[Gastro-jejuno-coliques fistula caused by recurrent]

Gastro-jejuno-colic fistula caused by recurrent ulcer was a frequent complication of surgery for peptic ulcer. Since the completion of the vagotomy in the surgical treatment of this pathology, gastr-jejuno-colic fistula is becoming increasingly rare but continues to see. We try to study different profiles: clinic, diagnostic, and therapeutic of this complication. Six cases of gastro-jejuno-colic fistula caused by recurrent ulcer were studied retrospectively between 1969 and 2009. All the patients were operated for duodenal ulcer; the first intervention consisted of gastro-entro-anastomosis alone in three cases. Clinical presentation was dominated by diarrhea, abdomen pain and weight loss. Fistula was demonstrated on barium enema in three patients. All our patients had a one stage resection and repair of the fistula by gastro-jejunal anastomosis in three cases; segmental resection of the colon was done in two cases; postoperative recovery was simple. In spite of varied clinical presentation, gastro-jejunal-colic fistula caused by recurrent ulcer can be readily diagnosed by barium enema. A one stage resection is the procedure of choice

[Surgical management of complicated diverticular disease of the colon]

In occidental countries, more than 50% of people aged more than 80 years have a pelvic colon [sigmoid] diverticulosis. In absence of any epidemiological study, in Morocco, this affection seems to be rare. We report here 4 cases admitted in a non urgent surgical department during 10 years, two men and two women, aged between 40-58 years old. All of them were managed for a complicated stage of sigmoid diverticulosis. These complications were presented by sigmoid stenosis, perisigmoid abcess, purulent peritonitis and acute sigmoiditis. The first three patients were operated. The first one had a non urgent recto-sigmoidal hinge resection. The other two had an urgent intervention, but the diverticular origin was not evoked except after the surgical intervention, one only of them had another intervention for resection of the recto-sigmoidal hinge. The second patient refused to be reoperated. The last patient was medically treated. For a better therapeutic management of diverticular diseases we must know the evolutional aspects of this disease

Rectal prolapse

Twenty-five interventions for rectal prolapse have been done for 23 patients during 20 years, 12 direct rectopexies, 9 Orr-Loygue procedures, 2 resections, Delorme's procedure for 1 patient and one cystectomy. We observed 4 recurrences i.e. 17,3%. Abdominal rectopexy seems to be the best treatment for rectal prolapse

Cancer colique revele par une thrombocytose

We report a case of a 60-year-old woman who presented thrombocytosis at 2.400.000 m[3] associated with a tumor of the colon. This article describes a paraneoplastic thrombocytosis higher a 2.000.000 mm [3] probably secondary to the elevation of the serum interleukin 6 levels of the thrombocytosis