Health-Related Quality of Life in Children With Cochlear Implants From Parents’ Perspective

Background and Objectives@#To evaluate the health-related quality of life (HRQoL) in parents of children with cochlear implants and assess influencing factors. These data can enable practitioners to support patients and their families in utilizing the cochlear implant and its benefits to the fullest extent. @*Subjects and Methods@#A retrospective descriptive and analytic study was conducted at the Implantation center Mohammed VI. Parents of cochlear implant patients were asked to fill out forms and answer a questionnaire. Participants included parents of children <15 years old who underwent unilateral cochlear implantation between January 2009 and December 2019, presenting with bilateral severe to profound neurosensory deafness. Participants completed the children with cochlear implantation: parent’s perspective (CCIPP) HRQoL questionnaire. @*Results@#The mean age of the children was 6.49±2.55 years. The mean time between implantation for each patient and this study was calculated as 4.33±2.05 years. There was a positive correlation between this variable and the following subscales: communication, well-being and happiness, and the process of implantation. For these subscales, the score was higher as the delay was greater. Parents of children who received speech therapy before implantation were more satisfied on the following subscales: communication, general functioning, well-being and happiness, implantation process, implantation effectiveness, and support for the child. @*Conclusions@#The HRQoL is better in families of children who received their implant at an early age. This finding raises awareness of the importance of systemic screening in newborns.

Prevalence of cervical cancer in Ain Defla region (Algeria)

The high rate of cervical cancer in Algeria and the absence of organized screening programs are well shown in this study, which aims to determine the prevalence of cervical cancer and describe the risk factors associated with this alarming prevalence. This retrospective study is based on data collected from medical records and A questionnaire was developed to assess the risk factors (such as: parity, age at first marriage, smoking, oral contraceptive, and Hormonal status) of cervical cancer among the participants. Face to Face interview were conducted with the participants. The result obtained from this study revealed that cervical cancer occupies the fourth place of cancer in the Wilaya of Ain Defla (4,71 %); the results confirm the effect of several risk factors such as early marriage age (below 20 years: 46.66 %), multiparity (53.33%), menopause (66.66 %); taking contraception (53.33%) and smoking in the development of this pathology. The adoption of an early and annual screening program in our region would be very important to us. In addition, the interest of annual screening is to raise women's awareness of this pathology, particularly in isolated regions. (

Covid-19 et système cardiovasculaire / Covid-19 and cardiovascular system

L'expansion planétaire du covid19 représente une crise sans précèdent ; cette pandémie a fait plus d'un million de mort en une année. En plus de l'atteinte pulmonaire, le virus a des implications majeures sur le système cardiovasculaire : les maladies cardiovasculaires pré existantes représentent un facteur de risque d'infection sévère avec augmentation de la mortalité, d'autre part l'infection entraine des complications cardiovasculaires qui aggravent le pronostic. Le lien entre le Covid19 et le système cardiovasculaire découle principalement de la voie d'entrée cellulaire du virus qui est assurée par sa liaison à une protéine membranaire l'enzyme de conversion de l'angiotensine (ECA), qui joue un rôle clé dans la régulation neurohumorale ; cette protéine est très présente au niveau du cœur et du poumon, d'où le tropisme du virus qui entraine la dysrégulation de cette voie cellulaire avec des répercussion sur la fonction cardiaque et respiratoire. Une polémique a déferlé concernant les traitements anti hypertenseurs et notamment les inhibiteurs du système rénine angiotensine aldostérone mais après évaluation des données actuelles, il est de consensus de ne pas arrêter ou changer les traitements anti hypertenseurs. L'augmentation des troponines cardiaques est un facteur de mauvais pronostic qui aggrave le tableau. La myocardite est définie par une inflammation myocardique, Les tableaux cliniques sont variables de la forme légère à la forme grave ; les biomarqueurs myocardiques restent un test incontournable en cas de suspicion clinique, le pronostic est incertain avec des formes fulminantes qui peuvent régresser et enfin pour le traitement les corticoïdes semblent être efficaces. Une autre complication du virus sont les accidents thrombo-emboliques et le dilemme occasionné par le risque accru aux thromboses et la thrombopénie induite par l'utilisation de l'héparine (TIH). On note une augmentation de l'incidence des syndromes coronaires aigus chez les sujets atteints du covid19.

The global expansion of covid19 represents a global crisis; this pandemic killed more than a million people in one year. In addition to pulmonary involvement, the virus has major implications on the cardiovascular system: pre-existing cardiovascular diseases represent a risk factor for severe infection with increased mortality, on the other hand the infection causes cardiovascular complications which worsen the prognosis. The link between the Covid19 and the cardiovascular system stems primarily from the virus's cellular entry pathway, which is provided by its binding to a membrane protein, the angiotensin converting enzyme (ACE) wich plays a key role in neurohumoral regulation; this protein is very present in the heart and lungs, hence the tropism of the virus which causes the dysregulation of this cellular pathway with repercussions on cardiac and respiratory function. A controversy broke out concerning the antihypertensive treatments and in particular the inhibitors of the renin angiotensin aldosterone system but after evaluation of the current data, there is a consensus not to withhold or change the treatments. The increase in cardiac troponins is a factor of poor prognosis which worsens the picture. Myocarditis is defined by myocardial inflammation, its clinical form ranges from the mild form to the severe one; the myocardial biomarkers remain an essential when the clinical suspicion rise, the prognosis is uncertain with fulminant forms which can regress; for treatment corticosteroids seem to be effective. Another complication of the virus are thromboembolic events and the dilemma caused by the increased risk of thrombosis and thrombocytopenia induced by the use of heparin (TIH), and there is an increase in the incidence of acute coronary syndromes in patients affected by covid19.

Profil épidémiologique des thrombopathies constitutionnelles dans l'ouest algérien / Epidemiological profile of constitutional thrombopathies in western Algeria

Introduction. Comme pour toutes les maladies rares ou maladies orphelines, l'étude des thrombopathies devrait être multicentrique pour recenser le maximum ou tous les patients dans une région ou dans le pays concerné. Notre étude a pour objectif d'évaluer la prévalence des thrombopathies constitutionnelles dans l'Ouest Algérien, et décrire ainsi les caractéristiques épidémiologiques de notre population. Patients et méthodes. Il s'agit d'une étude descriptive régionale du profil épidémiologique de 61 patients de l'Ouest Algérien présentant une thrombopathie constitutionnelle. Résultats. Dans notre étude a trouvé 34 thrombasthénies de Glanzmann (TG), 18thrombopathies de Jean Bernard Soulier (JBS), 08thrombopathies de May-Hegglin (MH) et un syndrome de Scott avec une prévalence globale de 1,8/1 million habitants. Conclusion. Notre travail nous a permis d'avoir un contexte global sur les thrombopathies constitutionnelles qui serait sans doute la base d'autres études de caractère clinique, biologique ou même moléculaire surtout en matière de recrutement de patients.

Introduction. As with all rare or orphan diseases, the study of inherited platelet disorders should be multicentric to identify as many or as few patients as possible in a given region or country. The aim of our study is to evaluate the prevalence of inherited platelet disorders in Western Algeria, and thus describe the epidemiological characteristics of our population. Patients and methods. This is a regional descriptive study of the epidemiological profile of 61 patients in Western Algeria with inherited platelet disorders. Results. In our study we found 34 Glanzmann thrombasthenias (TG), 18 Jean Bernard Soulier thrombopathies (JBS), 08 May-Hegglin thrombopathies (MH) and one Scott syndrome with an overall prevalence of 1.8/1 million inhabitants. Conclusion. Our work has allowed us to have a global context on inherited platelet disorders which would undoubtedly be the basis of other studies of clinical, biological or even molecular character especially in terms of patient recruitment.

L'autogreffe de cellules souches hématopoïétiques non cryopréservées, un exemple de recherche clinique permettant une plus value en matière de soins: expérience de l'EHU 1er novembre d'Oran / The autographt of non-cryopreserved hematopoietic stem cells , an example of clinical research allowing more value in care: the experience of EHU 1st November of Oran

L'autogreffe de cellules souches hématopoïétiques (CSH) est une technique thérapeutique, permettant d'utiliser les cellules souches du patient afin de contourner l'écueil de l'aplasie sévère post chimiothérapie. Son coût de revient très élevé l'a rendue inaccessible dans de nombreux pays et en particulier en Afrique où on n'en compte que six pays avec 16 centres par rapport à 679 en Europe, ce qui représente un déficit de 98%. En Algérie, la première greffe de cellules a été effectuée en 1998 au niveau du CPMC d'Alger. Le 2ème centre de greffe de CSH a vu le jour en 2009 à l'EHU 1er Novembre d'Oran et est devenu un centre de greffe à vocation nationale. Nous présentons dans ce travail, le cheminement de la mise en place de la procédure de greffe de cellules à Oran, selon les recommandations internationales et leurs adaptations selon les conditions locales de travail.

Fine needle non-aspiration cytology for the diagnosis of cervical lymph node tuberculosis: a single center experience / Punção não aspirativa com agulha fina para o diagnóstico de tuberculose linfonodal cervical: experiência de centro único

Abstract Introduction: The fine-needle cytology is being used as a first line of investigation in the diagnosis of head and neck swellings, as it is simple, cost effective and less invasive as compared to biopsy. Objective: The aims of this study were to evaluate the results of the fine-needle non-aspiration cytology of cervical lymphadenopathy and to study the factors influencing the rate of non-diagnosis results. Methods: This retrospective study was conducted on selected patients with cervical lymphadenopathy that had undergone a fine-needle non-aspiration cytology followed by a histological biopsy. The sensitivity, specificity, positive predictive value and negative predictive value of fine-needle non-aspiration cytology for diagnosing tuberculosis were estimated. The risk factors of non-diagnosis results were evaluated. Results: The sensitivity, specificity, positive predictive value rates of fine-needle non-aspiration cytology for tuberculosis were 83.3%, 83.3%, 78.9% and 86.9% respectively. In total, 47 out of the 131 samples (35.8%) were considered non-diagnosis. Of the non-diagnosis samples, 84.2% (38 out of 47) were benign mostly due to tuberculosis (30 cases). Among the studied factors, only tuberculosis (confirmed by histopathological examination) was significantly associated with non-diagnosis cytology (p = 0.02, Odds-Ratio = 2.35). Conclusion: Tuberculosis is currently the commonest cause of cervical lymphadenopathy in North Africa. Fine-needle non-aspiration cytology is safe and accurate in the diagnosis of cervical tuberculous lymph node that is associated with the risk of non-diagnosis cytology.

Resumo Introdução: A punção não aspirativa com agulha fina tem sido utilizada como primeira linha de investigação no diagnóstico de tumores de cabeça e pescoço, por ser uma técnica simples, custo-efetiva e menos invasiva quando comparada à biópsia. Objetivo: Os objetivos deste estudo foram avaliar os resultados de citologia por punção não-aspirativa com agulha fina de linfadenopatias cervicais e estudar os fatores que influenciam a taxa de falha diagnóstica. Método: Este estudo retrospectivo foi realizado em pacientes selecionados com linfadenopatia cervical submetidos a punção não aspirativa com agulha fina, seguida por biópsia histológica. Foram estimadas a sensibilidade, especificidade, o valor preditivo positivo e valor preditivo negativo da punção não aspirativa com agulha fina para o diagnóstico de tuberculose. Os fatores de risco dos resultados com falha diagnóstica foram avaliados. Resultados: As taxas de sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo da punção não aspirativa com agulha fina para tuberculose foram de 83,3%, 83,3%, 78,9% e 86,9%, respectivamente. Das 131 amostras, 47 (35,8%) foram consideradas como falha diagnóstica. Das amostras não diagnosticadas, 84,2% (38 de 47) eram benignas, principalmente devido à tuberculose (30 casos). Entre os fatores estudados, apenas a tuberculose (confirmada pelo exame histopatológico) estava significativamente associada à citologia com falha diagnóstica (p = 0,02, odds ratio = 2,35). Conclusão: A tuberculose é atualmente a causa mais comum de linfadenopatia cervical no norte da África. A punção não aspirativa com agulha fina é uma técnica segura e precisa no diagnóstico de linfonodos cervicais associados ao risco de citologia com falha diagnóstica.

An unusual presentation of ovarian dermoid cyst: a case report and review of literature

Dermoid cysts or mature cystic teratoma are the most common type of ovarian germ cell tumor. It may be complicated by torsion, rupture, chemical peritonitis and malignant change but is rarely complicated by infection. We present a case of an ovarian dermoid cyst with super-infection caused by Schistosoma haematobium (S. haematobium). We present here a case of incidental finding of S. haematobium eggs in an infected cystic teratoma of the ovary because of the rare occurrence of this lesion. A 45-year-old Moroccan woman admitted to the gynecological department because of abdominal pain and fever. Gynecological examination, ultrasonography, and abdominopelvic computed tomography scan revealed an ovarian mass thought to be a dermoid cyst. The pathological evaluation suggested infected ovarian dermoid cyst with the presence of adult worm in the tumor, contains same eggs of S. haematobium. Super-infection of an ovarian dermoid cyst is a rare event, and the association with S. haematobium is extremely rare in the literature.

Toxicology, biosynthesis, bio-control of aflatoxin and new methods of detection

Mycotoxins and their derivatives since their discoveries and until the present time are behind unspecified economic and medical damages. Aflatoxins are classified according to their physical–chemical and toxicological characters in the most dangerous row of the mycotoxins. These aflatoxins are in part responsible, of irreversible medical disasters that are not easily manageable such as cancer of the liver and kidneys, and in the other part, of losses in the stored cereal products. Based on these crucial findings, monitoring of this toxin became imperative in post-harvest food products, during storage, during transformation chain and even during the long phases of conservation. Vigilance of this toxin is delivered by detection methods using very advanced technologies to respond in the shortest possible times. In addition, the knowledge of factors supporting the biosynthesis of aflatoxins such as the temperature, moisture content, concentration of nitrogen and carbon, and the molecules responsible for the genetic control of the synthesis will be reflected later in the choice of bio-control techniques. This control is currently based on new strategies using the bioactives substances of the plants, the lactic bacteria and some strains of actinomycetes that have good inhibiting activity against aflatoxins with fewer side effects on Man. On the other hand, this brief review summarizes the results of new studies demonstrating the toxicity of the toxin, new detection methods and bio-control.

A Rare Highly Aggressive Tumor of the Kidney: The Pure Epithelioid Angiomyolipoma.

Aims: The authors presents a case of pure Renal epithelioid angiomyolipoma (EAML) and discuss the clinicopathological characteristics and the diagnosis problems of this entity. Case Presentation: A 51 year-old man presented with a persistant pain in the left lumbar region. Imaging revealed a left kidney tumor that was hemorrhagic and necrotic on gross examination. At histology, proliferation of 99% of atypical epithelioid cells, staining for HMB-45 and Melan A was observed. Our patient had lung and right adrenal metastasis six months after surgery and succumbed one year later. Conclusion: In summary, the pure form of EAML is extremely rare. When diagnosed, the risk of tumor progression is high, especially if other histological predictive parameters of progression are observed. In that case, active treatment should be undergone and patients should be closely monitored.

Urinary Bladder Cavernous Hemangioma: A Case Report.

Aims: The authors present a case of urinary bladder cavernous hemangioma and discuss the clinical and pathological features of this entity. Case Presentation: We report a solitary bladder cavernous hemangioma occuring in a 19-year-old man. The patient presented with macroscopic hematuria. Radiologic findings revealed an intravesical exophytic tumor. Cystoscopy revealed a sessile, reddish mass, measuring 2 cm in diameter located in the right sided wall of the bladder. Endoscopic resection of the mass was performed and the pathologic examination revealed a cavernous hemangioma. No recurrence was noted at the 3-year follow-up. Conclusion: Hemangioma is a benign vascular tumor accounting for about 0.6% of bladder tumors. Its prognosis is generally good but a long follow-up observance is mandatory to detect recurrence or residual disease.

A Rare Case of Neglected Congenital Muscular Torticollis in an Adult and Review of Literature.

Aim: We report a rare case of congenital muscular torticollis in an adult and review most of the different treatment approaches reported by authors. Presentation of Case: A 25 year old woman who underwent an unsuccessful surgery for her congenital torticollis in the childhood, presented to our department for the same problem. We performed a unipolar release of the sternocleidomastoid muscle with a large dissection and a resection of a fibrous part of the clavicular head followed by a muscular rehabilitation. Result was satisfactory with an 18 month follow-up. Discussion: Congenital muscular torticollis is rarely seen in adults. There are almost as many treatment protocols for congenital muscular torticollis as authors, with unequal outcomes. Surgical treatments give the best results in adults. We review most of the treatment protocols described in the literature. Conclusion: As surgeons, we have to deal with every special situation in the aim of respecting the integrity of healthy tissues and providing the best care for good functional and cosmetic outcome.

Upper digestive stenosis due to a hydatid cyst of the liver

The complications of the hydatid cyst of the liver are dominated by infection and rupture. The compression of adjacent organs [mainly the inferior vena cava, the portal vein and the bile ducts] can be seen, when the cyst is located in the dome, in the hilum or within the hepatic parenchyma. Upper digestive stenosis by compression of the duodenum by the hydatid cyst is an exceptional complication. A 63 year-old patient had, for two months, upper digestive stenosis associated with a sensation of weight in the right hypochondrium. Digestive endoscopy showed an extrinsic compression of the second portion of the duodenum. Biopsies were negative. Abdominal CT showed up a hydatid cyst in the segment VI of the liver, adhering to the duodenum, with an exo-vesiculation compressing it. The patient was operated on: There was a hydatid cyst of the right lateral sector compressing the duodenum. A partial intralamellar pericystectomy was performed. Hydatid cyst of the liver, a parasitic disease described as benign, may give mechanical complications related to compression of adjacent organs [especially the bile ducts and veins]. Compression of the digestive tract is exceptional. This is due to the proximity of the cyst to the duodenum and the thickness of the cyst wall

New robbins dispositive to evaluate antimicrobials activity against bacterial biofilms on central venous catheters

Layouts of biomedical devices were tightly related with the emergence of Staphylococcus epidermidis as a major cause of nosocomial infections because of its ability to form biofilm on the biomaterial surfaces. This fact led researchers to develop in-vitro models to simulate what is really happening during biofilm formation process in order to have a better understanding of this phenomena and then to control it and to resolve the associated problems. The aim of this paper was to develop a homemade dynamic device based on instruments used in clinical practice, easy to mount, with low coast and with no sophisticated features. Used to evaluate this dispositive were hydrodynamic calculation and enumeration of bacterial cells on petri dishes and with real time polymerase chain reaction during simulation of Staphylococcus epidermidis biofilm eradication with daptomycin. With hydrodynamic calculation, Reynolds number was estimated to be 26.62 corresponding to a perfect laminar flux giving suitable dynamic growth environment for such experiment. Data recovered from cell enumeration with the two methods showed that bacterial colonization of the tested catheter segment was significantly reduced after 24 and 48h of treatment with daptomycin [P<0.01] reflecting a considerable reliability of this device. The simple dispositive developed in this work has shown acceptable hydrodynamic proprieties and good reliability making research on biofilm easy to reach

Tuberculosis lymphadenitis in a southeastern region in Tunisia: Epidemiology, clinical features, diagnosis and treatment

To evaluate patients' profiles, demographics, clinical and therapeutic approaches and strategies in patients with tuberculous lymphadenitis [TBG]. A retrospective study of all TBG-confirmed cases admitted in a tuberculosis-specific health care facility between 1 January 2009 and 16 June 2013. A total of 181 clinical files were examined. Mean age was 32 years old; the female/male ratio was 1.78 to 1. Raw milk consumption was noted in 1/3 of patients. Most cases involved the head and neck region [83.4%], nodes involvement, including axillary [12 cases], and mediastinal [9 cases]. Clinical symptoms were present in only 55.2%. Tuberculin skin test [TST] was conducted with 82.6% positive responses. Diagnostics confirmation was done with anatomical pathology in most of the patients; only 56 of them had any microbiology analysis done. Demonstration of acid-fast bacilli in microscopy from either fine-needle aspirates or biopsies was done in 17.5% of cases, and cultures yielded positive results in 27%. Treatment duration was varied. Paradoxical reactions were noted in 12% and persistent lymphadenopathy after treatment completion was noted in 10% of cases. TBG remains a disease of interest. Today, its diagnosis and management is still a problem despite its increasing worldwide incidence, and especially in this study area. Disease control should be strengthened in this country

Antimicrobial activity of some essential oils against oral multidrug-resistant Enterococcus faecalis in both planktonic and biofilm state

Objective: To evaluate some essential oils in treatment of intractable oral infections, principally caused by biofilm of multidrug-resistant Enterococcus faecalis (E. faecalis), such as persistent endodontic infections in which their treatment exhibits a real challenge for dentists. Methods: Ten chemically analyzed essential oils by gas chromatography-mass spectrometry were evaluated for antimicrobial activity against sensitive and resistant clinical strains of E. faecalis in both planktonic and biofilm state using two methods, disk diffusion and broth micro-dilution. Results: Studied essential oils showed a good antimicrobial activity and high ability in E. faecalis biofilm eradication, whether for sensitive or multidrug-resistant strains, especially those of Origanum glandulosum and Thymbra capitata with interesting minimum inhibitory concentration, biofilm inhibitory concentration, and biofilm eradication concentration values which doesn't exceed 0.063%, 0.75%, and 1.5%, respectively. Conclusions: Findings of this study indicate that essential oils extracted from aromatic plants can be used in treatment of intractable oral infections, especially caused by biofilm of multidrug-resistant E. faecalis.

Antimicrobial activity of some essential oils against oral multidrug-resistant Enterococcus faecalis in both planktonic and biofilm state

<p><b>OBJECTIVE</b>To evaluate some essential oils in treatment of intractable oral infections, principally caused by biofilm of multidrug-resistant Enterococcus faecalis (E. faecalis), such as persistent endodontic infections in which their treatment exhibits a real challenge for dentists.</p><p><b>METHODS</b>Ten chemically analyzed essential oils by gas chromatography-mass spectrometry were evaluated for antimicrobial activity against sensitive and resistant clinical strains of E. faecalis in both planktonic and biofilm state using two methods, disk diffusion and broth micro-dilution.</p><p><b>RESULTS</b>Studied essential oils showed a good antimicrobial activity and high ability in E. faecalis biofilm eradication, whether for sensitive or multidrug-resistant strains, especially those of Origanum glandulosum and Thymbra capitata with interesting minimum inhibitory concentration, biofilm inhibitory concentration, and biofilm eradication concentration values which doesn't exceed 0.063%, 0.75%, and 1.5%, respectively.</p><p><b>CONCLUSIONS</b>Findings of this study indicate that essential oils extracted from aromatic plants can be used in treatment of intractable oral infections, especially caused by biofilm of multidrug-resistant E. faecalis.</p>

Autoimmune Pancreatitis, a report of 5 cases from Tunisia: diagnostic challenge

In this study, we aimed to review retrospectively the records of 5 patients who were treated in our hospital and to review the current approaches in diagnosis and management of autoimmune pancreatitis [AIP]. The series of patients diagnosed with AIP during the last seven years [January 2006 - August 2012] was the basis of this study. All records were retrieved and analyzed. The diagnosis of AIP was established on the basis of imaging studies, serology, cytology and response to treatment. Five patients were diagnosed with AIP pancreatitis during this 7-years period. Four of the 5 patients were males. The most common presenting symptom was abdominal pain [4/5]. Two patients with the preliminary diagnosis of pancreatic mass underwent surgery. Histological analysis of the surgical resection did not reveal any malignancy. During the follow-up, one of them has developed Crohn's disease and Sjogren syndrome. One of the patients had obstructive jaundice and abdominal pain for several months. Abdominal contrast enhanced computed tomography [CECT] suggested the diagnosis of AIP, cholangitis with renal atrophy and retroperitoneal fibrosis. He was started on steroids to which he responded dramatically. One patient had been diagnosed as primary sclerosing cholangitis few months earlier on the basis of abdominal CECT features showing a dominant stricture in the common bile duct. During the follow-up, the diagnosis of AIP was suspected and finally established on the basis of repeated magnetic resonance imaging [MRI]. The last patient had history of acute pancreatitis, obstructive jaundice and abdominal pain for 3 months. An abdominal CECT suggested autoimmune pancreatitis which was confirmed by MRCP. He was started later on steroids to which he responded significantly. IgG4 was done in all cases, high in four patients. AIP is a disease with increasing incidence and characterized by lymphoplasmacytic cells infiltration and fibrosis. It is necessary to evaluate patients in terms of AIP serologically to avoid wrong diagnosis and the morbidity of surgery

[Laparoscopy for perforated duodenal ulcer: conversion and morbidity factors: retrospective study of 290 cases]

Feasibility and advantages of laparoscopic approach in performed duodenal ulcer have no longer to be demonstrated. Laparoscopic suture and peritoneal cleaning expose to a conversion rate between 10 and 23%. However less than laparotomy, morbidity of this approach is not absent. This study aim to analyze factors exposing to conversion after laparoscopic approach of perforred duodenal ulcer. We also aim to define the morbidity of this approach and predictive factors of this morbidity. Retrospective descriptive study was conducted referring all cases of perforated duodenal ulcer treated laparoscopically over a period of ten years, running from January 2000 to December 2010. All patients were operated by laparoscopy with or without conversion. We have noted conversion factors. A statistical analysis with logistic regression was performed whenever we have sought to identify independent risk factors for conversion verified as statistically significant in univariante. The significance level was set at 5%. Analytic univariant and multivariant study was performed to analyze morbidity factors. 290 patients were included. The median age was 34ans.T he intervention was conducted completely laparoscopically in 91.4% of cases. The conversion rate was 8.6%. It was selected as a risk factor for conversion: age> 32 years, a known ulcer, progressive pain, renal function failure, a difficult peritoneal lavage and having a chronic ulcer. Postoperative morbidity was 5.1%. Three independent risk factors of surgical complications were selected: renal failure, age> 45 years, and a chronic ulcer appearance. Laparoscopic treatment of perforred duodenal ulcer expose to a conversion risk. Morbidity is certainly less than laparotomy and a better Knowledge of predictif's morbidity factors become necessary for a better management of this disease