[Hypoglycaemia after surgery on phaeochromocytoma]. / Hypoglycémie compliquant la chirurgie d'un phéochromocytome.

Few cases of postoperative hypoglycaemia complicating the removal of a phaeochromocytoma have been reported in the literature. We reported one case of hypoglycaemia secondary to the removal of right phaeochromocytoma in a 30-year-old patient. Seven hours after the excision of the tumour, the patient developed a severe hypoglycaemia at 1.67 mmol x l(-1) revealed by seizures completely resolving in 24 h. The hypoglycaemia in this context resulted probably from the massive secretion of insulin by the beta cells of Langerhans islands due to the suppression of alpha-adrenergic inhibition. The prevention of this complication requires the repeated measurement of the capillary glycaemia in the postoperative period. An important supply of carbohydrate may be necessary to maintain a normoglycaemia.

[Quadriplegia secondary to potassium depletion]. / Tétraplégie secondaire à une hypokaliémie de déplétion.

Muscle paralysis due to potassium depletion are unusual. We report the case of a patient who developed quadriplegia and language disorders due to potassium depletion, following large intestinal resection. Potassium supplementation was given intravenously at a rate of 0.25 mmol.kg-1.h-1 during the first 48 h. This allowed complete total and rapid recovery from the paralysis.

[Emphysematous pyelonephritis: a case report]. / La pyélonéphrite emphysémateuse: à propos d'un cas.

In this study, a case of emphysematous pyelonephritis has been reported in a 70-year old diabetic male with a non-functional contralateral kidney. In spite of appropriate medical treatment and surgical drainage, the outcome was negative. The case in question concerned a rare form of the disease, i.e., emphysematous pyelonephritis, a severe and necrotizing infection which is characterized by the presence of intraparenchymal gas produced by anaerobic bacteria, and the rapid development of acute sepsis or septic shock. Medical treatment alone is seldom sufficient, and surgical intervention, in most instances consisting of radical nephrectomy rather than surgical drainage, is advocated due to the extent of the necrotic lesions.

[Ulcero-hemorrhagic rectocolitis: operative morbidity and mortality. Apropos of 100 cases]. / La recto-colite ulcéro-hémorragique morbidité et mortalité opératoires. A propos de 100 cas.

We performed a retrospective analysis of morbidity and mortality in 100 cases of ulcerative colitis treated at the surgical care unit of the Ibn Sina hospital over a 10 year period from 1984 to 1994. One major complication, usually infection, was observed in 40% of the cases. Overall mortality was 22%, a rate higher than the larger published series. The main factor incriminated in our study ; besides surgical circumstances, was the delay in care, including in the intensive care unit. It must be concluded that medical and surgical management must be initiated as soon as a flare up is diagnosed.