[Abdominal actinomycosis mimicking an abdominal tumor. Case report in Senegal]. / Actinomycose abdominale tumorale. Une observation au Sénégal.

The purpose of this report is to describe a case of abdominal actinomycosis (Actinomyces israelii) with a pseudo-tumoral appearance in a 57-year-old Senegalese woman.

[Epidemiological, therapeutic and prognostic aspects of breast cancer: about 473 cases collected in Hopital Principal de Dakar]. / Aspects epidémiologique, thérapeutique et pronostique des cancers du sein: a propos de 473 cas colligés a l'Hôpital Principal de Dakar.

INTRODUCTION: The aims of this study were to appreciate the epidemiological, therapeutic and pronostic aspects of breast cancer. This retrospective study was carried out in gynecology service in Hopital Principal of Dakar. We collected 473 cases of breast cancer over a period of 15 years, from January 1986 to December 2001. MATERIALS AND METHODS: Only the patients having a histological diagnosis were involued. The identification of patients, their medical history, their present complaints and the different treatment performed, were registred. The actuarial method of survival was used. RESULTS: The mean age of patients was 42.5 years; the average of parity was 4.7. The patients live in Dakar in 245 cases (51.7%). We had observed 279 cases (59.1%) diagnosed between six months and twelve months. Only 74 cases (15.8%) were diagnosed less than three months. In 282 cases (60%) the disease stage was T4N1Mx in TNM classification. In 425 cases (89.89) the histological type was infiltrate canal carcinoma. The surgery had concerned 441 patients (93.2%). And 52 of them (11%) underwent conservative treatment and 309 out of them (65.2%) underwent total mastectomy associated to axillary cleaning out like Patey method. Chemotherapy had been done in 426 cases (90%), hormonotherapy in 92 cases (19.4%) radiotherapy in 83 cases (17. 5%) and surgical costiation had been performed in 42 cases (8.8%). The overall survival at 15 years was (8.5%). CONCLUSION: According to the issues of other african series we found out that our patients were young at the time of the diagnosis, We think that early diagnosis and appropriated treatment must improve the prognosis of breast cancer. The mass screening politics must be involved.

[Appendicectomy in the tropics: prospective study at Hôpital Principal in Dakar]. / Appendicectomies en milieu tropical: étude prospective à l'Hôpital Principal de Dakar.

Acute appendicitis is the most common surgical indication in Africa. It is associated with higher mortality and morbidity than in industrialized countries. The purpose of this prospective 100 case study was to evaluate diagnostic, clinical and paraclinical features as well as surgical modalities especially with regard to approach and postoperative recovery in patients that underwent surgical treatment for appendicitic syndromes over a 9-month period at our institution. Analysis of study data confirmed that surgical indications could be established based on clinical examination alone and that adjuvant investigations only delayed therapy while providing little specific, useful information. Delayed management is a specific feature of tropical areas. Surgical exposure was achieved by the MacBurney approach in 65% of cases, celioscopic approach in 18%, and median laparotomy in 17%. The benefit of the celiosocopic approach was statistically signicant in terms of resumption of eating, duration of hospitalization and incidence of postoperative complications. Mortality in this series was 0% and morbidity was 7% mainly due to parietal complications.

[Continent esoduodenal intubation after total gastrectomy for cancer. An African experience apropos of an initial series of 17 cases]. / L'intubation oeso-duodénale continente après gastrectomie totale pour cancer. Expérience africaine à propos d'une série préliminaire de 17 cas.

On the basis of a series of 17 cases in which GI continuity was restored by a containing esoduodenal intubation, the authors describe the technique, which consists in the approximation of the duodenum opposite the diaphragm. Esophageal intubation in the duodenum, the margins of which have been everted, allows preserving the physiological circuit, producing a new container within 3 months and ensuring an effective protection against reflux. The 17 patients had undergone total gastrectomy for advanced cancer, Gutman's stage II in 80% of all cases and stage III or more in the other 20%. 88% of the tumors were adenocarcinomas. There were no clinical or radiological signs of reflux, and no esophagitis was noted on repeated endoscopies. The postoperative mortality rate was 5.8%. The shortest time lapse is 1 year.