Open window thoracostomy for a chronic calcified pleural empyema in the setting of a closed chest trauma.

This case report is a chronic calcified pleural empyema in a patient who suffered a closed chest trauma 30 years ago. The first goal is to demonstrate how the closed chest trauma caused a bronchopleural fistula of the calcified pleural empyema, since the patient began to report continued purulent sputum after his trauma with weight loss and the appearance of an air-fluid level in the chest CT scan (no pleurocutaneous fistula in the clinical examination). The second goal is to reveal the rule and the interest of an open window thoracostomy in the management of chronic calcified pleural empyema, since a decortication remains difficult to perform in cases like this one.

[Recurrent postpartum pyoderma gangrenosum and fatal cardiomyopathy]. / Pyoderma gangrenosum récidivant du post-partum et cardiomyopathie fatale.

BACKGROUND: We report a case of recurrent post-partum pyoderma gangrenosum (PG) complicated by post-partum cardiomyopathy (PPCM). PATIENTS AND METHODS: A 23-year-old woman presented with a previous medical history of aseptic abscess of the left breast in her fourth pregnancy, which developed after surgical drainage of an inflammatory ulceration treated by atraumatic topical care. During her fifth pregnancy, the patient presented a large and painful ulceration in relation to the scar of the Caesarean section, despite the introduction of broad-spectrum antibiotic therapy. Bacteriological samples were negative. Histological examination militated in favor of PG. One week after initiation of corticosteroid therapy, the patient suddenly showed signs of heart failure. Based on trans-thoracic echocardiography PPCM was diagnosed, and the outcome was fatal. DISCUSSION: This observation raises the question of the relationship between PG and pregnancy and describes the association of PG and PPCM. PG occurs rarely during pregnancy and it may be induced by the rise in G-CSF levels found in pregnant women. The association with PPCM seen in our patient could have been due to the development of an anti-angiogenic climate at the end of pregnancy, together with inflammatory myocardial aggression linked to the PG.

[Retroperitoneal leiomyoma: a case report]. / Léiomyome rétro-péritonéal: à propos d'un cas.

Retroperitoneal leiomyoma is a rare benign tumor of the retroperitoneum. We report a clinical case of a 43-year-old patient, who suffered from back pain and weight loss. Imaging revealed a retroperitoneal mass, then the patient had a total excision of the tumor. Histological examination of the surgical specimen concluded to retroperitoneal leiomyoma. The evolution was good without recurrence after 12 months.