[Myofibroblastic tumor of the great omuntum]

Myofibroblastic tumors are a spindle cell lesion at indeterminate malignant potential. Abdominal location was rare. We report a case of an unusual location at myofibroblstic tumors in the great omuntum. A 63-year-old women presented with a one year of isolated left hypochondrium pain. Physical examination was normal. CT scan of the abdomen showed a multicystic and a multilocular building-up of the great omentum suggestive of a peritoneal haemolymphangioma. Besides, at the MRI, this lesion showed up with threefold component: cystic, plump and fibrous, all leading towards a myofibroblastic tumor. At laparotomy, there was already a 10 cm diameter cystic tumor of the great omentum, composed of numerous cystic sockets, all filled with a thick brunish substance. A total resection of the great omentum was done, thus taking away the whole tumor. The histological examination confirms the diagnosis of myofibroblastic tumor of great omentum. Post operative evolution was uneventful. One year later there were no signs of recurrence. Myofibroblastic tumors of the great omentum are rare. The diagnosis is often confirmed by careful microscopic examination or immunohistochemical markers. Treatment consists on a complete surgical resection and life time follow-up is needed because the risk of recurrence

[Squamous cell carcinoma arising in Verneuil's disease]

Verneuil's disease or hidradenitis suppurativa is a chronic suppurative, and cicatricial inflammatory disease, mainly affecting apocrine-bearing area of the skin. Squamous cell carcinoma is an uncommon but a frightening complication of hidradenitis suppurativa. To report a new case of squamous cell carcinoma arising in Verneuil's disease. We reported a case of 60 year old man with a 30 years history of hidradenitis suppurativa in which squamous cell carcinoma arise. A wide surgical excision removing the tumour and leaving a large defect was performed. The patient had a well recovery, wounds healed well by primary intention. No recurrence observed at 18 months of follow up. Squamous cell carcinoma is an uncommon complication of hidradenitis suppurativa. Surgical excision represents also the treatment of choice

[Idiopathic renal vein thrombosis. About two cases]

Renal vein thrombosis is a rare pathology diffcult to diagnose. It has quite various clinical expression and biological consequences. The diagnosis is based upon radiologic explorations. This entity may have various causes. Detecting this condition may lead to restoration of renal function compromised by renal vein thrombosis. The treatment of renal vein thrombosis is mainly medical and based on anticoagulants. The role of fibrinolytic treatment is controversial. Surgical is exceptional. We report two cases of idiopathic thrombosis of the renal vein in adult patient. Also, we have done a review of the literature on this clinical syndrome and its diagnostic and therapeutic aspects

Facteurs predictifs de morbidite et de mortalite de la chirurgie du vieillard

The aim of the study was to determine prognostic factors of post operative morbidity and mortality for patients aged 80 years and older. We compared two groups of patients aged 80 and over operated to determine predictive factors of morbidity and mortality group of patients who presented post operative complication within 30 days after surgery and group of patients without any complication. Comparison of the two groups for global morbidity using univariate analysis showed only one prognostic factor: surgery of diabetic foot [p = 0.034]. Predictive factors of mortality according to univariate analysis were: pre-operative shock [p = 0.001], abdominal wall pathology [p = 0.027], gastric or duodenal ulcer diseases [p= 0.011] and global morbidity [p = 0.006]. After logistic regression, only pre-operative shock was an independent predictive factor of mortality [p = 0.0023]. Risk for morbidity after surgery in the elderly 80 years and over is linked with type of surgery and not with soil. Likewise, risk for mortality is linked with advanced stage of disease that is presence of pre-operative shock and not with soil

Facterus pronostiques des splenectomies pour rate hematologique

The aim of this study was to identify the prognostic factors of intraoperative haemorrhage, perioperative blood transfusions and morbidity. We collected 120 splenectomies in Beau sejour department of surgery, charles' Nicolle Hospital, Tunis, Tunisia between 1979 and 1999. the descriptive analysis showed sex ratio 0.82 with mean age [ +/- standard deviation] 30.6 +/- 15 year. Idiopathic thrombopenic purpura was the principal disease indicating splenectomy. Morbidity was defined as occurrence of post operative peritoneal sepsis or bleeding. The mortality and morbidity rates were respectively 0.8% and 6.6%. the prognostic anlysis didn't identify predictive factors of intraoperative haemorrhage, however it identified two independent predictive actors of specific morbidity: intraoperative haemorrhage [p = 0.03] and preoperative rate of haemoglobin [p = 0.0049]