Fournier's gangrene, a rapidly progressive necrotizing fasciitis of the perineum and external genitalia that leads to extensive soft tissue necrosis, remains a medical‐surgical emergency. The authors present a case of coverage of a scrotal loss of substance with testicular exposure by a medial fasciocutaneous flap of the unilateral thigh after debridement and initial medical treatment of Fournier's gangrene in a 50‐year‐old quadriplegic patient. The clinical examination at 8 months showed an aesthetic and functional result. The trophic‐cutaneous thigh flap that the authors propose for frail, elderly, and neurological subjects with low functional requirements allows coverage of the scrotal region with relatively thick skin, color, and texture close to those of the scrotum. It also offers technical simplicity, moderate scarring, and functional remnants at the price of less morbidity.

Aim: There were no data about esophageal cancer in Burundi. The aim of the study was to highlight the epidemiological, clinical and histopathological aspects of the esophageal cancer. Method: A retrospective study over a 24-years period (from January 1988 to December 2011) was carried out at Kamenge university hospital, including patients with esophageal cancer. The cases were selected on basis of the histological evidence of the cancer. Results: A total of 34 cases were retrieved and included for analysis. Among them, 24 patients (70.5%) were males. The esophageal cancer constituted 8.6% of digestive cancers over the period of the study. The average age was 50.9 years. It was revealed by dysphagia in 32 patients (94.1%) and was concomitantly metastatic in 12 patients. The squamous cell carcinoma was 30 cases (88.2%). 27 patients underwent a curative resection, but the outcome and prognosis were poor. In-hospital mortality and morbidity rates were respectively 8.8% and 17.7%. Conclusion: The present study showed evidence that the esophageal cancer in our country had the same characteristics and distribution as well as in developing countries. It had a poor prognosis and efforts had to be done in the early cancer detection.

Fournier’s gangrene, a rapidly progressive necrotizing fasciitis of the perineum and external genitalia remains a medical-surgical emergency. The authors present a case of coverage of a scrotal loss of substance with testicular exposure by a medial fasciocutaneous flap in a fifty years male patient.

Femoral neck fracture occurring after an epileptic seizure is a rare and under-diagnosed injury. The majority of the reported cases in literature are old patients with osteoporosis. Younger patients present several risk factors of osteopenia and the treatment remains controversial. We present an outcome of a 23 years old patient with unilateral femoral neck fracture occurring during an epileptic seizure and we discuss the associated multiple risk factors of osteopenia and osteonecrosis of the hip. The patient was brought to the emergency department of Teaching Hospital of Kamenge (CHUK) complaining of pain in his left hip that had been progressing for one month after an epileptic seizure. There is a history of HIV infection since birth and epileptic seizures with ongoing treatments for both diseases. Despite the high risk of avascular necrosis, the treatment choice has been influenced by the patient's age and a conservative surgery by internal fixation with Dynamic Hip Screw has been made. Unfortunately, this treatment early resulted in osteonecrosis of the hip since HIV infection itself and the highly active anti-retroviral therapy increase its risk.

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