[Intrapleural rupture of pulmonary hydatid cysts]. / La rupture intrapleurale des kystes hydatiques pulmonaires.

INTRODUCTION: Intrapleural rupture of pulmonary hydatid cyst (PHC) is a rare but dangerous complication. The purpose of this study was to report the characteristics of this form of thoracic hydatidosis and analyze the favoring factors. MATERIALS AND METHODS: Between 1996 and 2011, 75 patients were operated in our department for PHC ruptured in the pleura (PHCP). The characteristics of this group were compared with those of a control group of 300 patients randomly selected from patients operated during the same period for PHC. RESULTS: PHCP patients were younger than controls (23 years old vs. 27,56) (P=0.03) with male predominance (70% vs. 46%) (P=0.01). The PHCP were often located in the lower lobes (64% vs. 48%) (P=0.03). Anatomic resections were more used in control group (P=0.03) whereas decortication and pleurectomy were more frequently in PHCP (P=0.001). CONCLUSION: Young age, male sex, and basal locations of PHC promote their rupture in the pleura. Surgical treatment of these cysts requires less anatomic resections but more decortication and pleurectomy.

[Cardiac metastasis of bronchial squamous cell carcinoma]. / Métastase cardiaque d'un carcinome épidermoïde bronchique.

Secondary location of lung cancer are frequent but the location heart is rare and often diagnosed postmortem. We report a case of a patient of 67 years without disease history, individuals smoking outside a chronic carrier of bronchial squamous cell carcinoma and the staging of which finds a secondary location within the left atrial. Through this observation, the authors propose an update on this rare and exceptional location.

[Boerhaave's syndrome and pleural tuberculosis]. / Syndrome de Boerhaave et tuberculose pleurale.

INTRODUCTION: Boerhaave's syndrome is a rare condition involving spontaneous rupture of the oesophagus. The diagnosis is difficult and the prognosis depends on early diagnosis and treatment. CASE REPORT: We report a case of spontaneous rupture of the oesophagus in a 70-year-old woman where the diagnosis was delayed. Initial treatment comprised dual antibiotic therapy and feeding via a jejunostomy. Three months later, direct suture of the oesophagus was performed successfully. A routine pleural biopsy performed during the surgery revealed pleural tuberculosis. Antituberculous treatment was given for 6 months with good progress after 16 months follow up. CONCLUSION: Boerhaave's syndrome is a rare condition, the diagnosis of which remains difficult. The prognosis is related essentially to the speed of diagnosis. The treatment is always surgical within the framework of appropriate medical management (intensive care, antibiotic therapy). There should be a systematic search for associated pathology.

[Outcomes after thoracotomy for intra-abdominal hydatid cysts ruptured into the thorax (a 160 case series)]. / La place de la thoracotomie dans le traitement des kystes hydatiques abdominaux rompus dans le thorax.

INTRODUCTION: The purpose of this study was to assess the results of the surgical treatment of abdominal hydatid cysts ruptured in the thorax. PATIENTS AND METHODS: We collected data from 160 patients who experienced the intra-thoracic rupture of an abdominal hydatid cyst during the period 1997 - 2008: 158 located in the liver, one in the spleen and one in the kidney, which had been treated surgically in a single centre. Diagnosis was based on a history of surgery for abdominal hydatid cysts, specific symptoms including biliptysis (40% of the cases) and expectoration of hydatid cysts, as well as radiological findings (chest x-ray; abdominal ultrasound and CT-scan). All patients were operated on through a thoracotomy. RESULTS: In-hospital mortality was 7.5%. Postoperative complications occurred in 16% and mainly consisted of pleural and pulmonary disorders. CONCLUSION: Thoracotomy offers simultaneous and adequate access to address thoracic and abdominal injuries with a reasonable mortality and morbidity in patients with this condition.