[Colorectal cancer discovered during pregnancy]. / Cancer rectocolique et grossesse: à propos de deux cas.

Colorectal carcinoma during pregnancy is very rare. Prognosis is severe because of the advanced stage due to delay in diagnosis and the aggressiveness of this widespread metastatic disease. We present two cases of colorectal cancers, discovered during pregnancy, as well as the results of a literature review to apprehend this clinical situation, and we describe recommended medical and surgical management.

[Anorectal Buschke-Lowenstein tumor. (Three cases report)]. / Tumeur de Buschke- Lowenstein à localisation anorectale. (A propos de trois cas).

Buschke-Lowenstein tumor or giant condyloma acuminata is characterized by a proliferation locally aggressive with extensive tissue destruction. We report three cases of Buschke-Lowenstein tumor with anorectal localization. The histology is characterized by papillomatosis and endo or exophytic acanthosis secondary to papillomavirus. The variety of treatment regimens applied do not allow formulation of definitive therapeutic guidelines.

[Incidence of surgical wound infections a prospective study in the Rabat Mohamed-V military hospital, Morocco]. / Incidence des infections du site opératoire étude prospective à l'hôpital militaire d'instruction Mohamed-V de Rabat, Maroc.

OBJECTIVES: The authors had for aim to determine prospectively the incidence of surgical site infections (SSI) in a visceral surgery department, in the Mohamed V military hospital (Rabat), and to identify risk factors. PATIENTS AND METHODS: All patients who had undergone surgery between April 1 and September 30, 2002 and were then admitted in the visceral surgery unit were included in this study. Patients were assessed within the following month. For each patient, data including perioperative factors, type of procedure, and SSI occurrence were collected on a standardized form. RESULTS: During the study, 310 patients were operated. The number of surgical wound infections was 16 (5.2%). This analysis pointed out: 11 superficial wounds, 5 deep wounds, and 1 organ/site wound. Emergency, age, ASA score, Altemeier classification, and procedure duration were found to be risk factors for SSI in visceral surgery. According to the NNIS index, SSI rates increase from 2.7% for patients with a risk index of 0 to 10.2% for patients with a risk index of 3. CONCLUSION: The high incidence of SSI emphasizes the importance of implementing SSI surveillance in surgery to obtain standardized incidence ratios necessary for adapted control measures.

[Hydatid cyst of the Douglas' cul-de-sac with fistula to the bladder. Report of 2 cases]. / Le kyste hydatique du cul-de-sac de Douglas fistulisé dans la vessie. A propos de deux cas.

The present study reported two cases of hydatid cysts localized in Douglas space and that broke in the bladder. The clinical course was characterized by urinary symptoms and by presence the cysts in urine. Abdominopelvic ultrasonography is essential for diagnosis and identification of other sites. When diagnosis is unclear, then CT scan plays a role. Therapy included cystectomy and pericystic resection in one case and intravescical injection of H2O2 in the second case. The course was favorable in both cases.

[Exceptional location of hydatid cyst: primary hydatid disease of the mesentery]. / Localisation exceptionnelle du kyste hydatique: l'hydatidose primitive du mesentere. l'hydatidose primitive du mésentère.

The hydatid cyst of the mesentery is a rare localization of hydatid disease; most often it is secondary to a hydatid cyst of the liver. Its primitive form remains exceptional and is due to an arterial haematogenous dissemination. We report a case of primary hydatid cyst of the mesentery in a patient of 43 years. The diagnosis was established by ultrasonography and computed tomography with positive hydatid serology. The aim of this work is to remind, through this observation and a literature review, clinical aspects and therapeutic management of this disease.

Le kyste hydatique du mésentère est une localisation rare de la maladie hydatique, le plus souvent elle est secondaire à un kyste hydatique du foie. Sa forme primitive reste exceptionnelle et serait due à une dissémination hématogène par voie artérielle. Nous rapportons un cas de kyste hydatique primitif du mésentère chez un patient de 4 3 ans. Le diagnostic a été établi par l'échographie et la tomodensitométrie avec une sérologie hydatique positive. Le but de ce travail est de rappelé, à travers cette observation et une revue de la littérature, les aspects cliniques et la conduite thérapeutique de cette maladie.

Intérêt des marqueurs tumoraux sériques dans les cancers digestifs

Les marqueurs tumoraux sont des composés produits par les cellules cancéreuses ou leur environnement se retrouvant en quantité suffisante dans le sang, les urines et les liquides d'effusion. Les marqueurs les plus utilisés en pathologie digestive sont l'antigène carcino-embryonnaire (ACE), l'alpha foetoproteine (_FP) et le CA19-19. Le but de notre travail est de discuter l'intérêt de ces trois marqueurs dans le dépistage, le suivi et le pronostic des cancers gastriques, pancréatiques, colorectaux et hépatiques.La faible sensibilité et l'existence de faux positifs rendent parfois ces marqueurs impropres à une stratégie de dépistage. Par contre, seul l'_FP a une valeur diagnostique dans les hépato carcinomes pour les populations à haut risque. L'ACE et le CA19-9 ont une bonne sensibilité et une spécificité relative qui leur permettent de suivre l'évolution des cancers digestifs en particulier les cancers colorectaux. Ils constituent les meilleurs marqueurs pour évaluer le pronostic, l'efficacité thérapeutique et pour dépister les récidives de façon précoce. Leur association est justifiée et permet d'atteindre 91% de spécificité et 76% de sensibilité.Devant la place occupée par la biologie dans le diagnostic, le pronostic et le suivi des cancers digestifs par le dosage des marqueurs tumoraux, nous nous devons que de reconnaître tant leurs performances que leurs limites

[Renal hydatid cyst. Apropos of 22 cases]. / Le kyste hydatique rénal. A propos de 22 cas.

Renal hydatid cyst ranks third among all visceral localisations. It is most often latent due to the deep situation of the kidney. The authors report their experience with 22 cases of hydatid disease of the kidney, and place special emphasis on wedge resection of the cyst which is a simple and effective operation.