Interest of laparoscopy in polysplenia syndrome.

Polysplenia syndrome (PS) is usually discovered in symptomatic patients in association with congenital heart disease or biliary atresia. Asymptomatic patients can present associated anomalies of the digestive tract such as intestinal malrotation and gastric or splenic malfixation. We report a case of PS presenting as a left flank mass shown to be an accessory spleen by denatured red blood cell scintigraphy. Upper gastrointestinal tract studies showed intestinal malrotation. Laparoscopic exploration confirmed intestinal malrotation and showed the absence of fixation of the accessory spleen. We performed a laparoscopic Ladd's procedure followed by fixation of the accessory spleen and resection of Meckel's diverticulum through a short left-flank incision.

[Infectious perforation of the terminal ileum. Apropos of 42 cases treated in the Islamic Republic of Mauritania]. / Les perforations infectieuses de l'iléon terminal. A propos de 42 cas traités en République Islamique de Mauritanie.

The authors report 42 infectious perforations of terminal ileum operated at the National Hospital of Nouakchott (Islamic Republic of Mauritania) from 1985 to 1988. The main etiology is typhic (67 p.c.). The mortality is important (21 p.c.). The standardization of medico-surgical treatment and the use of cotromoxazole open the way to a better prognosis, but differed diagnosis and socio-economical conditions are some burdens, common to developing countries that have to be taken into consideration.