[Preoperative portal vein embolization]

The liver failure is a severe complication of major hepatectmies. Preoperative portal vein embolization allows a prior interruption of the portal flow in the liver territories that are to be resected, inducing their atrophy and the compensatory hypertrophy of the futur liver that persists after this removal. It is interesting to discuss the feasibility of this technique in our contexte starling from accessibles means for obtaining satisfactory results. Patient aged 55 years old, who presented for two months a cholestatic jaundice cutaneous mucosal. The Magnetic Resonnance Imaging abdominal showed an appearance very evocative of a cholangiocarcinoma of the biliary confluence reaching the right hepatic duct type IIIA of bisthmuth and cornette. Three weeks after portal vein embolization, an hypertrophy of the futur remaining liver is obtained. Finally, we perfomed a right hepatectomy extended to segments IV anterior and I. The postoperative course was uneventful. The major hepatectomy carries the risk of postoperative liver failure. Portal vein embolization of the liver to resect aims to redistribute the portal flow to induce a hypertrophy of the futur liver remnant. Portal obstruction can be used by an embolization with biological glue, acrylic adhesives, alcohol, or by a ligation. It can be done by ultrasound guided percutaneous transhepatic or by catheterization of an ileocolic vein. However, given the specific equipment required for the percutaneous and human skills still not widespread, it is best in our context the ileal way that is accessible to all surgeons and also effective. Major liver surgery is developing in our country, thus preoperative portal vein embolization can now make extensive liver resections with less risk and complications

[Primary linit plastica of the rectum in child]

The plastic linit is defined-as the infiltration of the wall of a hollow body by a diffuse anaplastic cancer . Its most frequent seat is gastric. The rectal primitive linit is very exceptional. All diagnosis, therapeutics and prognosis aspects this affection were discuss. A 12 year ad girl is hospitalized for primitive rectal linit. She was treated by abdominoperineale amputation after radiochemotherapy. The patient have received adjunct chematherapy. The out come was simple without recurrence after 4 months. The plastic linit of the rectum is a little differentiated shape of adenocarcinoma. The diagnosis is provided on a major biopsy and the absence of gastric attack. The farecast is very bad in spite of intencive treatment, associating surgery, radiotherapiy and chemotherapy

inflammatory pseudotumors of the colon

The inflammatory pseudotumors of the colon are very rare benign lesions, of unknown etiology and whose differential diagnosis is difficult with the adenocarcinoma. Young girl patient of 12 years old, presented with mass in the right iliac fossa, the preoperative assement was in favour of right colon malignancy with retro peritoneal extension. Right colectomy was done, histological examination confirmed the diagnosis of inflammatory pseudotumors of the colon. The inflammatory pseudotumors of the colon are benign tumor they can be the origin of local and general signs colonic localization is exceptional and etiology remains unknown. Surgery is necessary to obtain an histological diagnosis of the lesion and to eliminate malignant tumor