[Iatrogenic paratesticular fibrous pseudotumor]. / Pseudotumeur inflammatoire paratesticulaire iatrogène.

Authors report a case of probably iatrogenic paratesticular fibrous pseudotumor. A 33-year-old man presented with a history of increased scrotal volume after laborious urethral catheterism. Ultrasound scanning first suggested testicular malignant lesion. Surgical findings showed thick and fibrous scrotal wall surrounding a pseudocystic cavity which contained urine coming from a bulbar urethral rupture. Testicles were normal. Urethral suture and total excision of the scrotal mass were performed. Diagnosis was histologically corrected. Diagnosis and management are discussed with a review of the literature.

[Chronic dysphagia in a patient from Madagascar]. / Dysphagie chronique chez un Malgache. Un dentier incrusté dans loesophage.

While esophageal foreign bodies are a common occurrence, late discovery is rare. The purpose of this report is to describe an unusual case in which a set of dentures lodged in the thoracic esophagus was discovered and surgically removed 15 years after accidental ingestion. Inadequacy of health care in remote regions of Madagascar accounts for this clinical case. Diagnosis and management of esophageal foreign bodies are discussed.

Deux observations de syndrome canalaire du membre superieur d'etiologie exceptionnelle

Les syndromes canalaires du membre superieur couvrent des pathologies variees. Les manifestations vasculaires au cours de ces syndromes sont rares mais graves. Nous rapportons deux cas atypiques d'etiologie exceptionnelle; dont un cas du syndrome de canal carpien provoque par une tumeur de type rhabdomyosarcome alveolaire; de la partie distale de la face anterieure de l'avant bras et un cas de syndrome de la traversee cervico-thoraco-brachiale du a une exostose de l'extremite superieur de l'humerus. Notre objectif est de rapporter ces deux cas et de realiser une revue de la litterature sur les aspects clinique et therapeutique de ces affections

Rupture vesicale du post partum; a propos d'un cas

La rupture secondaire vesicale intra peritoneal du post partum est rare. Nous rapportons une observation inhabituelle chez une femme de 25 ans qui etait adressee pour douleur abdominale aigue. Cinq jours auparavant; elle presentait un accouchement dystocique d'une grossesse menee a terme. Elle presentait une occlusion intestinale aigue du grele mecanique. L'abord median sus et sous ombilical permettait d'objectiver une rupture vesicale intra peritoneale et de traiter la lesion par suture en deux plans sous couvert d'une sonde uretro vesicale. La lesion vesicale etait parvenue au cours d'un accouchement dystocique sur vessie pleine. Une verification systematique du bas appareil urinaire apres toute intervention obstetricale laborieuse permet d'evoquer le diagnostic

[Case report of solitary breast cysticercosis in Madagascar]. / Une observation de cysticercose mammaire isolée à Madagascar.

The purpose of this report is to describe a case of solitary breast cysticercosis presenting as a banal breast lump in a 15-year-old girl. Surgical excision was performed and histological examination demonstrated the presence of two Cysticercus cellulosae larvae. Characteristic features of this uncommon location are discussed based on a review of the literature.

Large Adrenal Pseudocyst. Report of a Case

Authors report a case of large adrenal pseudocyst in a 53 year-old woman. A voluminous abdominal mass with malnutrition and dehydration symptoms were found. Surgical excision was difficult but complete after 6L fluid aspiration. Histologic examination showed fibrous and inflammatory cystic wall with groups of adrenal cells. No epithelial lining was present and the diagnosis of adrenal pseudocyst was made. Pathogenesis; histology; diagnosis and management were discussed

Hamartome sebace pseudo-tumoral a l'age de deux mois?

L'hamartome sebace est une malformation congenitale interessant habituellement l'extremite cephalique. Il ne regresse jamais et peut degenerer a l'age adulte en epithelioma baso-cellulaire. Nous en rapportons un cas chez un nourrisson de deux mois qui presentait des lesions tres etendues et de localisation atypique au niveau de l'hemicorps. Les aspects clinique et histologique observes etaient de type adulte. Une chirurgie d'exerese etait entreprise au niveau cephalique devant le probleme esthetique et du caractere tumoral des lesions

Pancreas ectopique; cause inhabituelle d'une invagination intestinale aigue

Un pancreas ectopique a l'origine d'une d'invagination intestinale est rare. Nous en rapportons un cas chez une femme de 33 ans qui avait presente une occlusion intestinale aigue du grele. L'exploration chirurgicale en urgence montrait une invagination ileo-ileale dont l'origine etait une tumeur grelique de 1;5cm de diametre. L'histologie concluait en un ilot pancreatique ectopique. Les suites operatoires etaient simples. Les aspects epidemiologiques; diagnostiques et therapeutiques sont discutes

Teratome intra pulmonaire. A propos d'un cas

La localisation intra pulmonaire des teratomes est inhabituelle. La forme maligne de cette pathologie constitue une eventualite rare et particuliere des cancers du poumon. Nous rapportons un cas de teratome intra pulmonaire de forme maligne chez une femme de 52 ans. Notre objectif; a travers ce cas; est de faire connaitre cette pathologie et de realiser une revue de litterature afin de soulever les aspects clinique; therapeutique et evolutif

[Anal adenocarcinoma revealed by a fistula-in-ano. Report of a case]. / Fistule périanale révélatrice d'un adénocarcinome du canal anal. A propos d'une observation.

Anal adenocarcinoma revealed by a fistula-in-ano occurs rarely. Authors report a case in a 56 year-old man. The pathogeny is still unknown. Symptomatology has no specificity and the diagnosis is often late, in an advanced stage of the sickness. Recurrent or non recurrent fistula-in-ano requires multiple biopsies for pathology analysis in order to screen a related cancer. Tumor dimension, lymph node involvement, histologic grade and treatment modality are independent prognosis factors for survival. Our objective is to show physiopathological, clinical and therapeutical characteristics from a review of the literature.

[Seromuscularis rupture of the oesophagus after vomiting: a rare cause of hemothorax]. / Rupture séro-musculeuse de l'oesophage après vomissement: une cause rare d'hémothorax.

We report a case of seromuscularis rupture of the oesophagus occurring after an episode of vomiting and revealed by a left hemothorax. Diagnosis was established at thoracoscopy and was related to the nosologic setting of post-emetic syndromes. All unusual pleuropulmonary symptoms after vomiting must make evoke this diagnostic hypothesis.

[A case of acute gastric volvulus in a child]. / Un cas de volvulus aigu de l'estomac chez l'enfant.

Gastric volvulus is an abnormal rotation of the stomach around its axis. The acute form is a surgical emergency, which doesn't tolerate any therapeutic delay. We report on a case in a young girl, revealed by painful epigastric mass and distended gastric bubble on abdominal X-ray. This case was been successfully treated by detorsion and gastropexy. The clinical picture of gastric volvulus is characterised by the Borchardt triad of symptoms: upper abdominal pain, vomiting and difficulty to pass a nasogastric tube. The gastrointestinal barium series and CT-scan help to confirm the diagnosis. As was demonstrated in this case, the treatment is surgical by reducing the volvulus and fixing the stomach to prevent recurrence.

[A case of Klippel-Trenaunay-Weber syndrome of the hand: description and review of the literature]. / Un cas de syndrome de Klippel-Trenaunay-Weber de la main: description et revue de la littérature.

We report the first malagasy case of a 10 years-old child with a Klippel-Trenaunay-Weber syndrome. The patient presented with cutaneous hemangioma, varicosities and unilateral hypertrophy of soft tissues of the left hand. Arteriovenous fistula was findings by the echo-doppler. Ligature of the fistula was performed.

[Children's strangulated inguinal hernia]. / Les hernies inguinales étranglées chez l'enfant.

The inguinal hernia, malformations caused by persistence of peritonea-vaginal duct, is frequent in children. It is a benign affection as long as it is not strangled. During our five-year-retrospective study, we have found 32 cases (30 boys and 2 girls) of strangled inguinal hernia. There are 78,12% of cases under five years old. In 54%, the hernia was on the right side. Malnutrition and inguinoscrotal hernia are very exposed to strangulation. We observed obstruction syndrome in 81,25% of cases. We have to deplore one case of scrotal fistulae by intestinal necrosis and two cases of testicle necrosis. For all of our patients, the peritonea-vaginal duct was closed with ligature, associated with pre-funicular parietal refection. One case of recurrence is found in postoperative time.

[Two cases of breast tuberculosis in Madagascar]. / Deux observations de tuberculose mammaire a Madagascar.

Breast tuberculosis is rare. It usually involves young women of childbearing age. The purpose of this report is to describe two cases of breast tuberculosis observed in Madagascar with focus on epidemiological, clinical, and therapeutic features. Infection of the breast is usually secondary by lymphatic, contiguous, or, more rarely haematogenous spreading. Primary infection is uncommon. The most frequent clinical form is the fistulised nodular form observed in both patients described in this report. The diffuse form is the least common form and the sclerous form occurs in the elderly. Histology is a valuable diagnostic tool if bacteriological findings are inconclusive. Patients respond favourably to antimycobacterium treatment with or without surgery.

[Spontaneous gastric perforation in a neonate. A case report]. / Perforation gastrique néonatale spontanée. A propos d'un cas.

Gastric perforation in the neonate is rare. The authors report a 3-day-old male infant, born through a normal delivery after an uncomplicated pregnancy, who presented with a sudden gross distention of the abdomen followed by respiratory distress. Abdominal X-ray examination showed a massive pneumoperitoneum. After a brief resuscitation, an isolated perforation of the stomach was discovered on laparotomy and was sutured. Outcome of spontaneous gastric perforation in newborns is favourable provided the disease is early recognised and treated.

[A case of anal Burkitt's lymphoma]. / Une observation de lymphome de Burkitt à localisation anale.

Burkitt non hodgkin lymphoma affects children and young adults. It is endemic in tropical Africa and it has especially facial and abdominal localisations. We report a case of anal localisation in a 22 years-old man, human immunodeficiency virus (HIV), negative aiming to show clinical, therapeutical and evolutive particularities of this exceptional localisation. Only two cases were reported but in HIV positive patients. Perianal abscess was first evoked, but per-operatory findings and histology rectify the diagnosis. Without chemotherapy, the "natural" evolution was rapidly fatal. Despite the efficacy of nowadays protocols, showing 80% of recovery, this observation illustrates the difficulty of malignant affection's management in developing countries caused by diagnostic delay and high cost of chemotherapy.

[A case of giant malignant adrenocortical carcinoma]. / Une observation d'un volumineux corticosurrénalome malin.

Adrenocortical carcinoma is a rare disease. We report here a case of huge adrenocortical carcinoma. The aim of this study is to show the presence of this pathology in Madagascar despite its rarity, and the different steps undertaken for its diagnosis, treatment and evolution. A huge right adrenocortical carcinoma was incidentally diagnosed in a 42 year old man by ultrasonography and confirmed by computed tomography. The right adrenalectomy followed by an Op'DDD treatment gives good results in a short term. This case gave us the evidence of the usefulness of ultrasonography as a first intention investigation and the computed tomography as the only way to confirm the diagnosis. However, we can only rely on the histological findings even if the borderline between benignity and malignity is sometimes debatable. Open adrenalectomy is the main treatment, completed with an Op'DDD therapy whose efficiency is doubtful. The evolution is uncertain and the prognosis is poor.

[Bartholin gland tuberculosis: a case report in Madagascar]. / Bartholinite tuberculeuse: une observation à Madagascar.

Female genital tuberculosis is relatively frequent in developing countries. Most cases occur in young women of childbearing age. The most common locations are the tubes, endometrium, and ovaries. Bartholin gland involvement is rare. The purpose of this report is to present a case of Bartholin gland tuberculosis in a 50 year-old woman and to describe the special epidemiological, clinical and therapeutic features associated with this location. Bartholinitis develops insidiously until spontaneous fistula formation. The lesion then gradually assumes a vegetative appearance that persists despite antibiotic treatment. Diagnosis requires biopsy findings demonstrating the presence of granulomatous tissue with caseous necrosis. Patients respond favorably to specific medical treatment. The recent spread of human immunodeficiency virus has increased the need to continue and improve efforts to control turberculosis particularly in endemic zones.