surgical treatment of the dilatations of the bronchi [about 48 cases]

In spite of the progress of the medical treatment of the bronchiectasies or dilations of the bronchi, a certain number of patients can benefit from a surgical treatment. The aim of our work is to value the results of the surgical treatment and to specify the moment of the surgical intervention. Our work is about 48 cases of bronchectasies operated in the service of the emergencies visceral Ibn Rochd of Casablanca between January 1994 and February 2001. It was about 30 women for 18 men, the middle age of our patients was 27 years. It was a sequelae of respiratory infections of the childhood in 22.9%, of tuberculosis in 35.42% of the cases, and 10.41% of the patients had presented a pulmonary abscess. The dilations of the bronchi were apparently primitive in 31.45% of the cases. The sits of the bronchiectasies has been specified the most often by a thoracic computed tomography in 80%, in 20% of the cases the lesion was bilateral. The type of intervention practiced was 33 cases of lobectomies, 6 cases of bilobectomies and 9 case of trisegmentectomies. The operative continuations were simple in the majority of the cases, except in 9 cases: 4 cases of pyopneumothorax, 2 case of emphysema under cutaneous and 3 case of parietal suppuration. The long-term follow-up interested 34 patients, 30 became asymptomatic, 1 patient presented a parietal pain, an obstinate cough has been noted in one patient and two patients presented occasional respiratory infections

Volvulus of the sigmoid colon. Therapeutic strategy. About 38 cases

A retrospective study of 38 cases of sigmoid volvulus is reported. The relative frequency of this pathology among young people in Morocco is noted. In 82% of cases diagnosis was without difficulty; and in two cases an associated small bowel volvulus was found. When deciding on the therapeutic approach it is essential to differentiate between cases in which the sigmoid colon is necrotic and those in which the changes are reversible. In the latter, the authors recommend a non surgical reduction [using flatus tube or better: colonoscopy] with elective surgery performed at later date. If initial reduction proves impossible, colonic resection whith colostomy appears to give the best results

Huge neurofibroma of intrathoracic vagus

A case of neurofibroma of the left vagus nerve associated with a Recklinghausen's disease is reported. The review of the literature shows how rare is this type of localisation, only 62 cases are reported since 1926. The authors remind us the absence of specific signs of vagal involvement and mildness of postoperative course of surgical excision

[Benign pancoast and tobias syndrome. report of a case]

The authors report on a case of Pancoast and Tobias syndrome due to a mediastinal and right apical hydatic cyst. This parasitosis, so frequent in North Africa, is with tuberculosis the least rare benign etiology of Pancoast and Tobias syndrome. A conservative treatment has lead to a satisfactory result