Delayed repair for traumatic abdominal wall hernia: is it safe?

Abdominal wall hernias after trauma have been recognized for more than a century, with the first case reported as occurring after a fall. Traumatic abdominal wall hernias (TAWHs) after blunt trauma are uncommon. The timing of definitive repair, early or delayed, is not clear. We report a case on TAWH and mesenteric avulsion, highlighting the reasons for immediate or delayed repair. A single case study can hardly be considered as a basis for profound changes in the management of post traumatic hernias. However, damage to all layers of the abdominal wall indicates high-energy trauma. In such cases, the damage is not, in all probability, limited to the integumentary system. For the moment, the timing of surgery in any TAWH should be considered differently according to the trauma, the wall defect, clinical and radiological findings, associated injuries, and the clinical status of the patient.

[Hibernoma of the forearm]. / Hibernome de l'avant-bras.

Hibernomas are rare benign tumours originating from the brown fat found in the foetus and animals that hibernate. In most cases they present as a slowly growing painful mass situated in those regions where this type of fat persists in the adult. We report a case of hibernoma of the forearm, which is an unusual localization, and we review the diagnostic and therapeutic aspects of this of tumour whose main differential diagnosis is liposarcoma.

[Primary pelvic hydatid cyst: a case report]. / Un cas rare de localisation primitive du kyste hydatique dans le pelvis.

The purpose of this report is to describe a case of primary pelvic hydatid cyst in a 30-year-old man who presented with abdominal symptoms related to compression of the rectum and urinary tract. This unusual location was initially considered as a tumour process. Proper diagnosis can sometimes be based on ultrasound and computerised tomography. However in some cases such as ours surgical exploration may be necessary for definitive diagnosis.

Sensitivity of the ultrasonic CARI technique for breast tumor detection using a FETD scheme.

The CARI (clinical amplitude/velocity reconstruction imaging) technique is a new ultrasonography for better detection of the breast cancer. The method uses the mammography-like positioning of the breast and a reference structure to assess the changes of sound velocity in the screened region. In this work, we present a first attempt to simulate the CARI technique using finite element time-domain (FETD) wave propagation. The CARI sensitivity to the size, shape and location of the tumors is investigated via the simulations on 2D and 3D breast models. Small lesions can be detectable under a suitable spatial resolution. 3D simulations agree with the quantitative results of the 2D case. Moreover, the FETD approximation is proving to be a simple, but robust tool in the CARI simulation.

[Peritoneal hydatid cysts. Apropos of 12 cases]. / L'hydatidose péritonéale. A propos de 12 cas.

STUDY AIM: The aim of this retrospective study was to report on 12 cases of peritoneal hydatidosis observed in the same hospital from 1989 to 1998. PATIENTS AND METHODS: Four men and 8 women (mean age: 37 years) were included in the study. Four of them had been operated on for liver hydatidosis, 3 to 9 years before. The peritoneal hydatidosis was asymptomatic (n = 2), revealed by pain and/or fever (n = 9) and by hydatid peritonitis (n = 1). Diagnosis was performed by ultrasonography in seven cases out of 10. Preoperative treatment with albendazole was given to one patient only during 1 month. All patients were operated on. Peritoneal cysts, with different locations, were secondary in 11 patients. Nine patients had concomitant liver hydatidosis and two concomitant retroperitoneal hydatidosis. Hydatid cysts were usually sterilized with oxygen water and treated by resection of the protruding dome. Postoperative treatment with albendazole was given to five patients. RESULTS: Postoperative complications occurred in five patients: intestinal occlusion, abscess in a residual cavity, purulent fistulas, biliary fistulas with a favorable issue. With a mean 38-month follow-up, all patients were alive, with only one recurrence in a liver hydatid cyst. CONCLUSION: Peritoneal hydatidosis was secondary in 11 out of 12 patients. Diagnosis was performed with ultrasonography in seven out of 10 patients. All patients were operated on. With a mean follow-up of 38 months, only one recurrence has been observed.