole combination, especially as it is simpler to use.