[Ganglioneuroma of the mediastinum. Apropos of a case]. / Ganglioneurome du médiastin. A propos d'une observation.

The authors report a case of a large ganglioneurinoma located in the mediastinum. The clinical course of this rare benign neurogenic tumour of the posterior mediastinum includes a low risk of medullary compression. The treatment is surgical resection.

[Bronchial cancer with normal thoracic image discovered by endoscopy. Apropos of 11 cases]. / Cancer bronchique à image thoracique normale de découverte endoscopique. A propos de onze observations.

The authors report about eleven cases, distributed over four years, of bronchial cancers with a normal thoracic image that were discovered on bronchial endoscopy. In this context, they sum up the limitations of medical imaging, the undisputed merits of bronchial endoscopy, and the major epidemiological and therapeutic features of this clinical form of bronchial cancer.

[Giant cell tumors of the ribs. Apropos of a case]. / Tumerurs à cellules géantes des côtes. A propos d'une observation.

The authors report a case of grade I-II giant-cell tumour of the ribs extending to the thorax and the vertebral column. The tumour was treated by surgical resection followed by vertebral curettage in two stages and adjuvant regional radiotherapy. Giant-cell tumours of the ribs are exceptional and rarely found in the literature. They raise a therapeutic problem (surgery is essential, but radiotherapy is controverted), and a prognostic problem (there is always a potential risk of recurrent malignancy).

[Rare tumor of the posterio-superior mediastinum. Therapeutic approach. Apropos of a case. Review of the literature]. / Tumeur rare du médiastin postéro-supérieur. Attitude thérapeutique. A propos d'un cas. Revue de la littérature.

The authors report an exceptional case of giant cell tumour of the third thoracic vertebra revealed by its mediastinal development. Despite intimate involvement of the large mediastinal vessels, a double surgical approach, starting with sternotomy to ensure vascular control then anterolateral thoracotomy, allowed curative resection of this tumor. Treatment was completed by a second neurosurgical operation followed by 5,000 rads of radiotherapy. Based on a review of the literature, the authors discuss the pathogenesis and consider the various therapeutic problems raised by giant cell tumours of the vertebrae (situated above the sacrum).

Bilateral bronchial anastomosis in double lung and heart-lung transplantations.

During heart-lung or double lung transplantation, the airway anastomosis is usually made at the tracheal level. Healing of this anastomosis is one source of postoperative complications especially after double lung transplantation (DLT). In this series of 10 patients with cystic fibrosis undergoing DLT, the tracheas of donor and recipient were anastomosed with omental wrapping in 2 cases while the two main stem bronchi were joined without omental wrapping in 8. Endoscopy disclosed no sign of ischaemia in the patients with bilateral bronchial anastomoses. Three patients died on day 20, 21 and 35, respectively, after DLT. Two of these patients (one with a tracheal and the other with bronchial anastomoses) showed no complication at the level of the suture line. The third patient (with bronchial suture) suffered dehiscence of both anastomoses which was attributed to a misdosage of corticosteroids. Of the 6 patients alive after bronchial anastomosis, 3 recovered uneventfully and 3 who had required prolonged postoperative mechanical ventilation developed bronchomalacia. Bronchomalacia was treated by laser resection and stenting. Dehiscence did not occur in any of these six cases. This technique was based on the findings of 12 fresh cadaver dissections showing that collaterals between the bronchial arteries and the pulmonary arteries and veins extend up to the origin of the main stem bronchus. Bronchial suture without omental wrap may be used for double lung and heart-lung transplantation instead of tracheal suture.

[Unilateral hematoma of the adrenal gland. Review of the literature. A case report]. / Hématome unilatéral de la surrénale. Revue de la littérature. A propos d'une observation.

The authors report one case of post-traumatic hematic pseudocyst of the right adrenal demonstrated with magnetic resonance imaging. Total adrenalectomy was performed; the clinicopathological examination confirms the absence of any underlying tumoral process and allows the hypothesis that stress was a fostering factor. After a review of the literature noting that the risk of hemorrhagic recurrence is underestimated, while the number of underlying cancers is small and easily detected since imaging of the adrenals has been refined, the authors discuss the procedure of treatment and the technical aspects of surgery for the hematomas confined to the adrenal space: surgical exeresis is proposed as a rule, but this should be qualified, as a medical alternative can be justified provided the causal affection disappears and a strict observation with computed tomography or magnetic resonance imaging is ensured.

[Current therapeutic attitude in volvulus of the pelvic colon in tropical areas]. / Attitude thérapeutique actuelle devant le volvulus du colon pelvien en milieu tropical.

Diagnosis of the acute sigmoid volvulus is made by opacification of the colon by water-soluble chemicals. Therapeutic attitude is oriented by the results of an emergency colonoscopy. An emergency laparotomy is indicated when the mucosae presents an ischemic or necrotic aspect; a resection without anastomosis is performed according to Bouilly-Volkman's intervention in the best cases, Hartman's one in others. A normal colonoscopy authorizes a medical treatment with attempt of detorsion by passage of a flatus tube per rectum. A controlled success permits a delayed intervention ten days after with resection and anastomosis. Failure of medical treatment returns the surgical approach in emergency circumstances]

[Genitourinary bilharzioma. Isolated cases of vesical bilharzioma and epididymal bilharzioma]. / Le bilharziome génito-urinaire. Un cas de bilharziome vesical et un cas de bilharziome épididymaire isolés.

The authors report on two isolated cases of bilharzioma: one vesical revealed by an hematuria and one epididymal constituting an intrascrotal mass. Clinical signs did not oriented toward these diagnosis and biology was helpless. Serodiagnosis by hemagglutination was negative, but immunofluorescence was more reliable. On the contrary both tumors were detected by echotomography of which the efficiency is determinant for the diagnosis and must be underlined. Only anatomopathology was able to confirm the diagnosis of tumor. As a matter of course, surgical exploration and excision are necessary in these types of tumors with negative biology. In both cases, effects were isolated. In one patient, infestation was old and already treated; in the second one, infestation was probably light. The authors recall also bilharzioma physiopathology. Frequency of vesical bilharzioma is about 20% of genito-urinary schistosomiasis while epididymal bilharzioma reaches only 0.29 to 4.8%. Direct line between bilharzioma and cancer is likely but controversial, schistosomiasis beeing a true irritative agent.

[Strangulated or impacted diaphragmatic hernias. Treatment of six cases (author's transl)]. / Les hernies diaphragmatiques étranglées ou engouées. Considérations thérapeutiques à propos de 6 cas.

The authors report the cure of six recent cases of strangulated or impacted diaphragmatic hernia: 3 post-traumatic, 2 hiatal, one congenital. Strangulation or simple impaction are responsible for ischemic phenomena with necrosis and intrathoracic visceral perforation. Intensive care for respiratory, cardio-vascular and metabolic complications, including gastric aspiration, has transformed the prognosis which was recently so poor in this condition. The thoracic approach is advised for the usual reasons and owing to frequent intrathoracic adhesions. It is also advised for ease of treatment of the strangulated viscus and local septic complications.