[Paraumbilical block for strangulated umbilical hernia in emergency]. / Bloc paraombilical pour l'anesthésie de la hernie ombilicale étranglée en urgence.

The authors describe a strangulated umbilical hernia surgery performed in emergency with a paraumbilical block associated with a local infiltration. For this patient, 3-4 ASA status, in occlusion, with iterative vomiting and coagulation disorders, general or spinal anaesthesia were high-risk technics. Paraumbilical block, sometimes used for anaesthesia or/and analgesia for programmed umbilical hernia surgery, allowed surgery with good conditions and procured prolonged postoperative analgesia. This block, easy to perform, is an interesting alternative in emergency for general or spinal anaesthesia in high-risk patients.

[Evaluation of inguinal hernia management in ambulatory surgery]. / Evaluation de la prise en charge des hernies inguinales en chirurgie ambulatoire.

AIM: To evaluate the prospects of ambulatory surgery for inguinal hernia. PATIENTS AND METHODS: From January 1995 to June 2001, 599 operations on inguinal hernias were performed. Patients were composed of 554 men and 45 women. The average age was 58 years (7-95). All patients were examined by their primary doctor on the first and the third day, and by the surgeon on the 10th day. RESULTS: Four hundred and eighty-one patients were operated on by ambulatory surgery (80.3%). The "Tension-free" technique was carried out among 495 patients (82.6%). Loco-regional anaesthesia was used for 499 patients (83.3%). The postoperative rate of complications was 10.4% (62 patients). Only 201 patients presented postoperative painful symptomatology (33.6%), 341 a discomfort (56.9%), and 57 (10%) experienced no pain. The overall satisfaction rate was 92.9%. CONCLUSION: Use of the "Tension-free" technique under loco-regional anaesthesia for inguinal hernias allows ambulatory surgery with a low rate of complications and high satisfaction for the patients.

[Biliary peritonitis caused by perforation of the intra-hepatic biliary ducts. 2 new cases]. / Péritonites biliaires par perforation des canaux intra-hépatiques. Deux nouveaux cas.

Two cases of biliary peritonitis by perforation of intra-hepatic biliary ducts are presented. In both cases there is a perforation from a gallstone. In the first case the perforation is located at the proximal part of the left hepatic bile duct, in the second case it is at the proximal and distal portion of the third segment bile duct. Those peritonitis are rare and their diagnosis is difficult. Gallstone is the main cause. Removing bile duct obstruction is the treatment.

[Cancers of the thoracic esophagus in gastrectomized patients. Technical problems]. / Cancers de l'oesophage thoracique chez les gastrectomisés. Incidences techniques

The authors report three cases of carcinoma of the thoracic part of the esophagus who had previously undergone gastrectomy. They study, in the absence of a stomach, the possibilities of restoration of digestive continuity after esophagectomy and describe three possibilities: -- mobilisation and use of the remaining gastric stump; --esophageal resection and anastomosis restoring continuity; -- colonic interposition. Of the three procedures used, only the first and last are advised by the authors.