[ thoraco-Abdominal injury: about 78 cases]

The authors report a series of 78 cases of the thoraco-abdominal wounds collected between 1992 and 2002.The mean age of the patients is 27 years old [16- 60 years old] with male predominance [90%].The aggressions with a blade [stab] are the exclusive etiology [100%]. The left hemi thorax represents the Site of penetration in 80% of cases. The clinical symptoms at the admission were dominated by the respiratory detress. The chest radiography that has been achieved systematically. In all our patient, showed a hemothorax [39 cases] hemopneumothorax [20 cases], the radiography was normal in 27 cases. The abdominal ultrasound was done in 36 cases when the thoraco-abdominal injury was suspect, however the clinical examination and radiography were normal. It's showed a double peritoneal and pleural effusion in 36% of the cases. About the therapeutics, the treatment has been always surgical, so, the laparotomy has been necessary in 66 patients, the thoracotomy in 2 cases, the thoraco-laparoscopy in 4 cases, and the thoracoscopy in 2 cases. No death was noticed in this series The immediate following have been simple in the majority of the cases, in 6 patients, pleuro-pulmonary complications have been occurred. The thoraco-abdominal injuries have sometimes a problem of diagnostic, specially if only the diaphragm was injured. We believe that the thoracoscopy is the best exam to confirm the diaphragm injuries. The thoraco-laparoscopy can be the best surgical approach

Pheochromocytoma [a report of 8 cases]

We reviewed a serie of 8 patients, 6 females and 2 men operated for a pheochromocytoma. Sex patients had a high blood pressure; permanent in 4 cases and paroxystic in two. Three patients had a left ventricular hypertrophy. The vanyl-mandalic-acid was elevated in 5 cases and dopamin in one case. This study confirmed the remarkable sensitivity of computed tomography [100%] for the detection of the pheochromocytoma. The ultrasonography was objectived the surrenalien tumor in 5 cases. The surgical procedure consisted on a total resection of the tumor by an anterior intraperitoneal approach. There was no mortality in our serie. Only one patient kept a high blood pressure after the resection neverthless negativity of the check-up. The pre-operative treatment is systematic and the only treatment of pheochromocytoma remains ablation of the tumor