[Surgical treatment of secondary hyperparathyroidism in chronic renal failure. Report of 57 cases]

The aim of this study was to report the experience of the department of general surgery [Aile III] Ibn Rochd Hospital in surgical management of hyperparathyroidism in patients with end-stage renal disease [ESRD]. Fifty seven patients [24 M, 33F] with hyperparathyroidism underwent surgical parathyroidectomy from 1998 to 2004. Surgical indication was established according to clinical or biological assessment. Fifty nine operations were performed [57 first-hand cervicotomies and resumptions in two cases]. Histological examination of parathyroid gland specimens disclosed adenoma in 33 patients and hyperplasia in 14 patients. The follow-up was normal in 52 patients, marqued by cervical hematoma in 2 cases and death was deplored in 4 patients. The post-operative calcium level was in the normal range in 43 cases, low comparatively to the baseline in 12 cases and high in 2 cases. The PTH level was normal in 55 patients and high in two patients. Long-term outcome was evaluated in 36 patients mean follow-up [18 months]. A good evolution was noted in all patients referring to clinical, biological and radiological investigations. That, in our context, surgical parathyroidectomy still an appropriate approach for the treatment of hyperparathyroidism in patients with end-stage renal disease

[ gastric trichobezoard: a case report]

Trichobezoar is defined as the presence of a foreign body in the stomach. This body is formed by a hair mass or fibres. The typical patient presenting with a trichobezoar is an adolescent experencing mental disturbance or retardation. A voluminous trichobezoar was discovered in a young woman aged of 23 years old. The diagnosis was easily made by computerized tomography and endoscopy. The surgery was performed without complications. Psychiatric follow-up is needed to prevent the recurrence

Mature retroperitoneal teratoma in adult [Two cases report and litterature review]

Retroperitoneal teratomas are rare tumours in adults. We report two cases of primitif mature retroperitoneal teratoma. The first, a 60-year-old woman was with general fatigue and being treated for acute pyelonephritis. The second patient, 30-year-old woman, presented with 2 years history of right hypochondral pains. The clinical exam found a mass of right hypochondrium. In both cases, the initial diagnosis with sonography and computed tomography suspected a retroperitoneal teratoma. The treatment consisted of a total tumoral excision. The follow-up was simple and no recurrence after 60 and 24 months respectively. The anathomopathologic exam concluded with a teratoma without signs from malignity in both cases. We conclude that teratoma is a rare tumour, which need histological examination to confirm diagnosis and seek an immature composent, sign of malignancy

Pheochromocytoma [a report of 8 cases]

We reviewed a serie of 8 patients, 6 females and 2 men operated for a pheochromocytoma. Sex patients had a high blood pressure; permanent in 4 cases and paroxystic in two. Three patients had a left ventricular hypertrophy. The vanyl-mandalic-acid was elevated in 5 cases and dopamin in one case. This study confirmed the remarkable sensitivity of computed tomography [100%] for the detection of the pheochromocytoma. The ultrasonography was objectived the surrenalien tumor in 5 cases. The surgical procedure consisted on a total resection of the tumor by an anterior intraperitoneal approach. There was no mortality in our serie. Only one patient kept a high blood pressure after the resection neverthless negativity of the check-up. The pre-operative treatment is systematic and the only treatment of pheochromocytoma remains ablation of the tumor

foreign bodies after abdominal surgery

The authors report a review of literature about the foreign bodies missed after abdominal surgery. The anatomical aspect are discussed. Diagnosis is helped by the history of disease and a plain X ray of the abdomen. Prophylaxis is based on a better organisation of the abdomen operation room and the introduction of a radio-opaque marker in the linen