[Medical decision in a very elderly patient: a case report of application of the Leonetti law in emergency medicine]

Advanced care decision in emergency medicine is difficult for the elderly. How to be fair, avoiding an unreasonable obstinacy? Based on the case of very old person, we show how an optimal management can be decided in accordance with the spirit of the law.

[Malignant hyperthermia: multifactorial events leading to a crisis]

This case-report focused on the occurrence of a crisis of malignant hyperthermia on a young biker (21 y.o.) victim of a severe traffic accident. This observation gives some key points: the delayed occurrence of the crisis after 4 hours of surgery, the multi-factorial events that triggered the crisis; the choice to perform a quick diagnosis through gene analysis in comparison to the standard tests of caffeine on a muscular biopsy. These different points are discussed with a proposal of algorithm in the situation.

[Ménétrier disease associated with a gastric adenocarcinoma. Apropos of 2 cases]

Two new cases of Menetrier's disease with gastric adenocarcinoma in two men aged 62 and 81 years, respectively, are reported. In both cases, the diagnosis was established by histologic examination of the operative specimen. Emphasis is placed on diagnostic difficulties and on the risk of malignant transformation of Menetrier's disease, which should be viewed as a precancerous gastric lesion.

[Rupture of a hydatid cyst of the liver into the peritoneal cavity. Value of computed tomography]

The authors report one case of a intraperitoneal rupture of an hydatic cyst. The diagnosis of rupture was performed pre-operatively by tomodensitometry which has demonstrated the rupture and an intraperitoneal epanchement.

[Cystic lymphangioma of the spleen. An exceptional site]

The authors report a case of cystic lymphangiomatosis of the spleen. Study of this case and a review of the literature confirm the rarity of this site and problems of differential diagnosis with hydatid disease. Treatment remains surgical and the prognosis is good.