Pulmonary sequestrations of the upper lobe in children: three presentations.

Pulmonary sequestrations are congenital abnormalities where nonfunctioning lung tissue receives its vascular supply from the systemic circulation (thoracic or abdominal aorta). It is necessary to establish the diagnosis in childhood when the lesions are uncomplicated. The authors present three cases of sequestration of the apex (2 extralobar and 1 atypical) with the main clinical and radiological features. Sequestrations in the upper lobe are rare, and the usual site is the left lower lobe. Plain x-rays show a dense opacity, sometimes air-filled and sometimes with an air-fluid level: angiography is currently the best mean for definitive diagnosis; however, computed tomography will probably be very useful in the future. Differential diagnosis includes tumours of the superior mediastinum (neurogenic tumours, digestive duplication, bronchogenic cysts, pheochromocytoma and hydatid cysts).

[Chondrodysplasia punctata and maternal alcohol intoxication. Apropos of 7 cases]. / Chondrodysplasie ponctuée et intoxication alcoolique maternelle. A propos de 7 observations.

The authors report 7 cases of chondrodysplasia punctata in whom maternal alcohol intoxication was found. Most often, it consisted of chronic and confirmed alcoholism, except for the last case, in which an acute intoxication had occurred at about the 4th or 5th week of pregnancy. Clinically, the appearance of the children was evocative of fetal alcohol syndrome, except in the last case when, in contrast, the facial dysmorphy was very typical of chondrodysplasia punctata. The skeletal anomalies preferentially involve the lower limbs, sometimes the sacrum, and in one single case, the dorsal spine. Upper limbs are always spared. The maternal hepatic lesions may be responsible for the skeletal impairment, due to their repercussion on the metabolism of vitamin K. This skeletal impairment would then be close to that induced by treatments with warfarin during pregnancy. Whatever, it is absolutely necessary to X-ray the lower limbs in cases with fetal alcohol syndrome, in order to not overlook associated bone lesions.

[Hyperthermia in children, efficacy of a drinkable solution of paracetamol]. / L'hyperthermie de l'enfant, efficacité du soluté buvable de paracétamol.

The results of a clinical trial of a new presentation designed for pediatric patients in 29 children are reported. Rectal temperature was recorded every 3 hours, for 12 hours. Patients were given a 12 mg/kg dose every 6 hours. A significant and satisfactory decrease in body temperature was observed. No undesirable side effects were recorded.

[Rare posterior mediastinal tumors in children (author's transl)]. / Tumeurs rares dans la médiastin postérieur chez l'enfant.

When there is a posterior mediastinal mass on a chest X-RAY, a neurogenic tumor is usually evocated. However the occurrence of several other tumors is possible and they should be looked for preoperatively. The literature on the subject is very scarce. We report three cases of uncommon posterior mediastinal tumor. A bronchogenic cyst located between the trachea and the esophagus is described in a two months old girl. The diagnosis is made by tracheoscopy and esophagal contrast study. The anatomic situation explains why even a small tumor induces severe respiratory troubles and requires urgent treatment. An esophageal cyst is described in a 13 year old boy--the mediastinal mass is found incidentally on a routine chest X-RAY because of the risk of complications, the resection of this cyst is required and usually easy when they are intramural. A mediastinal pheochromocytoma is described in a five years old girl. The tumor is discovered during the investigation of a hypertensive syndrome. This location is very uncommon and may be unique or associated with more usual locations. The resection is delicate because of the situation of the tumor in the upper mediastinum. The preoperative angiogram is very helpful in deciding the operative approach.