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The Polysplenia Syndrome (PSS) is a form of heterotaxy, a rare congenital anomaly with an estimated incidence of 1 in 250,000 live births, first described by Helwig in 1929. Most patients with polysplenia syndrome die during the neonatal period due to severe associated cardiac and biliary anomalies. Nevertheless, some individuals present with moderate cardiovascular malformations or abdominal anomalies, often discovered incidentally in adulthood. PSS is categorized under ambiguous situs syndromes or heterotaxy, also known as left or bilateral isomerism. However, it remains a complex and controversial entity, lacking specific pathognomonic features but exhibiting a broad spectrum of anomalies. We report the case of a 29-year-old woman admitted for acute chest pain, associated with lightheadedness and syncope. Clinical examination revealed tachycardia and tachypnea. A thoraco-abdominal CT angiography identified 3 splenules, auricular and bronchopulmonary isomerism, along with cardiovascular and digestive anomalies, suggestive of polysplenia syndrome. Symptomatic treatment was initiated, with a favorable clinical outcome and no need for specific therapeutic intervention., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Duodenal metastases from pulmonary adenocarcinoma are rare. Early detection, diagnosis, and treatment are crucial for improving the prognosis of patients with duodenal metastases from primary lung cancer, which often go unnoticed due to their low incidence and diagnostic challenges. Here, we present the case of a 64-year-old man with an unusual occurrence of duodenal metastases from pulmonary adenocarcinoma, admitted with symptoms of cholangitis. Radiological findings revealed a mass in the D2-D3 segments of the duodenum. Endoscopic ultrasound with biopsy was performed, and immunohistochemical analysis confirmed that the mass was a duodenal metastasis of pulmonary adenocarcinoma., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Lung hernias are rare. They are defined by the protrusion of lung parenchyma through a defect in the chest wall. A distinction is classically made between supraclavicular, thoracic or diaphragmatic hernias and congenital or acquired hernias. The latter can be classified by etiology as post-traumatic, postoperative, or pathological but can be spontaneous (even rarer) caused mainly by coughing efforts. The diagnosis is guided by the clinical presentation and confirmed by radiographic analysis, especially CT scan. The management, by conservative or surgical approach, depends on the clinical condition of the patient, the characteristics of the hernia and the existence or not of complications. We report the case of a 58-year-old patient, chronic smoker with no history of trauma, who presented with a chronic cough not improved by symptomatic treatment and in whom the clinical examination was without particularities. Chest CT scan showed discrete pulmonary emphysema with an intercostal pulmonary herniation at the level of the right fifth intercostal space associated with a bony outgrowth at the level of the middle arch of the right fifth rib. The pulmonary protrusion occurred through a parietal defect between the fifth rib and the bony protrusion. The management consisted of conservative treatment of the hernia with close clinical and radiological follow-up and medical treatment of the pulmonary emphysema and chronic cough associated with smoking cessation and hygienic and dietary rules., (© 2022 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)