[Surgical treatment of a ruptured aneurysm of the left common iliac artery in a patient with miliary tuberculosis]. / Traitement chirurgical d'un anévrisme rompu de l'artère iliaque commune gauche chez un patient présentant une tuberculose miliaire.

Tuberculous aneurysms of the common iliac artery are rare. Only a few cases have been reported in the literature. We report a new case in a 47-year-old man admitted for abdominal pain and persistent fever. The aneurysm was evoked in the duplex ultrasound scan and confirmed by computed tomographic angiography. The patient underwent an extra-anatomic femorofemoral bypass with a dacron prosthesis and ligation of the aneurysmal artery. The postoperative course was marked by febrile dyspnea related to the tuberculous miliary found on the chest x-ray. Histological analysis of the operative specimens confirmed the tuberculous origin of the aneurysm. The patient was put on antituberculous drugs and the follow-up was uneventful. With a follow-up of four months, the patient was asymptomatic and the bypass was well patent.

[Dramatic evolution of a bilateral femoral artery aneurysm in a 16-year-old girl]. / Évolution dramatique d'un anévrisme bilatéral de l'artère fémorale chez une fille de 16 ans.

Femoral artery aneurysm is a rare entity among the vascular complications of Takayasu's disease. It is sometimes characterized by the risk of serious local complications with hemorrhagic or ischemic event, as well as by a big therapeutic handling difficulty. We report a case of bilateral femoral artery aneurysm in a 16-year-old girl having a dramatic evolution turn after surgical treatment and irreversible limb ischemia.

[Ectopic pregnancy in Madagascar: 107 cases]. / Grossesse extra-utérine à Madagascar: 107 observations.

INTRODUCTION: Ectopic pregnancy is a serious gynecological disease requiring early diagnosis and treatment. The aim of this study is to analyze the epidemiologic, diagnostic and therapeutic aspects of this disease in a reference hospital in Madagascar. PATIENTS AND METHODS: This prospective and descriptive study included all women diagnosed with and treated for ectopic pregnancy at the University Hospital of Gynecology and Obstetrics of Befelatanana during the 6-month period from January 1 to June 30, 2011. RESULTS: We recorded 107 cases of ectopic pregnancy, accounting for 2.48% of all deliveries and 5.71% of surgical procedures. The age group most often concerned was that aged 31 to 35 years (28.97%). The main risk factors were a history of miscarriages (36.45%), spontaneous abortions (29.90%), sexually transmitted infections (21.50%), and smoking (16.82%). Amenorrhea was followed by pelvic pain and then bleeding in 78.50% of patients. Tubal rupture occurred in 71% of the cases. Ultrasonography contributed to the diagnosis in 93.5% of patients and a pregnancy test in 91.6% of cases. All cases were treated and resolved by surgery, with salpingectomy in 90.7%. Anemia was the main complication and blood transfusions were required for 27.1% of the women. CONCLUSION: The prevention of risk factors, the education of the population to consult early, and the use of laparoscopic surgery are useful for improving the treatment and prognosis of ectopic pregnancy.