[Primary biliary peritonitis]. / Les péritonites biliaires primitives.

PURPOSE: The purpose of this study was to debate the epidemiologic and clinical features of primitive biliary peritonitis (PBP) as much as a rare pathology; and especially to obtain a more comprehensive view of factors associated with a severe prognosis. METHOD: It is a retrospective survey of 15 patients, collected from 2000 to 2003. Only primitive biliary peritonitis has been included. RESULT: It is a series of 15 patients, 6 men and 9 women, with a mean age of 62 years. Biliary lithiasis was incriminated in 14 cases. Clinical picture was an acute peritonitis in every case. Six patients were operated on by median incision, the others by costal one. The death rate is of 26,6%, all death were a direct complication of PBP. Factors associated with a higher mortality are an IGS II score superior or equal than 31 and a number of organ failures superior or equal to 3. CONCLUSION: PBP is a rare and severe pathology that concerns aged women. Biliary lithiasis is the main etiology. Treatment is essentially surgical, in association with active per-operative resuscitation.

[Superior mesenteric artery aneurysm revealing a Behçet disease: a case report]. / Anévrisme de l'artère mésentérique supérieure révélateur de la maladie de Behçet: a propos d'un cas.

Arterial involvement in Behçet's disease is rare. It represents one of the fashions of expression of this pathology. We report an observation of a 32-year-old man who was hospitalised for an intense abdominal pain. Doppler ultrasound and computed angiography showed a superior mesenteric artery aneurysm. The patient was operated in urgency and operating suites were simple. The etiologic inquiry of this aneurysm ended in the diagnosis of Behçet disease. The result underline the need to search for Behçet's disease in all cases of arterial involvement in young patient. The treatment of the aneurysm should not be delayed.

[Abdominal actinomycosis. Three cases]. / L'actinomycose abdominale. 3 observations.

BACKGROUND: Abdominal actinomycosis is a suppurating affection caused by a positive Gram germ, Actinomyces israelii. Manifestations of this rare disease are usually pseudotumoral syndromes leading to surgical exeresis. The diagnosis is obtained from the histologic report. CASES REPORT: We report three cases in all of which this disease presents with tumoral symptoms. The first affected the sigmoïd, the second affected the mesentery and the last affected the greater omentum and abdominal wall. In no case, the diagnosis was done before surgery. In 2 of the cases reported here, the patients had an old, incontrolled intra-uterine device. DISCUSSION: From a review of the literature, we observed that the diagnosis of abdominal actinomycosis remains difficult. The radiologic findings are nonspecific. Actinomycosis is treated with prolonged antibiotics, and surgery is only needed in abdominal abscess and fistula. CONCLUSION: Theses observations illustrates the difficulties of the diagnosis of this rare unrecognized disease.