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Background: Symptomatic pleural effusion following ventriculoperitoneal shunt (VPS) insertion is very rare and poorly understood in the literature in contrary to other mechanical complications. Case Description: We report a case of 15 month-year-old girl who had VP shunt for congenital hydrocephalus. Twelve months after surgery, she was diagnosed with massive hydrothorax. Chest X-ray and thoracoabdominal CT scan confirmed the right pleurisy and showed the tip of the peritoneal catheter in the general peritoneal cavity. We made thoracic drainage of the transudative pleural effusion. When we released the chest tube, 24 h after, the girl showed a respiratory distress again and the effusion resumed at the X-ray control. Her symptoms abated after the realization of a ventriculoatrial shunt “VAS.” Repeat chest X-ray confirmed the resolution of the hydrothorax. Conclusion: Despite the not yet well-understood mechanism of this rare and important VPS complication, management is simple based on X-ray confirmation, thoracentesis with biological analysis, and catheter replacement, especially in atrium “VAS.”

In current depressed oilfield industry environment, economical and operational effectiveness becomes even more important especially in complicated, challenging projects that demand large investments and simultaneous utilization of multiple technical services. In Petroleum Development Oman (PDO), there are a few gas fields having similar downhole conditions with multiple target pay zones, whereas fracturing operations are complicated by the requirement of CT cleanouts and/or milling in between the stages. Multizonal and multistage frac operations are commonplace in oil and gas reserves around the globe, however despite of increased number of wells stimulated using specialist multistage completion equipment, the most often utilized completion design for this operation is still plug and perf, especially in vertical wells. There are also techniques on the market involving coiled tubing for perforation and isolation between the stages, however they have their own constraints and limitations, especially in high-pressure and high-temperature environment. For PDO wells, multistage completion technologies were not feasible, therefore conventional plug & perf approach had been selected as the optimum option. The main drivers behind this selection are the challenges associated with precise deployment of the completion jewellery across small pay zones and limited coverage of the target zones when using frac sleeves. Another constraint in the past was the pressure rating of the multistage completion systems existed on the market. Plug and perf completions are designed to allow pinpoint placement of isolation and reservoir access with on the fly adjustability. This means that there is more freedom in selecting desired perforation interval, plug-setting depth and no additional restrictions on the pumping rates that are incurred by CT string inside the tubing as in some of the popular techniques. The zonal isolation is the portion of the design that allows the frac treatment to address the target intervals without affecting the others. In operations requiring 15k+ differential pressure ratings, isolation becomes extremely challenging and requires robust and reliable technology to ensure true integrity so stimulations can be placed as per design. This challenge may get even worse with increasing temperatures, whereas conventional composite compounds are not applicable due to "swelling", or getting softer. The primary job of the frac plug is to isolate but operational safety and millability also must be taken into consideration for the overall efficiency of a completion design. Additional challenges in the target fields are the depletion of the zones and their extreme breakdown pressures that are not only exposing frac plugs to extreme differential stresses but also causing difficulties during milling operations, whereas maintaining balanced circulation becomes a primary task in order to prevent coiled tubing differentially or mechanically sticking in the wellbore. That is adding another requirement for the frac plugs - be easily millable and produce as small cuttings as possible to improve debris removal. The high pressures, high temperatures, aggressive fluids and long exposure time seen by isolation plugs in these frac operations had been a challenge for current treatment and completion designs due to availability (and reliability) of equipment and tools represented on the market, therefore Petroleum Development Oman and the frac service provider collaborated to engineer a successful solution. It involved multiple steps, such as development of the specific design requirements, integrity-testing criteria and field trials before the plug could be adopted for wide application. The target design was a plug with a ~3.45" maximum OD, having true 15k+ differential rating at ~400F+. This composite/metallic hybrid plug was supposed to be able to withstand the harsh downhole environment seen in the various PDO fields in Oman land operations and resolve multiple complications associated with well interventions in these fields.

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Introduction: Solitary plasmacytoma is a malignant plasma cell tumor that is much rarer than multiple myeloma. The location in the vault of plasmacytoma is extremely rare. We report the case of a plasmacytoma of the cranial vault in a 53-year-old adult. Observation: A 53-year-old man consulted for tinnitus, left hypoacusis and trigeminal neuralgia of the left V2 and V3, which had been evolving for one year and was aggravated one month later by the appearance of a left temporal swelling with decreased visual acuity on the left. The MRI confirmed the existence of a lesional process of the temporal vault, in T1 iso signal, T2 hypersignal and flair, intensely and heterogeneously enhanced after injection of gadolinium. Anatomopathological study revealed a solitary temporal plasmacytoma, which was referred to oncology for further management. Discussion: Plasmacytoma is defined as an isolated malignant plasma cell tumor without clinical, biological, or radiological signs of Myeloma. Craniocerebral localization is rare and constitutes only 0.7% of all solitary plasmacytomas. Conclusion: Cranial plasmacytoma is a rare tumor that should be investigated for associated myeloma. Although the imaging appearance is not very specific, plasmacytoma should be considered in the differential diagnosis of any invasive lytic lesion of the cranial vault.