[ 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

[Liver abcesses: clinicals aspects and actual treatment]

A serie of 32 liver abcesses during a trial of 7 years is reported by the authors. The male sex is predominant [90%] The symptoms of the illness are typicaly those of the classic liver abcess. The treatment has improved with the progress of the imagery and especially the echography. The punction under echography had been tried in 7 cases, of which 6 were cured. When the seize of the liver abcess is small the medical treatment permits recovery in 68% of the cases. Only new cases that do not answer to medical treatment and punction are candidate to surgery