[CT guided dual site infiltration in pudendal neuralgia]. / Infiltration scano-guidée en deux sites dans la névralgie pudendale.

PURPOSE: To assess the value of CT guided dual site infiltration in patients with pudendal neuralgia and determine prognostic factors of efficacy. Materials and methods. Retrospective review of 49 patients with suspected pudendal neuralgia who underwent one or multiple injections of local anesthetics and steroids. Patients were classified based on clinical and electrophysiological findings. RESULTS: 70% of patients with typical symptoms of pudendal neuralgia responded favorably to the infiltrations compared to 27% of patients with atypical symptoms (p<0.05). The mean number of infiltrations was 2.2. 84% of responding patients experienced symptomatic relief after the first infiltration. The mean duration of symptomatic relief was 3 months. CONCLUSION: Infiltration is an effective treatment for patients with typical pudendal neuralgia, and should be included in the management of these patients.

[Large bowel obstruction secondary to lumbar hernia following latissimus dorsi flap]. / Occlusion colique sur hernie lombaire secondaire à un prélèvement de lambeau du muscle grand dorsal: à propos d'un cas.

The authors report the case of a 46-year-old woman with large bowel obstruction secondary to lumbar hernia following latissimus dorsi flap. Diagnosis was made by CT. This paper describes the CT features of this rare pathology. A brief review of the literature is also presented.

[CT guided neurolysis of the sphenopalatine ganglion for management of refractory trigeminal neuralgia]. / Névralgie faciale essentielle traitée par neurolyse du ganglion sphéno-palatin sous contrôle tomodensitométrique.

The authors present the case of a patient with recurrent trigeminal neuralgia, refractory to medical treatment and ablation of the trigeminal ganglion, who underwent three separate CT guided injections for pterygopalatine ganglion ablation over a two year period. Ablation of the pterygopalatine ganglion may be an effective technique for pain management in patients suffering from atypical facial pain syndrome, cluster headache, or neuritis. The technique used for CT guided ablation using alcohol or radiofrequency is described. The advantages and pitfalls of this technique are reviewed.

[Stellate ganglion radiofrequency neurolysis under CT guidance. Preliminary study]. / Neurolyse du ganglion stellaire par radiofréquence sous guidage scanographique. Etude preliminaire.

Sympathetically maintained pain syndrome of the upper limb is difficult to treat even with high doses of specific medication. Stellate ganglion block by in situ injection of a local anesthetic is an efficient and accepted method for diagnosis and treatment. The sedative effect is however transitory linked to the short effect of the drug. CT guidance, displaying an excellent contrast between soft tissues, bones, vessels and nerves, is a well suited and safe mean of guidance. Seven patients suffering from reflex sympathetic dystrophy were treated by stellate ganglion radiofrequency (RF) neurolysis at two sites (C7 and T1). Patients were evaluated for pain before and immediately after the procedure and at three months. Four patients had a significant (50%) pain relief lasting at 3 month. One patient had a temporary pain (one week) and 2 no pain relief. No patient had a Horner syndrome. One patient had a temporary neuralgia of surrounding nerves (brachial plexus). RF neurolysis of stellate ganglion under CT-guidance is precise and appears efficient but further investigation on a larger cohort of patients is needed.