[Isolated abscess of the thoracic and abdominal wall: an exeptional shape of tuberculosis]

The isolated thoracic parietal localization is a very rare shape of tuberculosis. It often leads to a diagnosis problem with the parietal tumours requiring surgical biopsy. We report a case of tubercular abscess localized in the antero-superior part of the thoracic wall with a second abdominal localization without any pulmonary localization. It was a 56-year-old woman presenting a swelling in the right side of the sternum accompanied after some months by a second swelling of the right flank of the abdomen, for one year. The radiological and biological explorations were in favour of a double localization parietal tumour. The diagnosis of certainty has been made by the histological exam of the surgical biopsy and the bacteriological exam of the trans-parietal withdrawal of the collection. The classic tuberculosis treatment has been maintained during 9 months with a good clinico-radiological evolution. Through this observation, we try to study the anatomo-clinical particularities and to clear the diagnostic difficulties of this affection

[Laparoscopic management of perforated duodenal ulcers results of a retrospective study]

Perforation of peptic duodenal ulcer is a frequent surgical emergency. The aim of this retrospective study is to evaluate the faisabiity and the results of laparoscopic management of perforated duodenal ulcers. Eighty-four patients had laparoscopic surgery for perforated duodenal ulcer. The duration of the study was seven years [2001 to 2007]. There were 81 men and 3 women aged from 16 to 64 years [mean: 28 years]. The mean duration between the onset of perforation and the time of operation was 20 hours [range: 6-72 hours]. The surgical procedure was suture and irrigation of the abdominal cavity. Conversion into laparotomy was performed in 14.2%of the patients. Mean operative time was 95 minutes. There was no post operative death. The morbidity rate was 15.4%. There was two surgical complications [post operative peritonitis and duodenal fistula] and ii medical complications. Mean hospital stay was 6 days. All patients were discharged with antibiotics for Helicobacter pylon eradication. Laparoscopic repair of perforated duodenal ulcer is a safe option providing low rates of morbidity, reoperation and mortality, and can be considered as the treatment of choice