Hirschsprung disease in an adult with intestinal malrotation and volvulus: an exceptional association.

Background: Hirschsprung disease is a neonatal discovery in almost all cases, and the association of Hirschsprung disease in adults with symptomatic intestinal malrotation is unusual. This combination delays diagnosis and can lead to mistake in surgical strategy.

Case Presentation: A 43-year-old patient with a history of colectomy for colonic inertia and megadolichocolon was admitted to the Carcassonne Hospital emergency room for a volvulus of small bowel obstruction in a chronic intestinal obstruction context with episodes of acute, variable-looking occlusive syndromes.

[Gastric necrosis following gastroplasty].

Introduction: Over the past ten years, laparoscopic surgery in the treatment of morbid obesity has expanded. However, there are few publications describing its side effects, notably the occurrence of gastric necrosis.

Observation: Two years after laparoscopic-banding for morbid obesity, a case of acute gastroenteritis in a 45 Year-old woman proved to be a gastric necrosis.

Methodological index for non-randomized studies (minors): development and validation of a new instrument.

Background: Because of specific methodological difficulties in conducting randomized trials, surgical research remains dependent predominantly on observational or non-randomized studies. Few validated instruments are available to determine the methodological quality of such studies either from the reader's perspective or for the purpose of meta-analysis. The aim of the present study was to develop and validate such an instrument.