[Sonography of peripheral nerves. Part II: lower limbs]. / Echographie des nerfs périphériques -- Deuxième partie: membre inférieur.

On sonographic images, the peripheral nerves have a fibrillary structure, ribboned on longitudinal images and ovoid on cross-section images. The nerves travel between the muscle groups, often with blood vessels, or in canals. Recently improved ultrasound devices are able to investigate the peripheral nerves along their entire length, as far as the sonographer has thorough anatomical knowledge, rigorous technique, and, when searching for pathology, good clinical notions. As in Part I on sonography of the peripheral nerves of the upper limbs, published in this journal, the objective of this general review is to present normal and pathological echoanatomy of the peripheral nerves of the lower limbs in an educational way.

[Gallstone ileus. Abdominal CT usefulness]. / L'iléus biliaire. Intérêt de la tomodensitométrie abdominale.

The authors report the case of a 93-year old woman referred to the emergency department and presenting with an intestinal obstruction. Abdominal CT reveals a biliary ileus caused by the migration and the impaction of a 3 cm gallstone in the small bowel. Surgical treatment by enterolithotomy was successful. In over 90% of cases, gallstone ileus is a complication of cholelithiasis and accounts for 25% of intestinal obstruction in patients over 65 years. To reduce morbidity and mortality, early diagnosis and prompt treatment are essential. Abdominal CT-scan is the gold standard technique.

[Tuberculous sacroiliitis: report of a case]. / Sacro-iliite tuberculeuse: à propos d'un cas.

Our case concerns a 32-year old Cameroonian male presenting with tuberculous sacroiliitis. Diagnosis was made on the basis of a positive abscess needle aspirate. Tuberculous sacroiliitis is rare and generally an isolated phenomenon. Its insidious presentation leads to delayed diagnosis. The affection is often overlooked due to lack of awareness of the clinicians, the usually good condition of the patient and minimal signs of sacroiliac joint infection. Haematological data are frequently non contributory. High risk groups include developing countries immigrants, immunodepressed patients and low socioeconomic status. Accurate diagnosis is based on percutaneous synovial fluid or abscess aspirate bacteriology. CT-scan and NMR are the most helpful radiological examinations.

[Jejunal lipomatosis with intussusception and volvulus. A case report]. / Lipomatose du jéjunum avec invagination et volvulus: à propos d'un cas.

We report the unusual case of a 48 year old woman with jejunal lipomatosis complicated by intestinal intussusception and volvulus. Showing fatty masses CT allowed accurate diagnosis.

Pulmonary nodular lesions in a 70-year-old man.

Bronchiolitis obliterans organizing pneumonia (BOOP) is an uncommon but increasingly recognized clinicopathologic syndrome. This report illustrates a proteiform clinical presentation of BOOP in a 70-year-old patient with cough, low-grade fever, weight loss, and hemoptysis. Chest radiograph and computed tomography (CT scan) showed nodular lesions. A video-assisted thoracoscopic procedure for biopsy of the largest nodule was performed at the end of an extensive work-up. A diagnosis of BOOP was established and, because of persistent symptomatology, corticosteroid therapy was initiated. This observation illustrates that the clinical and radiological findings of BOOP are non-specific and can sometimes mimic primary and/or secondary pulmonary malignancies.

[Fournier's gangrene: emergency diagnosis]. / La gangrène de Fournier: un diagnostic d'urgence.

We present one case of Fournier's gangrene in a 56-year alcoholic patient. The source of infection was an anal fistula. Prompt diagnosis was based on CT and ultrasonography of the pelvis. An orchidectomy was performed because of testicular involvement. Fournier's gangrene is an emergency that requires early recognition to ensure therapeutic success. Treatment involves aggressive surgical debridement, broad spectrum antibiotic therapy and haemodynamic stabilization. Hyperbaric oxygen therapy may be helpful.

[Spontaneous regression of testicular tumor]. / Tumeur testiculaire spontanement involuee.

We report the case of a 33-year-old man presenting with a retroperitoneal seminoma secondary to a testicular tumor which had completely and spontaneously disappeared (burned-out or shrinking seminoma). Ultrasound only showed a fibrous scar in the right testis. A careful study of the testicles should be considered in all male retroperitoneal tumor, even if they are asymptomatic, to exclude an occult cancer or more rarely a spontaneously involuted tumor. Testicular ultrasonography is today the gold-standard technique and any parenchymal echostructure abnormality should be verified histologically.

[Burkitt's lymphoma of the appendix]. / Lymphome de Burkitt de l'appendice.

We report the case of a 12-year-old European boy presenting with an appendicular Burkitt's lymphoma. He complained of right lower abdominal pain mimicking acute appendicitis. Ultrasonography and abdominal CT showed an appendicular mass which features were strongly suspicious for malignancy. This case emphasizes the importance of medical imaging to characterize appendicular lesions and to select the surgical technique. Accurate diagnosis was obtained histologically on resected specimen.

[Metastasis to the gallbladder secondary to a clear cell renal tumor]. / Métastase de la vésicule biliaire secondaire à une tumeur rénale à cellules claires.

Metastases from renal cell carcinoma metastases can involve unusual sites. We report the US and CT findings of such a metastasis to the gallbladder.