[Prioperative adverse events: critical reading of the data registry used in the surgery department of military hospital Moulay Ismail, Meknes]. / Evénements indésirables peropératoire: lecture critique du registre du bloc opératoire de l'hôpital militaire Moulay Ismail Meknès.

INTRODUCTION: Despite significant progress made in the field of safety in anesthesia, morbidity (serious or not, completely or partially related to anesthesia) remains common and no health practitioner is immune from accidents. In the current context where priority is given to training programmes, to quality and safety improvement in health care, the occurrence of an anesthesia-related accident in the surgery department is an extremely traumatic event. The fear of prosecution, the emotional context make it difficult to manage. For this reason, it must be codified according to Department protocols, based on three main axes of management: patient victim, medical and paramedical staff involved and accident analysis to prevent its recurrence. METHOD: In order to improve health care quality in surgery department we have implemented a continuously updated data registry containing the incidents and accidents occurred either in the operating room or in the post-interventional surveillance room A first reading was made on the occasion of Post Doctoral Training (JEPU) in Fez (Morocco) organized in partnership with the JEPU of the Pitié Salpêtrière in Paris at the School of Medicine and Pharmacy of Fez under the theme: «Critical Situations In Surgery Department¼ 17,18 April 2015. RESULTS: 1761 patients were admitted to different operating rooms, 96 in the endoscopy room and 17 under sedation in diagnostic radiology. 29 patients (1.64%) reported a perioperative incident and/or a perioperative accident. Most of the adverse events occurred during surgery (58.6%). 28.6% of cases in the immediate post-operative period or in the post-interventional surveillance room. The most frequent complications were respiratory (34%) or cardiovascular (31%). We recorded 5 perioperative deaths (mortality rate of 28%) Determining the cause is not always obvious. The human factor is responsible for 24% of incidents. CONCLUSION: This observation highlights the different adverse events which have been recorded since the establishment of the data registry 6 months before. We offer a critical reading of this data registry for the sole purpose of improving our practices with a view to strengthening safety during anaesthesia.

Dural tear of unusual cause.

Epidural analgesia is highly recommended in cancer anorectal surgery. In addition to the fight against pain it provides some benefit in allowing early rehabilitation of patients. One of the risks of this practice is the dural tear creating a cerebrospinal fluid leak (CSF) in the epidural space (EPD). Clinical features the typical positional headache, a procession of various more or less severe symptoms: nausea, vomiting, dizziness, visual or hearing impairment or radicular pain. We report a dural of unusual cause secondary of the obstruction of tuohy catheter by vertebral cartilage.

[Tuberculosis of the breast in a man]. / Tuberculose du sein chez l'homme.

Tuberculosis is a major public health problem in Morocco. A mammary localisation is very rare. The incidence of tuberculosis remains very low, even in developing countries where it is considered endemic, but the spread of the human immunodeficiency virus has led to an increased number of cases of extrapulmonary tuberculosis, even in the most developed countries. This disease presents essentially diagnostic problems, resolved only by histological and bacteriological study. The treatment is essentially medical, based on antibacterial chemotherapy associated with surgery in some advanced cases.

[Pancreatic tuberculosis as a pseudotumor: a case report]. / Tuberculose pancréatique : forme pseudotumorale À propos d'un cas.

Tuberculosis is a major public health problem in our country. Abdominal tuberculosis ranks third among the extrapulmonary localisations and account for 3% of the various topographic forms in Morocco. The pancreas and peripancreatic locations are much rarer than peritoneal and intestinal lesions. They present a pseudotumoral appearance that creates a diagnostic emergency. We report a case of pancreatic tuberculosis observed in the general surgery department of the 5th Military Hospital.