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Three cases of symptomatic right-to-left interatrial shunt through a patent foramen ovale were detected in the course of a case of paradoxical embolism related to a massive pulmonary embolism, a case of refractory hypoxemia after cardiopulmonary bypass and a case of refractory hypoxemia in a patient with tricuspid endocarditis. According to anatomic studies, the incidence of patent foramen ovale is 25-30% in healthy people. In that case any pathological event generating an increase in the right atrial pressure higher than the left atrial pressure may induce a right-to-left shunt with systemic arterial desaturation and possible paradoxical embolization. The reported cases emphasize the advantage of ultrasonic examinations (contrast sonocardiography, pulsated or coloured Doppler) to show the right-to-left atrial shunt. The demonstration of this acquired shunt requires appropriate measures in order to reverse the atrial gradient. Sometimes a specific therapy is required such as caval filter insertion in case of pulmonary embolization or surgical closure of foramen ovale in some patients.

A case of ruptured false aneurysm of the left common artery is reported, in which intra-operative haemostasis of the left internal artery proved particularly difficult. Permanent haemostasis was achieved by inserting an inflatable balloon intraluminally at the origin of that artery and leaving it in situ.

In the few cases of incisional hernia consecutive to transverse laparotomy the classical approximation of the rectus muscles cannot be performed due to the presence of transverse fibrotic scar tissue. An original technique using 4 aponeurotic quadrants cut out of the anterior surface of the rectus sheaths is described.

Transdiaphragmatic pericardio-peritoneal shunt is an effective answer to the problem of recurrent pericardial effusion. The EEA (end to end anastomosis) stapler is a perfect tool for this technique, being easy to handle and offering the possibility of a pathological examination of the pericardic fragment removed. Five patients underwent this type of surgery with satisfactory results on a 3 to 29 months' follow-up.

A series of 99 cases of injuries of the extensor system, followed in the 3 Traumatology and Orthopedics Ward (Dijon, France) is presented. Results were analyzed according to Verdan's classification. In most cases, a Jenning "barb-wire" type repair, introduced in France by Y. Allieu, was made. Early mobilization and skin tension problems are emphasized; two cases of degloving on the dorsum of the hand are presented with details. As well, a special place concerning the results of repair in the proximal interphalangeal joint must be reserved, because of the very frequent association of articular destruction and the very difficult problem s of surgical management which arise in these cases.