Surgical treatment of idiopathic megaoesophagus

About an analysis of 15 cas of mecaoesophagus, the authors underline it's clinical latency. The clinical features become clear when the megaoesophagus is already constitued after a certain delay. Heller's myotomy is the operation of choice that gives fonctionnals and anatomical results

Choledocal cyst in adult. Report of 2 cases

The congenital choledocal cyst is a rare but not exceptional affection. The diagnosis is rather easy, thanks of the clinical symptoms, the echography and the intravenous cholangiogram. The evolution with complication compulse a surgical treatment just after the diagnosis. The most complete removal of the cyst with choledocojejunostomy is the favorite technic for most authors

Hydatid cyst of adrenal gland. A case report

The authors report a case of hydatic cyst of the adrenal left gland in a 35 year-old woman. They give a clinical and paraclinical description. Such lesions are uncommon and only detected fortuitously or in case of hardly definable pains. Their diagnosis has largely profited by the contribution of echotomo-graphy and tomodensitometry. The removal of a cyst with conservation of the adrenal gland is the best approach of such lesions

defense du menisque

Between 1968 and 1982, 196 cases been selected. All the patients have presented sequellae that have been classifed. Bio-mechanic and anatomo-pathologic studies have allowed us to explain those sequellae. This investigation pointed out the major role of the posterior horn and the interdependance of the meniscus and the other ligaments including the crossed ones. The knee joint acts as whole will worsen if a part is deeply damaged. Thus, may be, it is better to leave a lightly damaged posterior horn than remove it, which implies been the most conservative as possible, and the removal of the meniscus is only allowed when the disturbance is important

Traitement chirurgical de l'infection dans l'osteite et la pseudarthrose infectee post-fracturaires

The authors report their experiment in treating osteitis and septic non-union. - The problem of fractured osteitis is relatively simple, the fracture being united. Different surgical methods are considered together, all having in common the excision of infected and necrotic tissue. Opinions are divided between supporters of "closed" treatment with "irrigation-drainage", and "open" treatment with cicatrization by a second intention. The latter being favored by most of the participants. Directed antibiotherapy remains a valuable addition; its utilization locally is discussed. - The treatment of septic "non-union" is more complicated in respect to healing. Different methods are examined with ' osteo-muscular decortication, used alone, led to healing in 17 out of 20 cases of non-union. It constitutes the first and formes treatment for non-union. Isolated, it is reserved for non-union without loss of osseous matter. A PAPINEAU intervention is the method of choice for septic non-union with loss of osseous matter. It was used once or twice in 51 cases and led to union and drving in 75% of the cases. Negative re-results were most often the apanage of diaphysaric resections. Inter-tibio-fibular grafting was only used in 8 cases, usually after the failure of other methods. It allowed union in 6 cases. It retains a non-negligible place after failure of a PAPINEAU intervention, which it can complete in case of insufficient solidity. Of 101 observations of septic non-union, 6 patients underwent amputation. This is most often the result of major traumatologic damage and deficient techniques. Its place should be more and more reduced. The authors conclude by recalling the importance of preventing post-operatory-infection, not by gross means but by rigorous measures in the organization, hygiene and education of hospital staff

Surgical treatment of oesophageal stenosis secondary to reflux oesophagitis. About 18 cases

Eighteen peptic oesophagitis have been treated in the University Hospital of Casablanca mainly by conservative surgery. The results obtained show that the surgical procedure should discharge always the oesophagus, distend the stenosis by candling and end by an anti-surging back method

[Surgical traumas of the main biliary duct]

The authors report 21 cases of operative traumatisms of the main biliary duct seen at the Medical School Hospitals of Rabat and Casablanca between 1971 and 1979. Eight accidents immediately admitted during the surgical procedure have been repaired with success. Thirteen accidents operated on secondarily ended in 3 deaths and 10 favourable results. The authors analyze the gravity factors of the complications dominated by the angiocholitis, the restenosis and the evolution to the biliary cirrhosis

[Psoas hydatid cysts]

Inspite of the endemic nature of the hydatic disease in Morocco, some localizations are unusual, the one of the psoatic muscle is rare. The authors report 5 cases and stress the diagnostic difficulties of this localization. The extraperitioneal surgical way is preferred whenever the lesion is isolated. The organs of the proximity, essentielly composed of vessels and nerves make the complete perikystectomy dangerous and incite to a partial perikystectomy.

Ultrasound diagnosis of an injury of the main biliary duct

An 8 months old undiagnosed injury of the main biliary duct which occured during a cholecystectomy and which was assumingly repaired in a second operation was revealed by an ultrasonographic investigation. This report emphasizes the value of ultrasound in the etiologic diagnosis of obstructive jaundice and in some surgical complications

[Intermittent volvulus of the stomach with hepatic atrophy]

Concerning two observations of hepatic atrophy with intermittent volvulus of the stomach, the different etiologic and therapeutic factors are analised, the treatment of the duodenal ulcer often associated is thrown into relief to avoid the recurrency of the torsion

[Duodenal obstruction by a calculus originating from the gallbladder]

Bouveret's syndrome, a pyloro-duodenal obstruction by a calculus originating from the gallbladder is a rare affection whose frequency can only grow less. Concerning a particular observation, the diagnostic difficulties as well as the possible different therapeutics are debated by the authors