Phéochromocytome et grossesse: une association rare à ne pas méconnaitre

L’association phéochromocytome et grossesse est rare, pouvant mettre en jeu les pronostics vitaux  maternel et foetal. Les auteurs rapportent deux observations de phéochromocytomes et grossesse chez deux femmes de 31 et 23 ans. Le diagnostic avait été évoqué devant une hypertension artérielle  paroxystique et un taux élevé d’acide vanyl mandélique. La localisation tumorale avait reposé sur l’échographie abdominale. Le traitement avait consisté en une césarienne à 8 mois et demi et une interruption de grossesse suivies d’une ablation de la tumeur dans un deuxième temps. Les suites avait été simples dans le premier cas et marquées par un décès post opératoire par collapsus à l’ablation de la tumeur dans le second cas.Mots clés : phéochromocytome - grossessepronostic.Pregnancy associated with pheochromocytoma is extremely uncommon but may have potentially  disastrous consequences for both the mother and fetus. The authors report on 2 cases of   pheochromocytoma in pregnancy concerning two patients aged 31 and 23. In the two cases, the diagnosis was evoked by paroxysmal hypertension and elevated levels of urinary vanyl mandelic acid. Topographical diagnosis calls for ultrasonography. A caesarean section at 8 months and a half and a therapeutic abortion were done first; tumor excision was done in a second time. The results were good in the first patient; the second patient died in the post operative period from collapsus due to tumor excision.Key words: pheochromocytoma- pregnancyprognosis

Notre expérience du traitement chirurgical de la lithiase de la voie biliaire principale : à propos de 17 cas

The aim of this study was to report our experience of the treatment of choledocolithiasis. From january 1985 to december 2004, 17 patients (11 women and 6 men; mean age 50 years, range 13 – 80) among 206 with biliary lithiasis were operated on for choledocolithiasis in our department. Diagnosis was made pre-operatively by abdominal ultrasonography in 88% of cases.The approach was a laparotomy in 15 cases and a right sub costal incision in 2 cases. The procedures performed were 2 transcystic extraction of stones with closure by ESCAT drain, and 15 choledocotomies: 10 vertical choledocotomies and 5 transverse. There was no operative mortality and morbidity. Treatment of choledocolithiasis has new changings with endoscopic sphincterotomy and coelioscopy. However in developing countries, conventional surgery is still the treatment of choice