[Sublingual haematoma: an unusual complication of oral anticoagulation therapy: about one case]. / Hématome sublingual : complication inhabituelle du traitement anticoagulant oral: à propos d'un cas.

Bleeding complications of oral anticoagulant therapy are not rare. The locations for bleeding are most often gastrointestinal, genitourinary and intracranial. Upper airway obstruction remains one of the reported complications. It is produced in most cases by a retropharyngeal haematoma. On the other hand, sublingual haematoma is exceptional and constitutes a problem to secure patient's airway. We report the case of a 16-year-old patient, admitted tenhours after accidental ingestion of 40mg of Sintrom((R)) with major breathing difficulty, haemoptysis and epistaxis. The endotracheal intubation was performed blindly using an Eschmann candle. This rare complication should be prevented by an adapted clinical and biological monitoring.

[Postoperative infection following craniotomy in adults]. / L'infection postopératoire après craniotomie chez l'adulte.

OBJECTIVE: The aim of this study was to determine the risk factors for postoperative infection after craniotomy, a threat for the vital prognosis, in order to define specific prevention measures. METHOD AND PATIENTS: An open prospective study was made on all adult patients undergoing craniotomy and followed 30 days postoperatively. The infections were defined according to CDCA criteria. The parameters studied were: age, sex, ASA and Glasgow scores, neurosurgical history, the type, the moment and the surface of shaving, antibioprophylaxis, and the type and duration of surgery as well as its emergency level. RESULTS: One hundred and seventy patients were included. Thirty presented with an infection (17.6%), nine with a skull infection, 13 with meningitis, three with empyema, and two with osteitis. The risk factors identified thanks to a univariate analysis were the emergency level of surgery (P < 0.01), duration of surgery >200 min, and duration of stay in ICU >72 h (P < 0.02).

[Renal angiomyolipoma complicated by retroperitoneal hematoma]. / Angiolipome rénal compliqué d'un hématome rétropéritonéal.

Renal angiomyolipoma (AML) is a benign tumor, they are generally asymptomatic or can manifested by abdominal pain, palpable mass or hematuria. We report an uncommoun case of 65 years old women who consulted for retroperitoneal hemorrhage by spontaneous rupture of renal AML with palpable mass. The ultrasound and CT abdominopelvic scan were performed in the preoperative diagnosis and showed a typical right renal AML with retroperitoneal hematoma. The right nephrectomy by transperitoneal approach was performed with a good follow-up. The histological examination confirmed the diagnosis for renal AML. About this case, the authors discuses the diagnosis and the management for AML with retroperitoneal hemorrhage.

[Surgical complications of nephrectomy in living donors]. / Les complications chirurgicales de la néphrectomie chez le donneur vivant.

Renal transplantation from a living donor is now considered the best treatment for chronic renal failure. We reviewed the operative complications in 38 living related donor nephrectomies performed at our institution over the past 14 years. The mean age of our donors was 30 years old with age range between 18 and 58 years old and female predominance (55.2%). These swabs were realized by a posterolateral lumbar lombotomy with resection of the 11 third. The left kidney was removed in 34 donors (90%), surgical complications were noted in 39.4% of the cases: one case of wound of inferior vena cava (2.6%), one case of release of the renal artery clamp (2.6%), four cases of pleural grap (10.5%), one case of pneumothorax (2.6%), one case of pleurisy (2.6%), three cases of urinary infection (7.8%), three cases of parietal infection (7.8%) and one case of patient pain at the level of the wound (2.6%). There were no mortalities. We conclude that the morbidity of living donor nephrectomy is negligible compared with the advantages for the recipient.

[Enterocystoplasty complications at the intensive care setting]. / Complications de l'entérocystoplastie en milieu de réanimation.

The cystectomy with substitute enterocystoplasty because of the bladder cancer is a surgical technique which is the origin of several problems that the medicosurgical team faces. The aim of this study is to evaluate the postoperative complications of this surgical technique. We have realized a retrospective study of 56 patients hospitalized in intensive care service between 1994 and 1997. The complications observed were dominated by postoperative peritonitis (5.2%), urinary fistula (3.5%), digestive fistula (1.7%). Other general complications were recorded as pneumopathy (3.5%), digestive hemorrhage (1.7%) and dehydratation (3.5%). One death case in multivisceral failure system was noticed. A precocious diagnosis, a good preoperative value, and a preoperative adapted supervision should improve surely the prognosis.

[Pheochromocytoma discovered in the preoperative period: analysis of 3 cases]. / Le phéochromocytome de découverte peropératoire: analyse de 3 cas.

Phaeochromocytoma is a rare tumour that may be discovered incidentally during a surgical operation that can sometimes cause fatal arrhythmias. The authors report 3 cases of phaeochromocytoma presenting in the form of hypertensive crisis and serious arrhythmias following manipulation of the tumour with a fatal outcome in 2 cases. These cases illustrate the severity and complexity of the problems encountered and the importance of preoperative detection of phaeochromocytomas, particularly at the pre-anaesthetic visit.