[Case of bilateral pulmonary dystrophy operated on at the Dakar General Hospital]. / A propos d'un cas de dystrophie pulmonaire bilatérale opéré a l'Hôpital Principal de Dakar.

The authors report one case of large bullous dystrophia of both lungs. It was operated in two phases at the hospital Principal, Dakar, Senegal. They emphasize the technics of anesthesia by thoracic high epidural block, surgical technics. They also point out the clinical improvement, as results of respiratory functional exploration did prove it.

[Plummer-Vinson syndrome or related syndrome in 3 black African women]. / Syndrome de Plummer-Vinson ou syndrome apparenté chez trois africaines de race noire.

The Plummer-Vinson syndrome or "sideropenic dysphagia" is exceptional among Blacks. One case was recently reported in a female patient from Guadeloupe. This study pertains to three cases observed in Senegalese Black women aged 28, 27, and 41 years. These three women were admitted for a dysphagia, in fact in evidence 10, 4, and 7 years respectively before the diagnosis was made. A clinical anemia was noted twice in addition to mucocutaneous disorders (cases 1 and 2). The laboratory tests showed in all three cases a hypochromic microcytic sideropenic anemia (serum iron levels at 32, 14, and 31 mcg 100 ml respectively). Barium swallow films showed esophageal rings in front of C5-C6 (case 1) of T2-T3 (case 2) and a web of fine mucosal folds in front of C5-C6 (case 3). These films were confirmed cineradiographically by esophagoscopy. The treatment consisted of blood transfusions (cases 1 and 2) and administration of iron by injections and or per os. The endoscopic exams were repeated two or three times. Medical treatment rapidly changed the course of disease for the better. No cause for bleeding was found. A chemical achlorhydria (case 1), a provoked hypoachlorhydria (cases 2 and 3) can be retained as associated factors. In light of the frequency of esophageal membranes in the general population and the incidence of sideropenic anemias among African women, the Plummer-Vinson syndrome should be more often detected in Black Africa.

[Indications for laparoscopy in an internal medicine department in Dakar as indicated by echotomography]. / Indications de la laparoscopie dans un service de médecine interne à Dakar à l'heure de l'échotomographie (E.C.T.).

A real time ultrasonography was set up in a senegalese hospital, resulting in a decrease of laparoscopy indications. Laparoscopy is given up for the diagnosis of liver abcess, jaundice and "abdominal masses". It must no more be included in the first step check up for hepatocellular carcinoma, because ultrasonography and cytology after puncture are enough to confirm the diagnosis. Laparoscopy remains essential for peritoneal diseases. Hepatic needle biopsy under laparoscopy control remains necessary to ensure with certainty the diagnosis of cirrhosis and especially chronic hepatitis, provided that no countraindications are found.