[Diabetic ketoacidosis and thyroid storm occurring while awaiting radical treatment, about 2 cases]

The association of uncontrolled type 1 diabetes and Grave's disease may induce metabolic decompensation leading to the simultaneous occurrence of diabetic ketoacidosis and thyroid storm. This double endocrine emergency, although rare, is known to be life-threatening. Diagnostic difficulties due to an atypical presentation of thyroid storm that can be masked by diabetic ketoacidosis result in delayed diagnosis and treatment and therefore in a fatal outcome. We report two cases in whom early recognition and intensive treatment have led to an improved outcome. Radical treatment of the Grave's disease immediately at the diagnosis of the associated type 1 diabetes may prevent this double complication

[Inguinal hernia of the bladder a cases report]

Inguinal hernia of the bladder is uncommon. The diagnosis is frequently done during surgery. It can be evoked before surgery when the patient presents with irritive and obstructive lower urinary tract symptoms. We report a case of left inguinal hernia involving the bladder in a 60 years old man who had obstructive lower urinary tract symptoms. The diagnosis was done on the retrograde urethrocystography. We performed inguinal mesh with herniated bladder reduction. The postoperative history was uneventful

[Abdominal cystic lymphangiomas-Report of three cases]

Cystic lymphangioma are rarely observed in the abdomen. Their incidence varies between 2 and 10% of all localisations. The diagnosis is based on histopathological exam but can be suspected by radiology. Laparoscopic removal of the cyst is possible offering many adantages. We report the case of abdominal cystic lymphangioma occurring in women respectively 60, 65 and 68 years aged. Abdominal pain was the main symptom. Diagnosis was suspected before surgery in two cases thanks to the radiological findings. In these two patients, the cyst was removed under laparoscopic surgery. The third patient was operated by laparotomy. The diagnosis was established on histopathological study. With a mean follow up of 36 months, there were no signs of recurrence

[Pancreatic insulinoma: diagnostic approach and therapeutic modalities]

The insulinoma is the most frequent neuroendocrine tumor of the pancreas. It is often a benign tumor but can expose to major hypoglycemia. The positive diagnosis is based on biological dosages. The topographic diagnosis can turn out difficult imposing the appeal to invasive explorations. The treatment is surgical and benefits at present from the contribution of the coeliochirurgie

Gastric stromal tumors, a retrospective - a study. About 19 cases

The purpose of this study is to define the therapeutic attitude to be adopted in front of a gastric stromal tumor, to estimate the results and to define the prognostic factors of these rare tumors. We report a retrospective study about 19 cases of gastric stromal tumors reported over a period of 12 years going from January, 1993 till December, 2004. All the patients were operated. Diagnosis was established by the histological and immunohistological study of gastric resection or biopsies. It was about 8 men and 11 women of whom the average age was of 62 years. The symptomatology was dominated by abdominal pain [63% of cases] and digestive bleeding [52% of cases]. A palpable mass was found in 16%of cases. The tumor location was antrum in 13 cases, fundus in 5 cases and under cardial in 1 case. A synchronous gastric and small intestinal locations was found in 1 case. The average tumoral size was 8.2cm ranging from 1.7 to 30cm. The tumor resection was achieved in 18 cases [95%]. It was widened to the adjacent organs in 1 case. Morbidity raised 5.2% and there was no operating death. At pathological examination the tumor was of weak rank of wickedness in 8 cases, high rank in 8 cases and in vague potential in 3 cases. The average follow-up was of 27 months [2 to 96 months]. During the postoperative follow-up, 3 cases of recurrence were diagnosed. The 2-year -overall survival was 83%. The prognostic factors influencing the overall survival were the high cellular density [p=0.01], local recurrence event [p=0.03] and high degree of malignancy [p=0.0002]. The treatment of gastric stromal tumors is surgical. Gastrectomy and wedge resections passing in macroscopically normal tissue are the mainstay of the treatment. Enucleating resection should be avoided. The lymph node dissection is not recommended. The new chemotherapeutic agents [the tyrosine kinase inhibitors] seem promising and could modify the current therapeutic attitude in the future

[Menetrier's disease - report of 6 cases]

This is a retrospective study and report of 6 cases of Menetrier's disease. The diagnosis is made preoperatively in three patients only. Four patients had an adenocarcinoma, an other patient had a dysplasia and another one a granulomatous gastritis. A total gastrectomy was performed in 5 cases, the remaining patient underwent a subtotal gastrectomy. One of patients died 45 days after surgery following surgical complications. In this study the stress is put on the difficulty of diagnosis, likelihood of degenerescence and the gastrectomy