[Duodenal varix rupture a rare cause of gastrointestinal bleeding from portal hypertension]. / Rupture de varice duodenale. Une cause rare d'hemorragie digestive liee a l'hypertension portale.

The duodenal varix rupture is a rare and serious complication of portal hypertension. The authors report one case of duodenal varix rupture in a 38 year old woman, revealing portal hypertension, which caused a massive gastro-intestinal bleeding. The endoscopy didn't allow to conclude to a diagnosis. An emergent laparotomy was necessary regarding the massive bleeding. A duodenal varix suture ligation was performed after pyloroduodenotomy. She had a well recovery. After a review of literature, the authors conclude that this abnormal situation is rare, its diagnostic is difficult and it has several therapeutic strategies.

[Rupture of the low thoracic esophagus after blast trauma]. / Rupture de l'oesophage thoracique distal par effet blast.

Closed traumatic rupture of the esophagus is uncommon. Early diagnosis and effective treatment are necessary to avoid death or serious illness. We report a case of a low thoracic rupture after blunt trauma diagnosed at the stage of esophago pleural fistula and mediastinal collection. The patient underwent a bipolar-exclusion of the esophagus. The digestive continuity was restored by a retrosternal coloplasty and an oesophagectomy was performed afterwards. The postoperative course was uneventful and the patient was in a good health three years after operation.

[Common bile duct injuries during laparoscopic cholecystectomy]. / Les traumatismes de la voie biliaire principale au cours des cholecystectomies laparoscopiques. A propos de 3 cas.

Laparoscopic cholecystecmy is the preferred method for removing the Gall bladder. The most frequent intra-operative complications are by for related to the biliary tract: wounds, section. From September 1995 to August 2001, the authors have realized 1570 cases of laparoscopic cholecystectomy. There were 3 lesions of the common bile duct. Most of those complications are directly proportional to the operators experience. Their prevention depends on a perfect technics, understanding of the mechanisms and no hesitation in converting to conventional laparotomy whenever difficulties are encountered.

[Laparoscopic cholecystectomy. Apropos of 1570 cases]. / La cholécystectomie laparoscopique. A propos de 1570 cas.

We realized a retrospective study concerning 1570 cases of celioscopic cholecystectomy screened during 6 years: from September 1995 to August 2001. There were 1328 females and 242 males with a wean age of 50 years. 256 patients underwent laparoscopic cholecystectomy for acute cholecystitis. There were one operative death. The morbidity is weak 2.1%. The rate of conversion is 12.4%. We performed 999 operative cholangiography, we found 82 common bile duct stones. Cholangiography should be systematic.

[Hemangioma of the spleen. A case report]. / Hemangiome de la rate. A propos d'un cas.

We report a case of hemangioma of the spleen in an 18-old-years female patient. Clinical presentation was abdominal pain in the left upper quadrant. Physical examination founding was normal. The hemangioma was presented as hyperechogenic mass on ultra sound imaging. On the computed tomography scan with contrast it became progressively hyperdense. Splenectomy is often indicated because of the risk of rupture and the doubt about malignant form in histological examination.