Intestinal volvulus is rare and responsible for upper bowel obstruction. They occur more frequently in a patient with abdominal surgery history. We report a case of small intestine volvulus on Meckel diverticulum, which occurred in a 21-year-old patient, with no history of laparotomy. The diagnosis confirmation was intraoperative, and the management consisted in a segmental resection of the small intestine with immediate anastomosis. The postoperative follow-up was good. This case underlines the scarcity and the severity of this presentation which therefore requires appropriate care in order to improve the prognosis.

Amyand hernia is defined by the presence of appendix herniating into the deep inguinal ring. It's a rare condition. We report the case of a 75-yearold male patient, presenting alcoholism, undernutrition and ischemic cardiopathy which required angioplasty and anticoagulation, admitted for a painful and hot swelling in right inguinal region evolving for five days. Blood analysis revealed infectious syndrome and important hemostasis disorders. Computed Tomography scan showed perforated appendix herniating through inguinal ring associated to a thrombus in the left ventricle. The evolution was marked by a Fournier's gangrene. After getting the normalization of the hemostasis values, a laparotomy was performed for appendicectomy, drainage. The right testicle, necrotized, was removed, with a wide debridement of the fasciitis. Although the parameters were stable during the surgery, the patient presented a heart failure with unsuccessful cardiopulmonary resuscitation.

Miliary abscess of the liver represents a rare presentation of multiple liver abscesses. They often occur in immunosuppressed patients, or those with underlying liver disease. We report the case of a 22-year-old patient, without known immunodeficiency factors, surgical history or notion of tuberculous contacts, who was admitted for generalized peritonitis and ileal perforation. An ileostomy was performed. The infectious syndrome persisted in post-operative period, associated with painful hepatomegaly. An contrast-enhanced abdominal CT scan led to the diagnosis of miliary abscess of the liver. A blood culture isolated Escherichia coli. The treatment included antibiotics and the clinical evolution was favorable. The follow-up abdominal CT scan was normal. Intestinal continuity was restored without complications. Miliary abscess of the liver is rare and requires rapid diagnosis. The treatment is based on antibiotic therapy.

male students giving a sex ratio of 2.55. 54.52% chose surgery but the proportion decreases with the years of study. So, we go from 65% in the third year to 36% in sixth year. The choice depends neither on students' sex nor on the number of completed surgical trainings. The favorite specialty was traumatology. As the year of study increases, fewer students choose surgery. The main motivation is the intellectual challenge. Non-availability of certain surgical specialties and lifestyle are discouraging factors. Conclusion: this study revealed a lack of interest in medical' students for specialization in surgery during their training. Solutions must be found to increase the number of surgeons long-term.

Primary carcinosarcoma of the spleen is a rare, aggressive splenic malignancy. To date, seven cases have been reported in the literature. We report a first case of primary carcinosarcoma of the spleen in France. A 75-year-old woman with a medical history of hysterectomy for uterine adenocarcinoma presented with left hypochondrium pain following blunt abdominal trauma. A splenic mass was noted on computed tomography (CT) scan. A splenectomy was performed by laparotomy. Histology revealed a malignant mixed Mullerian tumor. The PET scan allowed us to confirm that it was a primary lesion of the spleen. She is currently undergoing adjuvant chemotherapy despite the tumor progression. The interest of this case lies in the rarity of primary carcinosarcomas of the spleen and the circumstances of its diagnosis.