Biomedical subjects
Publications and source records attributed to P Baudain.
One case of Cutis marmorata telangiectatica congenita (CMTC) is reported with cutaneous signs, corporal asymmetry, macrocephaly and cerebral vascular malformation. This syndrome allows to recognize a particular type of CMTC and its relationship with other angiomatosis.
The authors report a case of tumour of the right iliac region in a 14 years old girl, disclosed by a light traumatism, without appreciable antecedents, nor locomotor disfunction. Ultrasonography and computed tomography showed its cystic constitution. Surgically, there was a synovial cyst of the ilioinguinal area, cyst of the iliopsoas bursa, with a hip joint communication. It was resected and a partial recurrence occurred, corrected surgically three years later. A recent MRI showed the spontaneous development of a same cyst on the left side, asymptomatic at all. A non exhaustive survey of literature confirmed the iliopsoas synovial bursa is uncommonly pathologic, but a constant natural formation in man. Pathology occurs only in over sixty years old adults. This case seems to be the first pediatric case. The cyst of the psoas bursa is generally revealed by an inguinal swelling; abdominal growing is rare. Imaging with ultrasonography, computed tomography and RMI such as in this case, showed the cyst issued between the coxofemoral joint and the iliac psoas terminal tendon. It can grow in a retroperitoneal way. Pathogenic hypothesis are debated. In this bilateral case, etiology evoke an anatomic anomaly, in relation a joint communication.
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Ultrasonography investigations of retroperitoneal tumors in children were conducted in 25 cases: 11 nephroblastomas, 11 neuroblastomas, 2 ganglioneuromas, and 1 rhabdomyosarcoma. Ultrasonographic exploration of such tumors should include analysis of the mass: echostructure, limits, interfaces and dimensions, and analysis of its extension. The latter should determine the position in relation to the median line, the condition of the large vessels (inferior vena cava and aorta), the homolateral renal cavities and the contralateral kidney, and the presence or absence of glandular spread and hepatic metastases. The semiology of each of these elements is described and discussed, to determine their individual diagnostic value.
The authors report 5 cases of bronchial cysts of the carina tracheae in girls. Symptomatic cysts were located on the left. Diagnostic delay was often very long: about 2 years between the first signs and surgery. When the cyst was on the left side, it was not directly visible on standard x-ray films or tomographies of the chest. Barium swallow shows a typical compression on the anterior part of the esophagus. In children with relapsing atelectasis or over distension, localized on the left, CT scan might allow for earlier diagnosis, as the density of bronchial cysts in high: about 50 Hounsfield units.
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The case of a 5 month old female infant with respiratory problems since birth in the form of a recurrent right pneumonia, associated with slight pulmonary arterial hypertension. Persistence of a paramediastinal opacity suggestive of a right upper lobe atelectasis led to bronchography being performed which revealed a bronchus implanted into the right side of the trachea. At operation there were two abnormalities: --an azygos lobe represented by the apical segment of the right upper lobe; --a tracheal bronchus, apical segmental apical, ventilating this territory. Simple disenclavement of the parenchyla and pleuroplasty led to regression of the respiratory disturbances. The special feature of the case lay in the rarity of an azygos lobe ventilated by a tracheal bronchus. The azygos lobe results from an abnormality in the topography of the arch of the azygos vein which draws the parietal pleura with it, forming a mesoazygos. It is not a supernumary lobe. Abnormalities of bronchial implantation are located above all along the right side of the trachea (tracheal bronchi) and correspond in most instances to ectopic positioning of a segmental bronchus of the upper lobe, as in the present case.
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The authors describe a new observation of a congenital aerobiliar fistula in a newborn infant showing choleptysies associated with a pulmonary obstruction. The most remarkable facts are the presence of a radiological pneumogallbladder, and the existence of a real trifurcation of the trachea on the bronchography, associated with a choledocal hypoplasia. The death having occured before the operation, the autopsy allowed the confirmation of the termination on the left hepatical duct and the duality of conformation of the fistula, respiratory and biliary. On the occurence of this 9th case, a review of the literature shows the stereotyped nature of the clinical signs and the course of the fistula which seems invariable. The different aspects of the malformation are considered as well as the treatment which necessitates an exeresis by thoracic pathway.
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