[Prader-Willi syndrome: a 5 cases report]

The Prader-Willi syndrome is a rare genetic syndrome. Its diagnosis is currently well codified, based on clinic and paraclinic criteria. Its management has to be precocious and multidisciplinary. The authors relate 5 cases, and they insist on the difficulty of the diagnosis and of the management of this syndrome. Method: 5 cases of Prader-Willi syndrome were diagnosed in the Unit of Endocrinology and Metabolic Diseases of Rabat Children Hospital. These cases were collected according to criteria's of diagnosis of the American Society of Human Genetics and the French association "AFPW". The mean age of diagnosis was 6 year-old. The circumstances of diagnosis were a behavior trouble in 1 case, a short stature in 1 case, a neonatal hypotonia 1 case and a suspicion of Cushing syndrome in 2 cases. In 4 patients the diagnosis was made according to the criteria of the AFPW, and by molecular biology in 1 case. 4 children had a facial dysmorphism and a psycho-motor retardation. The treatment was based on dietary management, and the treatment of other hormonal deficiencies. Conclusions: only an early diagnosis and a multidisciplinary management can improve the prognosis of this syndrome

cancers multiples synchrones du colon et du rectum [a propos de 5 cas]

Out of 230 recto-colic cancers being operated in 10 years [1981/1991], 6 double localizations were diagnosed [2,6%]. Pre-operative diagnosis was made in 2 patients. In 2 others, diagnosis was operaty. In the last patient, the second cancer is discovered one year later after a colic resection. The 5 observations are summarized, the authors discuss the epidemiologic and therapeutic aspects of this affection

Metastases intestinales et vesiculaires d'un melanome malin cutane revelee par une peritonite [a propos d'un cas]

The authors report the case of a 63 year -old woman, with multiple jejunal metastases from a cutaneous malignant melanoma, revealed by a peritonitis. The operation revealed a metastasis of the gall bladder. By means of this case, the authors insist on the frequency of this metastasic localisation in the intestinal tract, on the usual mildness of the symptoms produced by osuch a localisation, and on the usual rapid course of malignat melanoma in the intestine

Le traitement chirurgical de la rectocolite ulcero-hemorracique [a propos de 64 cas]

From 1984 to 1996, 64 ulcerative colitis cases were surgically managed at the Service of Surgery C [Hospital Ibn Sina]. In half of cases, the patients were young subjects with a slight female prevalence The study of lesions extend indicated 80% of pancolitis, located forms in 16% of two cases and toxic megacolon in one case. As for the indications for surgery, 73,4% of patients presented in serious acute condition, 20% of them were cold surgically managed and two toxic mega colon case. The total colectomy with one or two times ileorectal anastomosis was the most frequently used intervention [84%]. The ileo anal anastomosis with reservoir was carried out in 10 cases among which two was a transformation of ileorectal anastomosis into anal anastomosis. In our series, the operative mortality reached 7,8% because of the belated operative indications. Here were presented the different interventions and their indications and results respectively