Traumatic uterine rupture: A rare complication of vehicle accidents.

The rupture of the gravid uterus is a rare complication of trauma. It is reported in less than one percent of pregnant women who are victims of road accidents. The authors report the case of a 26-year-old nulliparous patient presented with a uterine rupture resulting in fetal death at 32 weeks of gestation following a nonpenetrating abdominal trauma in a road traffic accident. An extreme emergency operation and abdominal laparotomy confirmed the imaging findings and led to conservative treatment of the uterus and a splenectomy.

[Predictive factors for anastomotic leakage after colon cancer surgery]. / Facteurs prédictifs de fistule anastomotique après colectomie pour cancer.

Introduction: in colon cancer surgery, anastomotic fistula (AF) is considered the most feared complication. The purpose of this study was to identify predictive factors associated with anastomotic fistula after colon cancer surgical resection and to describe the impact of this complication on mortality and postoperative length of stay. Methods: we conducted a retrospective, descriptive and analytical study in the Department of General Surgery at the Habib Bourguiba Hospital in Sfax, Tunisia from 1st January 2013 to 31 December 2020. Results: we collected data from the medical records of 163 patients who had undergone surgery for colon cancer. The average age of patients was 62.7 years with a sex ratio of 1.36. The postoperative course was uneventful in 64.4% of cases and complicated in 35.6% of cases. Surgical morbidity was mainly due to anastomotic fistulas (22 patients). This study demonstrated that predictors of the development of this complication were: diabetes p = 0.04, smoking p = 0.01, hypoalbuminaemia p = 0.01, preoperative haemoglobin less than 10g/dl, p < 0.01, anastomotic fistula located in the left colonic angle p = 0.02, perioperative transfusion p <0.01, and duration of surgery longer than 180 min p = 0.04. Moreover, the occurrence of anastomotic fistula was associated with specific mortality rate (9%) and significantly prolonged postoperative length of stay. Conclusion: the prevention of anastomotic fistulas should be part of a multimodal approach based on the correction of nutritional deficiencies and possible pre-operative anemia.

Idiopathic sclerosing encapsulating peritonitis: An uncommon cause of intestinal obstruction in a virgin abdomen.

Idiopathic sclerosing encapsulating peritonitis is a clinical entity characterized by partial or complete encasement of the digestive tract by a fibrous membrane. The preoperative diagnosis is difficult to establish. The diagnosis of sclerosing encapsulating peritonitis should be considered for patients without any surgical history and admitted for intestinal obstruction, especially for patients having peritoneal dialysis. We herein report the case of a 50-year-old man with idiopathic encapsulating peritonitis complicated by intestinal obstruction and ischemia. Idiopathic sclerosing encapsulating peritonitis is a rare disease. The diagnosis is made generally during a surgical procedure. Surgery seems to be the best management option for patients with severe signs of intestinal obstruction. Total resection of membrane avoids recurrences but it is associated with higher morbidity and mortality.