[Duodenal tuberculosis: a difficult diagnosis]. / Tuberculose duodénale: un diagnostic difficile.

BACKGROUND: The polymorphous clinical presentation of tuberculosis located in the duodenum may mislead diagnosis. CASE REPORT: A 69-year-old man had duodenal stenosis associated with calculous common bile duct obstruction. Crohn's disease was initially diagnosed and the patient was treated with corticosteroids. Two months later, the diagnosis was rectified when pulmonary tuberculosis developed. DISCUSSION: This case emphasizes the lack of specific clinical, radiological, endoscopic and histological signs of duodenal tuberculosis.

[Successive cancers of the colon and rectum]. / Cancers successifs du côlon et du rectum.

The incidence of successive cancers of the colon and rectum varies from 1.4% to 5.1%. Among 350 malignant colorectal tumours operated in our unit, there were 7 cases of successive cancers (2%). The mean interval between the discovery of the first and second cancer was 4.9 years with a range of 1 to 10 years, 3 cases before 2 years and 4 cases after 5 years. The diagnosis of the second cancer was made by coloscopy in 4 cases and was revealed by rectal bleeding in 4. CAE level was unchanged in all 7 patients and was not contributive to diagnosis. At diagnosis of the first cancer there were 5 intraparietal tumours including 2 with lymph node dissemination. At diagnosis of the second cancer, there were 5 cases of intraparietal tumours with 1 lymph node extension. An association with benign polyps was observed in 2 of the 7 cases at the first diagnosis and in 4 of the 7 at the second. Prophylaxy requires complete work-up with total coloscopy at the diagnosis of the first cancer. Segmentary colectomy is sufficient in patients over 65, but we prefer total colectomy in patients under 65.

[Leiomyoma and leiomyomatosis of the esophagus. Apropos of 2 cases]. / Léiomyomes et léiomyomatose de l'oesophage. A propos de deux cas.

The authors present two cases of leiomyoma of the oesophagus treated by enucleation. They review the literature on this subject and distinguish single leiomyomas (97%) from multiple leiomyomas (2.4%). The early diagnosis is based on endoscopy and oesophagogastric barium studies. Biopsies are controversial. Surgical treatment remains the general rule, but the anatomical extension may be slow so that surgical abstention with regular follow-up is justified in asymptomatic patients.