[Surgical management of obstetric fistulae].

With three decades of experience in the treatment of obstetric fistulae (OF), the authors discuss surgical management of OF secondary to blocked labor (> 48 hours), the main cause of OF in poor countries. Clinical classification is mandatory to ensure the correct indication, with three situations of increasing difficulty. The technical principles are simple and few instruments are required.

WITHDRAWN: Experience of genital fistula at the Children's Surgical Centre, Phnom Penh, Cambodia.

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[Place of surgery in the prevention of recurrences of digestive haemorrhages at the patients presenting a portal hypertension due to Schistosoma mekongi].

In spite of a decrease of the prevalence of hepato-splenic schistosomiasis thanks to mass-treatment with Praziquentel from December 1994 till now (CNM - MSF - WHO - Health Provincial Director) of target-populations in Kratie Province, severe cases of portal hypertension are not exceptional (digestive bleedings, after rupture of oesophageal varices). Out of 106 cases of portal hypertension: alI patients have had clinical survey biological tests (liver function, haematology and serology). Most of them had ultrasonography (Aloka 55,500 Sound 3.

[Histology of liver lesions due to Schistosoma mekongi. About six cases with severe portal hypertension operated in Cambodia].

Schistosomiasis mekongi was shown to be endemic, along the Mekong River, in northern Cambodia, affecting many patients with portal hypertension. Surgical procedures were proposed to some patients with digestive haemorrhage history to avoid fatal recurrence. The aim of our study was to evaluate the intensity of the liver fibrosis among these patients.

[Solitary fibrous tumor of the urinary bladder].

Introduction: A solitary fibrous tumor is a rare circumscribed neoplasm that was long known in the pleura and has now described in many organs and soft tissues. Prognosis is favorable after complete excision.

Case: We report a solitary tumor fibrous located in the bladder of a 38-year-old man with dysuria and a palpable abdominal mass.

[Renaissance of training in general surgery in Cambodia: a unique experience or reproducible model].

Is the new surgical training program at the University of Phom-Penh, Cambodia a unique experience or can it serve as a model for developing countries? This report describes the encouraging first results of this didactic and hands-on surgical program. Based on their findings the authors recommend not only continuing the program in Phom-Penh but also proposing slightly modified versions to new medical universities not currently offering specialization in surgery.

[Caustic burns. Clinical study of 24 patients with sulfuric acid burns in Cambodia].

Over a period of 12 years, 24 burns have been treated by a Cambodgian and French team (Doctors of the World). This experience has revealed some characteristics of this population: (1) a majority of young women (2/3), (2) victims of assault (20 cases). These notions are found in the medical literature particularly South East Asia.

[Firearm wounds of the lower urinary tract in men. Surgical management in emergency context].

The lower urinary tract is injured in less than 1% of all firearm wounds in men. In war medicine, blast wounds occur in 75% of the cases while in civil medicine ballistic injuries are more frequent. When the bladder and the posterior urethra is involved, the projectile usually follows a path through the gluteal muscles and pelvis.

[Perineal-genital wounds in war medicine. Apropos of 18 cases].

Perineo-genital wounds involving the anterior perineum or the urogenital perineum are uncommon; 1-4% of all war wounds. We report 18 cases observed in war situations. Isolated uretrogenital wounds are rarely life-threatening, but the functional prognosis is always compromised in these men whose mean age is under 30 years.

Pressure sore carcinoma: a late but fulminant complication of pressure sores in spinal cord injury patients: case reports.

The development of a pressure sore carcinoma in scars of spinal cord injury patients is a rare event (less than 0.5%) and occurs late (more than 30 years after the spine injury) but the prognosis is very poor. Five cases are reported and different aspects are reviewed: anamnesis, clinical features, and follow-up studies.

[Musculocutaneous island flap using the upper gluteus maximus muscle].

The authors report 24 cases treated with an gluteus maximus musculocutaneous flap. The gluteus maximus is generally used as a VY flap. Our technique uses the superior part of the muscle with the overlying skin as a rotation flap.

[Hyperthyroidism in Chad and its treatment. 16 cases of which 10 were treated surgically in 1984-1985 in N'Djamena].

Sixteen patients with thyrotoxicosis were admitted during a period of eighteen months (1984-1985) in Central Hospital of N'Djamena (Chad). Clinical features, laboratory investigations are reported. Ten patients had a surgical treatment:subtotal thyroidectomy.

[Surgical treatment of complicated urethral stenosis (54 case reports)].

The authors report their surgical experience of complicated stenosis of urethra in the Department of Urology of the Central Hospital of N'Djaména (Tchad) from 1984 to 1987 (July). The surgical treatment was indicated for the complicated cases of stenosis of the urethra, which were obstructed (less than a quarter of the patients who were admitted for urethra stenosis). Before 1984 the only surgical procedure was called "Chemin de fer: a blind pull-through method with a lot of complications.

[Ureteral war injuries. Apropos of 3 African cases].

The war ureteral gunshot wounds (W.U.G.