Introduction: Delayed presentation of an iatrogenic diaphragmatic injury is rare. We report the case of a diaphragmatic hernia associated with a bowel obstruction occurring as a delayed complication of a right liver resection. This report emphasizes the rareness of such surgical outcome and the main CT-scan features of a diaphragmatic rent are discussed along with it. Case Report: A 30-year-old female was admitted to our emergency department with a clinical acute bowel obstruction syndrome. A chest and abdomen CT-scan revealed an ascent and strangulation by the entanglement of some jejunal loops through a right diaphragmatic hernia. A compression of the lung and the mediastinum were also observed. The patient was admitted to surgery. The non-viable ischemic loops were cut off, and the diaphragmatic defect is repaired after the reintegration of the abdominal structures and patient recovered uneventfully. Conclusion: Acquired diaphragmatic hernias are very rarely present on the right side. The CT scan findings suggestive of a diaphragmatic rent are highlighted and they should be carefully looked out for by the radiologist.

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Introduction: The Budd-Chiari syndrome is an obstruction of the hepatic venous drainage. It is not common as a complication of hepatic sarcoidosis but the association is possible. We report a case of Budd-Chiari syndrome complicating a hepatic sarcoidosis. Case Report: A 32-year-old female patient with a history of mediastino-pulmonary, hepatic, and splenic sarcoidosis since her young age, that stopped her medication, was readmitted at our Emergency Department for recurrent threatening hematemesis. The oesogastroduodenal fibroscopy found esophageal varices. Biological assessment found a cytolysis and cholestasis. Hepatic Doppler ultrasound showed nodular bumpy hepatomegaly, with outflow obstruction of the hepatic veins, and a laminated aspect of the inferior vena cava that remains permeable. Abdominal computed tomography (CT) showed multinodular liver and spleen, multiple lymphadenopathies, and a lack of individualization of hepatic veins. Chest CT showed an interstitial syndrome associated with bilateral mediastinal and hilar adenopathies. Viral serologies B and C, and the search for thrombophilia were negative. Hepatic sarcoidosis was previously confirmed by liver biopsy, with a negative tuberculosis testing and a high level of angiotensin-converting enzyme. All these assessments led to the diagnosis of Budd-Chiari syndrome complicating hepatic sarcoidosis. Conclusion: Budd-Chiari syndrome is thus an exceptional complication, but possible in case of hepatic sarcoidosis. Therefore, it is

Introduction: Chemotherapy induced nausea and vomiting (CINV) are frequent and heavily affect the quality of life of patients. They are multifactorial. Better control of these CINV must be maintained from the first cycle of chemotherapy. The aim of this study was to evaluate the different parameters involved in the CINV occurring after the first cycle of chemotherapy. Methods: This is a prospective study of 150 patients followed at the medical oncology department of the Hassan II University Hospital of Fez from January 10 to June 10, 2015. Patients completed on day one of the second cycle of chemotherapy the Arabic versions of 3 questionnaires: the anxiety and depression questionnaire (HADS), the quality of life questionnaire (EORTC QLQ-C30) and the CINV questionnaire (MAT questionnaire MASCC). Data were analyzed with SPSS software version 20.0. Results: The mean age of patients was 45 ± 15 years. Male gender was predominant (68% of cases). 30% of patients had toxic ingestion history. Location of the primary tumor was mainly in breast (35% of cases), head and neck (29%) and lung (15%). 45% of patients were aware of the occurrence of vomiting before the 1st treatment, and only 65% received antiemetic therapy on day 1. 85% of patients presented CINV after the first cycle. Among these patients, 65% were female, 55% had delayed vomiting and 85% were of type II of the NCI-CTCAE classification (National Cancer Institute-Common Terminology Criteria for Adverse Events). CINV were associated with impaired quality of life in 97% of cases, with r = -0.245 in case of acute vomiting, r = -0,422 in case of acute nausea, r = -0,398 for late vomiting and r = -0,498 in case of delayed nausea ( p < 0.05). Conclusion:The results of this study suggest that nausea and vomiting remains a major problem for cancer patients. This is consistent with results from other published studies. Several parameters are incriminated such as the patients' information and support and primary prophylaxis. These parameters can minimize the impact of these adverse reactions.