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Introduction: Venous thromboembolism (VTE) poses a significant challenge in cancer patients, particularly those with advanced malignancies. The management of recurrent VTE is complicated by the need for effective anticoagulation while addressing the underlying cancer progression., Cases: We present two clinical cases from the gastroenterology department at Percy French military hospital involving patients with progressive malignant digestive diseases. Patient 1, a 62-year-old woman, developed recurrent pulmonary embolism despite appropriate anticoagulation with low molecular weight heparin (LMWH). After treatment adjustments, she ultimately succumbed to tumor progression. Patient 2, a 54-year-old man hospitalized for pulmonary embolism, faced upper gastrointestinal bleeding and delayed anticoagulation initiation. Although he showed initial improvement with immunotherapy and stabilization of thrombotic events, he experienced oncological progression and recurrent VTE, leading to palliative care., Discussion: These cases illustrate the difficulties of managing recurrent VTE, even with curative anticoagulation and dose escalation. In case of VTE recurrence, it is essential to investigate for cancer progression and ensure patient adherence to treatment. A comprehensive management strategy should involve both the malignancy and the thrombotic complications., Conclusion: The management of recurrent VTE in cancer patients requires a multidisciplinary approach to evaluate the benefit-risk ratio of anticoagulation adjustments. These clinical cases highlight the necessity for integrated care that addresses both oncological and thrombotic concerns, emphasizing the importance of timely intervention and collaboration among healthcare providers., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Glomous tumors are rare and benign, generally affecting the fingers. Other localizations have nevertheless been described. We report the case of a patient who presented a supra-patellar glomous tumor provoking a pain-induced limp. Magnetic resonance imaging confirmed the diagnosis. The patient underwent complete surgical resection of the tumor followed by total resolution of the pain. Glomous tumors in an atypical localization may go unnoticed, with the risk of late or erroneous diagnosis. Symptoms are easily resolved with simple resection., (Copyright © 2019. Published by Elsevier Masson SAS.)

Accidental foreign body ingestion by children is not exceptional and occurs in most cases in children less than 5 years old. The impact is not well known. We present the case of a 31-month-old boy affected by peritonitis caused by several bowel perforations after swallowing three magnets at different times. A single foreign body magnetic ingestion does not often cause trouble, but if the ingestions are spaced out, then consequential complications can occur. This is why, in case of stomachaches in a child less than 3 years or a child with behavior problems, it is important to perform standard abdominal X-ray examination., (Copyright © 2012. Published by Elsevier SAS.)

When listening to speech in everyday-life situations, our cognitive system must often cope with signal instabilities such as sudden breaks, mispronunciations, interfering noises or reverberations potentially causing disruptions at the acoustic/phonetic interface and preventing efficient lexical access and semantic integration. The physiological mechanisms allowing listeners to react instantaneously to such fast and unexpected perturbations in order to maintain intelligibility of the delivered message are still partly unknown. The present electroencephalography (EEG) study aimed at investigating the cortical responses to real-time detection of a sudden acoustic/phonetic change occurring in connected speech and how these mechanisms interfere with semantic integration. Participants listened to sentences in which final words could contain signal reversals along the temporal dimension (time-reversed speech) of varying durations and could have either a low- or high-cloze probability within sentence context. Results revealed that early detection of the acoustic/phonetic change elicited a fronto-central negativity shortly after the onset of the manipulation that matched the spatio-temporal features of the Mismatch Negativity (MMN) recorded in the same participants during an oddball paradigm. Time reversal also affected late event-related potentials (ERPs) reflecting semantic expectancies (N400) differently when words were predictable or not from the sentence context. These findings are discussed in the context of brain signatures to transient acoustic/phonetic variations in speech. They contribute to a better understanding of natural speech comprehension as they show that acoustic/phonetic information and semantic knowledge strongly interact under adverse conditions., (Copyright © 2010 Elsevier Inc. All rights reserved.)

Mixed epithelial and stromal tumour of the kidney (MESTK) is a rare kidney neoplasm that occurs almost exclusively in perimenopausal women. Long-term oestrogen replacement appears to play a major role in its pathogenesis. Around 70 cases have been described in the international literature, none of which involve male children. Herein, we describe an atypical case of MESTK diagnosed in a 12-year-old prepubertal boy who presented with hematuria. Pathology and immunohistochemistry revealed a typical MESTK. The child was free of disease at 2-year follow up after a partial nephrectomy and tumour excision., (Crown Copyright (c) 2009. Published by Elsevier Ltd. All rights reserved.)

Neonatal splenic injury is a rare but serious condition, due to the risk of haemorrhagic shock. We report on the case of a newborn infant with a neonatal respiratory distress that first evoked materno-fetal infection. Clinical deterioration, with anemia and abdominal distension, led then to the proper diagnosis. Dystocia seems to be the most likely cause of the splenic rupture in this report. Medical treatment is advocated as first line, while surgical treatment may be necessary in some cases. In the case surgery is inevitable, a conservative approach is preferable.

Intestinal perforations in preterm newborn are characterized with high morbidity and mortality rates. They often are associated with necrotizing enterocolitis and seldom correspond to idiopathic spontaneous intestinal perforation. Perforations upstream of an intestinal organic obstruction (atresia), or of a functionnal obstruction (meconium-ileus, Hirschsprung disease) have been considered to be rare in preterm newborns. We report a case of caecal perforation with a pneumoperitoneum which occurred at 5 days of life, in a 28-week gestational age infant, that was treated by cecostomy. There were no signs of necrotizing enterocolitis. At 43 days of life, the preoperative contrast enema study revealed a left colon transition zone, suggesting a Hirschsprung disease, which was confirmed by rectal biopsies. Transanal pull-through was performed. There were no postoperative complication. This case demonstrates that an isolated intestinal perforation in very preterm newborn can reveal a Hirschsprung disease, especially if it occurs in the caecum.

Background: Intussusception due to lymphoma is a challenging condition for pediatric surgeons. The aim of this study is to report seven cases of this entity and to discuss its management., Case Report: Six boys and one girl, 3-15-years-old, were admitted for intussusception secondary to a lymphoma. All patients underwent laparotomy: biopsy of massive abdominal tumor 6 and 8 weeks following resection of an intussusception (two cases), ileal resection of non-reductible intussusception (one case), right hemicolectomy for tumor of the appendix (one case), tumorectomy of localized ileal tumor (two cases), enlarged mesenteric lymph node biopsy associated with simple reduction of intussusception (one case). All children were successfully treated with protocol chemotherapy with a 15-month to 13-year follow-up. No relapse was observed., Conclusion: Surgeons should be aware of operative sights of ileal lymphomas. Diagnosis of lymphoma may be difficult after manual reduction of intussusception. A sample of any abnormality (mesenteric lymph node, peritoneal fluid) should be taken. Intestinal resection allows to reduce the intensity of chemotherapy but must be as limited as possible: ileal resection in cases of complicated intussusception, tumorectomy "in sano" in cases of ileal parietal isolated tumor. Reduction of intussusception alone (with no resection of ileal tumor) seems to be effective if diagnosis of lymphoma is possible from peripheral samples (peritoneal fluid, pleural effusion, mesenteric lymph node, bone marrow biopsy...).

Background: Jejunal intussusception is uncommon in comparison with ileocolic form. It is more frequent in children over 2 years of age and has an atypical subacute presentation. An underlying anatomical cause is usually found., Case Report: A 14-year-old boy was admitted for abdominal pain with bilious vomiting. The physical examination was normal, with only the ultrasonography showing an intussusception in the left hypochondrium. At laparotomy the diagnosis of jejunal intussusception was made; its reduction was impossible. A resection and end to end anastomosis was performed. The anatomopathology examination found a polyp in ectopic gastric mucosa., Conclusion: Jejunal intussusception must be better understood as its diagnosis could be made too late. Surgical exploration is the treatment of choice because of the usual underlying anatomical cause.