[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.

[Stab wound of the spinal cord complicated by meningitis and subarachnoid fistula]. / Plaie vertébro-médullaire par arme blanche compliquée de méningite et de fistule du liquide céphalorachidien.

We describe a case of penetrating spinal cord injuries in an 20-year-old man after stab wound attack. The outcome was complicated with subarachnoid fistula and meningitis. The diagnosis and management of these complications are discussed.

[Paraplegia after cardiac arrest]. / Paraplégie après arrêt cardiaque.

We report a case of a permanent flaccid paraplegia, with a sensory loss at T12 level, not associated with cerebral damage, subsequent to a cardiac arrest of 15 minutes duration, in a 67-year-old patient, undergoing haemorragic surgery for gangrenous purulent cholecystitis. Besides cardiovascular collapse and subsequent circulatory arrest, possible favouring factors include anatomical anomalies in the territory of anterior spinal artery, surgical posture with hyperlordosis generating venous stasis, emergency haemostatic maneuvers with compression of the arterial territory providing spinal blood supply. Spinal cord lesions are probably more frequent than expected, as the often associated cerebral anoxic encephalopathy impedes their recognition. Only a systematic anatomopathological examination of the spinal cord, in patients who died after a cardiac arrest, would provide the accurate incidence of spinal complications.

[Cerebral complication in eclampsia]. / Complications cérébrales dans l'éclampsie.

Many brain complications occur during eclampsia with various degree of gravity. The pathogenesis of these lesions continues to be a source of considerable controversy. Five cases of eclampsia with severe neurologic manifestations were treated in our surgical intensive care unit. The CT image appeared to be related to haemorrhagic lesions (3 cases) and ischaemic lesions (2 cases). The clinical course was favourable, often reversible, in cases with oedema and ischaemia maternal prognosis was poor in the case with haemorrhage.

[Block of spermatic cord in surgery of the testis]. / Bloc du cordon spermatique en chirurgie testiculaire.

This study analyses 25 cases of spermatic cord blockade for scrotal surgery (hydrocele, spermatocele, tumor of epididymis). The spermatic cord was infiltrated, after identification of the pubic tubercle, with a mean total dose of 17 +/- 3 ml of a 2% lidocaine solution not containing adrenaline. The scrotal skin was infiltrated separately at the site of incision. Analgesia was excellent in 22 patients. The duration of analgesia was 82 +/- 33 min. No adverse effects occurred. It is concluded that the blockade of the spermatic cord is a convenient anaesthesia technique for testicular surgery.

[An unusual case of HELLP syndrome]. / Un cas singulier de HELLP syndrome.

The Hellp's syndrome is a complication of gravidic hypertension which associates the microangiopathic hemolysis, the cytolytic hepatic anomalies and a thrombocytopenia. There are resemblences between the biologic and histologic forms of the thrombotic microangiopathy and Hellp's syndrome. In this publishing, we report one case of Hellp's syndrome which the particular character is that the hepatic and hemolytic biologic anomalies are still very discrete, where as the thrombopenia is deep; this led us to rediscuss about the authencity of Hellp's syndrome. A neurologic complication, particulary gravissim, is noticed in one case, it concerns the intracerebral hematoma with left deficiency syndrome.

[Cardiac arrest and epidural anesthesia]. / Arrêt cardiaque et anesthésie péridurale.

A man 55 years old reached of chronic bronchopneumopathy was underwent a subumbilical surgery under an epidural anesthesia. The puncture has been realized at the level of the space L3-L4, with the location of an epidural catheter after negative aspiration test. The local anesthetic with lidocaine 2% (12 ml) Ten minutes later, the patient presented cardiac arrest that evaluated favourably under the cardiocirculatory intensive care. Blood and LCR analysis exclude the eventuality of a toxic accident, an anaphylaxia or spinal anesthesia.

[Subcapsular hematoma of the liver, a complication of pregnancy toxemia]. / L'hématome sous-capsulaire du foie, complication de la toxémie gravidique.

The authors report three cases of subcapsular liver hematomas occurring after delivery and diagnosed by ultrasonography (1 case), and exploratory laparotomy (2 cases). These three cases compared with the data from the literature, illustrate the conditions of occurrence and the clinical signs of subcapsular liver hematomas during pregnancy or in the post-partum period. The frequency of this complication is most likely underestimated, since benign forms remain latent and the severe forms, responsible for sudden death, eludes the diagnosis in the absence of anatomical confirmation.