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

Surgical resection of klmatskin tumor. About 6 cases

Hilar bile duct carcinomas or klatskin's tumors are rare that represent 1.5% of the digestive cancers and their prognosis is poor with a survival until 5 years less than 3%. From 1996 to 2001, 6 patients had beneficied from a surgical resection because of a tumor of the hepatic helium. It is about 2 men and 4 women aged from 34 to 51 year-old. Three patients had suffered from biliary lithiasis and all the patients presented a retential jaundice. Surgical procedure had consisted in a resection of the extrahepatic bile ducts [6 cases], pedicular ganglial curettage [6 cases] associated to a left hepatectomy in one case. The recovery of the continuity has been based in the patients on anastomosis between a well made bile mouth and a jejunal ansa in Y shape of 70 cm. The anatomopathologic study confirmed the diagnosis of a tubulosecreting adenocarcinoma in all patients. The operative mortality has been nil and the morbidity consisted in anastomatic fistula [1 case], pleuropulmonary infection [1 case], one patient died 9 months after a tumoral relapse. The radical surgical resection is the only therapeutic that permits to hope a prolonged survival and sometimes recovery

Ingestion of foreign body

Ingestion of foreign body. The ingestion of foreign body can be accidental or voluntary. It is frequent at old person having a defective set of teeth or with mental deficiency, but also at the child. Mortality of ingestion of a foreign body is at present lower than 1%, thanks to the improvement of taking in charge, and especially techniques of origin endoscopiques. The urgency of taking in charge the foreign body of the digestive tract rests essentially on the location especially oesophagal and character vulnerant of the foreign body. The foreign body can present an immediate danger, delayed during the elimination or still during its extraction. In the case, a fast extraction is necessary. If endoscopice extractionis difficult, with important risk of perforation, an urgent surgical operation is then indicated. In the case of the foreign body gastric, the spontaneous evacuation is usual and appeal to the surgery is exceptional. Besides, once the stomach exceeds, the risk of performing of small bowel is important, especially with sharp, stiff and long foreign body

Analytic study of 1481 appendicular syndrome

Our work consists of a retrospective study of 1.481 appendicular syndromes collected in the service of surgical emergencies from June 1980 to December 1984. Summarizing the date count, it emphasizes from our study: The acute appendicitis is the most frequent of abdominal surgical emergencies, it attacks both sexes with a light male predominance, the clinical is very polymorphic, and the confrontation anatomo-clinical, trial shows the absence of paralylism between the clinic, the operatory explorations and the histology