An obscure case of hepatic subcapsular hematoma.

Spontaneous liver bleeding is often reported in preeclampsia. It is otherwise rare and has been linked to gross anatomical lesions and coagulopathy. We report a case of subcapsular hematoma of the liver without any apparent lesion and in the absence of coagulopathy.

Iatrogenic cardiac tamponade after central venous catheter.

Myocardial perforations with a central venous catheter are rare in adults (67 cases published since 1968). These accidents are fatal in more than two-thirds of the cases owing to confusion caused by misleading symptoms which suggest pulmonary embolism. The perforation is generally localized in the right atrium (29 cases), less frequently in the right ventricle (18 cases).

[Dysmorphic syndrome and vascular dysplasia: an atypical form of type IV Ehlers-Danlos syndrome].

A 29 year old woman was hospitalized for the successive onset of extremely serious vascular accidents: rupture of the gastro-duodenal artery, aneurysm of the posterior tibial artery, discovery of bilateral carotid and vertebral aneurysm with development of a carotid-cavernous fistula. The patient had a very unusual morphotype with dwarfism, white hair and alopecia. Histological investigations failed to reveal atheromatous lesions and by contrast showed involvement of the skin (dermal atrophy) and in the blood vessels fibro-dysplasia of the media.

[Congenital anomalies of the renal and infrarenal segments of the inferior vena cava].

After a brief review of the embryology, the authors present the features of the principal anomalies of the renal and infrarenal segments of the inferior vena cava.

[Trapped popliteal arteries. Incidence, epidemiology, therapeutic considerations].

The trapped popliteal artery syndrome is an extrinsic dynamic compression of the vascular structures in the popliteal fossa by the surrounding fibromuscular structures. The condition mainly affects the popliteal artery resulting in atypical intermittent claudication because it often occurs in young and active patients. The arterial lesions are initially purely extrinsic and dynamic; sometimes they progress to thrombosis, embolism or aneurysm due to jet lesions.

[Iatrogenic internal mammary arteriovenous fistula. Apropos of 2 cases].

Two fairly similar cases of internal mammary arterio-venous fistula were observed in two patients involved in serious road accidents, following which a catheter was inserted into the subclavian vein for the purposes of resuscitation. The clinical diagnosis was made in both cases on routine examination, which revealed a continuous right subclavian bruit with extensive radiation three years after the accident. There were no functional implications.

[Must acute carotid thrombosis be surgically treated? 1962-1973: long-term results].

A study of long-term results (mean follow-up: 10.6 years) in 22 patients operated on for acute carotid thrombosis between 1962 and 1973 is reported. In most instances, surgery was performed at the acute phase of a massive cerebrovascular occlusion, usually more than 8 hours after onset (10 cases).

[Percutaneous electrocoagulation of angiomas and varices of the lower limbs].

The purpose of this method is to induce local thrombosis. A teflon-sheathed intraveinous needle is used to destroy by electrocoagulation the walls of subcutaneous vessels, thus inducing sclerosis at a distance.

[Was it necessary to treat acute carotid thromboses surgically? 1962-1973: long-term results].

A 13 years study of 22 patients with surgical treatment of acute occlusion of the internal carotid artery is reported. Mortality rate was 22% (5 patients). 35% had a complete recovery of the stroke without any sequelae.

[Compared results of flail chests treatments : standard internal pneumatic stabilization, new technics of assisted ventilation, osteosynthesis (author's transl)].

The analysis of 170 cases of flail chests, divide into three groups according to the type of treatment, proves the efficiency of the new technics of assisted ventilation and of the osteosynthesis by Judet clasps. The most significant advantages of those two complementary methods are a lowered mortality rate and a reduced frequency of refractory hypoxy and infectious complications.

[Venous Doppler ultrasonography. Methods, indications and limits].

The analysis of velocities by the Doppler effect has limited applications in venous pathology. There are, however, many potential advantages: the introduction of deep venous catheters, early diagnosis of venous thrombosis, studies of venous incompetence, right sided cardiopathies, follow-up of medical and surgical treatment (thrombolytics, venous thrombectomy, bypass surgery, vena cava clips). The results in a series of venous thrombosis are reported: the correlation between Doppler and phlebography was 86,5% in 110 investigations.

[Exploration of major veins by Doppler ultrasonography. Indications and limits (author's transl)].

Doppler ultrasonography is a first-choice, non-invasive, inexpensive and repeatable procedure for exploring major veins and for detecting venous thrombosis, venous insufficiency and arterio-venous fistulae. It also provides invaluable information on post-operative haemodynamics in cases of thrombectomy, venous shunt and vena cava clip, and helps in evaluating the effectiveness of thrombolytic agents. Its sensitivity is satisfactory: in 110 patients with suspected phlebitis, there was an 86,5% agreement between the results of doppler ultrasonography and those of phlebography.

[Iliac vein thrombosis with a "floating clot" at the 37th week of pregnancy. Caesarean section and the application of a clip on the inferior vena cava. A case history (author's transl)].

The authors describe a case of high venous thrombosis with floating clots at the 37th week of pregnancy. The problem of diagnosis was solved by urgent Doppler examination and by phlebograms of the legs. It is necessary to have a team of many disciplines that can be brought together at any time.

[Arguments for and description of the Doppler venous examination (author's transl)].

Analysis of blood flow rates by Doppler effect on veins has many advantages: deep insertion of venous catheters, diagnosis of deep veins thrombosis, venous insufficiency, right heart cardiopathies, and supervision of medical and surgical treatment of venous disease. The agreement between Doppler examination and phlebography was, in venous thrombosis, 86.5 % for 110 examinations.