[Treatment of rectal prolapse with elastic circling of the anus: Perspectives of utilization]. / Cure du prolapsus rectal par cerclage élastique de l'anus. Perspectives d'utilisation.

The Thiersch technique for treatment of rectal prolapsus has been largely abandoned because the metallic or non-resorbable wire is poorly tolerated and non-extensible. Silastic can fulfil these requirements and was used in 11 patients, including two who underwent reoperations. Good results were obtained in 9. This technique is simple and can be proposed when the general status of the patient does not allow surgical cure of the prolapsus.

[Adenoma of the choledochus]. / Les adénomes du cholédoque.

Two patients with signs of an obstructed main bile duct underwent surgery. Choleductectomy was performed followed by Mirizzi exploration. Extemporaneous pathology examination of the intra-ductal tissue revealed benign adenoma of the main bile duct. Resection of the main bile duct with hepato-duodenal anastomosis was performed in the first patient and resection with end-to-end anastomosis in the second.

[Choledochoduodenal fistula: an unusual complication of duodenal ulcer]. / Fistule cholédocoduodénale: complication rare de i'ulcère duodénal.

We report a case of choledochoduodenal fistula in a patient with a duodenal ulcer and poor compliance to treatment. The fistula tract was demonstrated on a plain abdominal X-ray (presence of air in the biliary tract), and was confirmed by a fistulography from the site of the ulcer (opacification of the bile duct). A Finsterer type 2/3 gastrectomy was performed in this patient, leading to the treatment of the ulcer and disappearance of the fistula following a gastrojejunal shunt of the duodenum. Clinical outcome was excellent.

[Endometriosis and diaphragmatic defect in catamenial pneumothorax]. / Endométriose et brèche diaphragmatique dans le pneumothorax cataménial.

Two cases of catamenial pneumothorax are reported, a rare condition characterized by its sudden occurrence in a female patient between the ages of 30 and 40 years, always at the onset of the menstrual cycle. Its exact origin is unknown, but the frequent co-existence of endometriosis and a defect in the diaphragm suggests that endometriosis may be important in the etiology both of the pneumothorax and the diaphragmatic lesion. Pelvic endometriosis was present in both our patients, one of whom also had diaphragmatic endometriosis. The treatment of the pneumothorax in both our cases consisted of pleural decortication with excellent results so far.

[Splenic localization of von Recklinghausen's disease]. / Localisation splénique de la maladie de von Recklinghausen.

The authors report about one case of splenic site in a polyvisceral involvement by von Recklinghausen's disease. This site was not found in the literature. Since it was impossible to confirm the benignancy of the lesions, the degenerative risks of which are well known, the authors carried out partial gastrectomy and splenectomy.

[Primary malignant melanoma of the small intestine]. / Mélanome malin primitif de l'intestin grêle.

The small intestine is a frequent site for metastases of cutaneous or ocular melanoma. When the latter are absent, the diagnosis of primary intestinal melanoma can be proposed. Primary malignant melanoma of the small intestine arises from melanoblastic cells of the neural crests, which migrate to the distal ileum through the omphalomesenteric canal. Incomplete regression of the later leads to persistence of Meckel's diverticulum. We report herein a case of malignant melanoma of the small intestine without evidence of a cutaneous and/or ocular origin. Based on its location in the distal ileum, we propose that this tumor be classified as a primary malignant melanoma of the small intestine.

[Isolated pulmonary choriocarcinoma]. / Choriocarcinome pulmonaire isolé.

The author report a case of isolated choriocarcinoma of the lung revealed in a young woman by a tumoral syndrome of the right base with haematoma. The diagnosis of isolated pulmonary choriocarcinoma was based on the lack of previous gynaecological history and tumour, on the singleness of the lung tumour at CT, and on the high initial beta-CGH level (3,300 ng/ml) in the absence of pregnancy. Surgical resection confirmed the diagnosis and lowered the beta-CGH level to 7 ng/ml. The various aetiopathogenic theories put forward and their relations with the prognosis disparity found in the literature are reviewed. The authors compare the prognosis of isolated pulmonary choriocarcinoma in a non-nulliparous woman to that of placental choriocarcinoma.

[Three cases of solid and papillary tumors of the pancreas in black women]. / Trois cas de tumeurs solides et papillaires du pancréas chez la femme de race noire.

Three cases of solid and papillary epithelial neoplasm of the pancreas are presented. These tumors occur more commonly in young patients with a predilection for young black females. They have a good prognosis allowing conservative surgery. The histological study of the specimens strongly suggests an endocrine tumor but all histological and immunocytochemical endocrine stains are negative. The ultrastructural study of these tumors has revealed the existence of borderline forms between these tumors and endocrine tumors.

[Leiomyosarcoma of the Meckel's diverticulum and multiple diverticulosis of the ileum. Apropos of a case]. / Léïomyosarcome du diverticule de Meckel et diverticulose multiple du grêle. A propos d'un cas.

We report a case of a leiomyosarcoma arising in a Meckel's diverticulum in a man of 90 years, with multiple ileal diverticulosis. The clinical picture was similar to acute appendicitis and diagnosis was not made until resection of an abdominal mass with histological appearance of leiomyosarcoma. 59 cases of leiomyosarcoma of Meckel's diverticulum have previously been reported in the literature. No case until now has been reported in a patient of Caribbean origin neither in association with ileal diverticulosis. Although rare, leiomyosarcoma is the commonest sarcoma of Meckel's diverticulum, and with full resection of the tumor the prognosis is very good.

[Anatomic pecularities of the inguinal canal in West Indians. Influence on the management of inguinal hernia]. / Particularités anatomiques du canal inguinal chez l'Antillais. Incidences sur la cure de hernie inguinale.

Inguinal and umbilical hernias are much more frequent in the black and half-breed than in the white population. We have observed anatomical differences in the inguinal region between Whites and Blacks. The latter have a vertical, wide subcutaneous ring and a smaller conjoined tendon, and it is hardly possible to reconstruct the fascia of the obliquus externus abdominis anterior to the cord in them. For Black patients, we propose the suture of the conjoined tendon to the crural arch, like in the Bassini procedure, and the suture of the fascia of the obliquus externus to the arch, but in a retrofunicular position. This technique allows, so to speak, duplicating the caudal connection of the conjoined tendon to the arch by means of the extensive suture of 2 tissues of similar nature, ie. the fascia of the obliquus externus and the crural arch.

[Endometriosis and ureteral stenosis. Apropos of 4 cases]. / Endométriose et sténose urétérale. A propos de quatre observations.

If endometriosis is particularly well known by Gynecologists, ureteral complications of this disease are very rare. We have had the occasion to observe four cases of ureteral stenosis by extrinsic compression of a pelvic endometriosis, and about these four cases, we have reviewed one hundred and fifty six cases in literature. We have emphasize that the fibrosis provoked by endometriosis can look like a neoplastic lesion, and get involved in very heavy therapeutic gestures. We insist on the fact that every endometriosis discovered should be on surgery of kidneys and ureters.

[Umbilical hernia and appendectomy]. / Hernie ombilicale et appendicectomie.

Results of 334 appendectomies carried out through the umbilical orifice are reviewed. Failures of treatment and complications of the method are reported while emphasizing that only 4 major complications occurred. When compared with the classical incision of right iliac fossa this procedure does not appear to provoke more risks and presents obvious esthetic advantages.

[Biliary peritonitis caused by perforation of the intra-hepatic biliary ducts. 2 new cases]. / Péritonites biliaires par perforation des canaux intra-hépatiques. Deux nouveaux cas.

Two cases of biliary peritonitis by perforation of intra-hepatic biliary ducts are presented. In both cases there is a perforation from a gallstone. In the first case the perforation is located at the proximal part of the left hepatic bile duct, in the second case it is at the proximal and distal portion of the third segment bile duct. Those peritonitis are rare and their diagnosis is difficult. Gallstone is the main cause. Removing bile duct obstruction is the treatment.

[Epiphyseal detachment of the proximal end of the tibia in a child with a vascular lesion. Apropos of a case]. / Décollement épiphysaire de l'extrémité supérieure du tibia chez l'enfant avec lésion vasculaire. A propos d'un cas.

The authors report a case of lesion of the popliteal artery associated with a fracture involving separation of the upper end of the tibia in a child following a serious accident. This lesion was treated by resection-vein graft after reduction of the fracture and immobilisation by two pins. In the light of this case, the authors undertake a review of the world literature, then assess the mechanism and the bone and vascular lesions, the various pathological classifications and the aetiologies. Finally, they emphasize the difficulty in diagnosing the bone lesion and, above all, the vascular lesion. Arteriography is indicated where there is the slightest doubt.

[Subacute ischemia of the lower leg caused by a popliteal synovial cyst. Apropos of a case]. / Ischémie subaiguë du membre inférieur par kyste synovial poplité. A propos d'une observation.

Based on the observation of a cyst compressing the popiteal artery, the authors discuss the characteristic clinical picture and radiology of this benign neoformation. They emphasize two possible causes: cystic degeneration of the arterial median or a cyst of articular derivation. Histological data from this observation supports the second hypothesis.