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Background/rationale: Tuberculosis is a public health issue. Extra-pulmonary presentations are rare and sometimes hard to diagnose and manage. Here, we report a case of tuberculosis of the chest wall in a 28-year-old man in order to discuss the mechanism, diagnostic and therapeutic problems posed by this rare localization. Description: The patient presented with wall swelling discovered after physical effort. Imaging was in favor of an abscess or infected hematoma. The excisional surgery established the tuberculous origin which was confirmed by histology. Anti-tuberculosis treatment during 9 months completed the surgical treatment and led to the patient's recovery. Discussion/conclusion: The rarity of this localization of tuberculosis should be investigated. Etiological treatment must be instituted and regular monitoring scheduled to avoid recurrence. Conclusion: Direct-acting antivirals are effective and characterized by good tolerance in these Malagasy hepatitis C patients.

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Delayed post-traumatic pericardial effusion is a rare condition after blunt trauma. The diagnosis of the effusion can be made by the clinical signs, which is not very specific and the cardiac echography. The etiological diagnosis remains difficult because it requires the elimination of the other causes of pericarditis. Their treatment consists in evacuating the pericardial effusion. The evolution thereafter is simple. We report four cases of patients with pericardial effusion late after a thoracic injury. Imaging the blood test, the examination of the pericardial fluid and the anatomopathological examination of the pericardium, eliminates the other etiologies.

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La tumeur de Pancoast-Tobias est rare. Les auteurs rapportent un cas chez un homme de 50 ans presentant une tumefaction cervicale et thoracique droite associee a une douleur de l'epaule droite; une nevralgie du membre superieur droit et un syndrome de Claude Bernard Horner evoquant le syndrome de Pancoast-Tobias. La radiographie et le scanner thoraciques confirmaient le diagnostic d'une tumeur apicale droite. Une exerese large etait pratiquee suivie d'une chimiotherapie. Aucune recidive n'etait observee apres un recul de deux ans. Les particularites de cette pathologie rare sont discutees a travers une revue de la litterature

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Mesenteric cystic lymphangioma is an uncommon benign tumor. The purpose of this report is to present a case involving a 7-year-old girl who presented hemoperitoneum due to traumatic rupture of a mesenteric lymphangioma cyst. The patient who had a huge preexisting tumor mass presented with hemorrhagic shock symptoms following a severe fall. Peritoneum puncture lavage confirmed hemoperitoneum. Exploratory laparotomy revealed a large bleeding cyst-like mesenteric tumor. Total extirpation was difficult but successful. Histological examination of the surgical specimen demonstrated mesenteric lymphangioma. In developing countries like Madagascar, rupture of parasitic splenic cysts is the most frequent underlying etiology in children presenting hemorrhagic syndrome after falls. This case shows that mesenteric cystic lymphangioma rupture can be a rare cause.

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Les syndromes canalaires du membre superieur couvrent des pathologies variees. Les manifestations vasculaires au cours de ces syndromes sont rares mais graves. Nous rapportons deux cas atypiques d'etiologie exceptionnelle; dont un cas du syndrome de canal carpien provoque par une tumeur de type rhabdomyosarcome alveolaire; de la partie distale de la face anterieure de l'avant bras et un cas de syndrome de la traversee cervico-thoraco-brachiale du a une exostose de l'extremite superieur de l'humerus. Notre objectif est de rapporter ces deux cas et de realiser une revue de la litterature sur les aspects clinique et therapeutique de ces affections

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Nous rapportons un cas de tumeur stromale gastrique chez un jeune homme de 20 ans; se manifestant par une hemorragie digestive haute persistante. Le traitement etait uniquement chirurgical; la tumeur; bien que volumineuse; etant localisee. L'evolution etait defavorable avec dissemination neoplasique amenant le deces du patient apres cinq mois. A travers une revue de litterature; les aspects diagnostiques et therapeutiques des tumeurs stromales sont discutes

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La localisation intra pulmonaire des teratomes est inhabituelle. La forme maligne de cette pathologie constitue une eventualite rare et particuliere des cancers du poumon. Nous rapportons un cas de teratome intra pulmonaire de forme maligne chez une femme de 52 ans. Notre objectif; a travers ce cas; est de faire connaitre cette pathologie et de realiser une revue de litterature afin de soulever les aspects clinique; therapeutique et evolutif

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Objectif: Les tumeurs mediastinales posent souvent un probleme diagnostique et therapeutique. La demarche diagnostique doit aboutir a la topographie et a la nature de la lesion pour mieux adapter le traitement. A travers une revue de litterature; notre objectif est de presenter les aspects diagnostiques et therapeutiques des tumeurs mediastinales par rapport a notre experience .Patients et methode: Notre etude porte sur 28 patients (24 hommes et 4 femmes) presentant une tumeur mediastinale; vus dans le service de chirurgie thoracique du Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona (CHU/JRA) d'Antananarivo (Madagascar) sur une periode de huit ans. Resultats: Les tumeurs mediastinales occupent 5des tumeurs observees dans notre service. Dans 85;71des cas; les patients sont ages de moins de 50 ans. Le syndrome mediastinal est rencontre dans 53;57des cas. La chirurgie etait pratiquee dans 39;29des cas et avait permis d'avoir la nature histologique. Conclusion: Dans notre contexte de pays en developpement; la chirurgie reste une alternative interessante pour obtenir la nature histologique des TM en vue d'une prise en charge multidisciplinaire adaptee

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Gastric volvulus is an abnormal rotation of the stomach around its axis. The acute form is a surgical emergency, which doesn't tolerate any therapeutic delay. We report on a case in a young girl, revealed by painful epigastric mass and distended gastric bubble on abdominal X-ray. This case was been successfully treated by detorsion and gastropexy. The clinical picture of gastric volvulus is characterised by the Borchardt triad of symptoms: upper abdominal pain, vomiting and difficulty to pass a nasogastric tube. The gastrointestinal barium series and CT-scan help to confirm the diagnosis. As was demonstrated in this case, the treatment is surgical by reducing the volvulus and fixing the stomach to prevent recurrence.

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We report the first malagasy case of a 10 years-old child with a Klippel-Trenaunay-Weber syndrome. The patient presented with cutaneous hemangioma, varicosities and unilateral hypertrophy of soft tissues of the left hand. Arteriovenous fistula was findings by the echo-doppler. Ligature of the fistula was performed.

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The inguinal hernia, malformations caused by persistence of peritonea-vaginal duct, is frequent in children. It is a benign affection as long as it is not strangled. During our five-year-retrospective study, we have found 32 cases (30 boys and 2 girls) of strangled inguinal hernia. There are 78,12% of cases under five years old. In 54%, the hernia was on the right side. Malnutrition and inguinoscrotal hernia are very exposed to strangulation. We observed obstruction syndrome in 81,25% of cases. We have to deplore one case of scrotal fistulae by intestinal necrosis and two cases of testicle necrosis. For all of our patients, the peritonea-vaginal duct was closed with ligature, associated with pre-funicular parietal refection. One case of recurrence is found in postoperative time.

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The primitive psoas abscess is a pathology extremely rare in the child. The diagnosis is difficult and often delayed. Their treatment requires a local and general sterilization of the infection. We report three observations of primary abscess of the psoas in the child. The clinic presentation is uncommon. Ultrasonography keeps an important place. The biology objective an infectious and inflammatory syndrome. Histology permits to put in evidence all shapes association of lesions. The bacteriological survey of the pus after drainage is only positive in one case. Surgical drainage with bactericidal antibiotherapy permit a definitive recovery.

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Abdominal actinomycosis is a rare and unrecognised disease. It is a chronic granulomatous suppurating infection caused by bacterial infection. The symptomatology is not specific including a tumour like abdominal lesion fistulized to the skin with issue of characteristic yellow granules. We report a case of a 12-year old boy with an abdominal mass fistulized to the navel in whom surgical treatment needs large resection of the tumour, resection anastomosis of the ileum and temporary colostomy. The diagnosis of actinomycosis was made by histolopathological study of the surgical specimen. This case demonstrates the difficulty to make a pre-operative diagnosis. To improve the prognosis, actinomycosis needs early diagnosis and should be included in the differential diagnosis of infiltrative neoplasic abdominal masses apparently.

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