[Cancer of the rectum in young adults. Apropos of 38 cases]. / Les cancers du rectum de l'adulte jeune. A propos de 38 observations.

This retrospective study is based upon 38 cases of rectal carcinomas occurring in young individuals aged under 25, collected during the 15 year period from January 1978 to December 1993. The mean age of the patients was 23 (range: 14 to 25), with a gender ratio of 2.1. Histology revealed a well differentiated adenocarcinoma in 12 cases, a moderately or slightly differentiated and undifferentiated carcinoma in 14 cases, a colloid carcinoma in 10 cases and a villous tumor with malignant change in 2 cases. Curative surgical excision was possible in only 11 patients. Sixteen patients underwent a palliative procedure, while 12 refused surgery. No treatment was proposed to 3 patients with visceral metastases. Only 11 patients could be followed up, with a mean 5-year survival rate of 10%. The prognosis of rectal carcinoma in young individuals is poor because of late diagnosis at an advanced stage and the aggressive histologic forms encountered.

[Tuberculous abscess of the liver. Apropos of 2 cases]. / Abcès tuberculeux du foie. A propos de deux observations.

The authors report two cases of tuberculous liver abscess. They stress the rarity of this site, and differential diagnostic difficulties with other types of infection and liver tumors, notably amebiasis, hydatid cyst and carcinoma. Echo- or Scan-guided needle biopsy is useful for diagnosis and, in some cases, treatment by drainage of the purulent cavity.

[Tuberculous anal fistulas. 13 cases]. / Fistules anales tuberculeuses. A propos de treize cas.

Our retrospective study concerns 13 cases of anal tuberculosis fistulas, studied over a period of 12 years, between January 1980 and December 1991. The mean age of our patients was 24 years and they were predominantly male. The diagnosis, which was suspected clinically, was confirmed histologically, either by ridge biopsies of the external orifice of the fistula or by surgical removal of the fistular passage in patients having undergone an initial surgical intervention. In 5 cases, we noted an associated pulmonary tuberculosis involvement. The treatment comprised 2 phases: an antibacillary medical treatment in all cases and a surgical treatment depending on whether the diagnosis was initially based on the ridge biopsies of the external orifice--6 cases (46.15%)--or after removal of the fistular passage--7 cases (53.85%). The outcome was good in all cases.

[Gastroduodenal tuberculosis. Report of 6 cases]. / Tuberculose gastroduodénale. A propos de six cas.

The authors report a retrospective study of 6 cases suffering from gastroduodenal tuberculosis which occurred in our gastroenterology department during a period of 14 years. This affection is rare and set a lot of diagnosis problems with a gastroduodenal neoplastic affection because of its clinical polymorphism and its radio endoscopic aspects which are very confusing. The association with a localisation of another tuberculosis has been found in all cases and this allowed us to guide the diagnosis. The specific medical treatment by antibacillaires rely on histologic evidence, either by epidemiologic arguments, clinic, paraclinic and therapeutic evidence.