Varying forms of enterocutaneous fistula are described in the literature. In all cases, they have a functional, esthetic and even vital impact. The treatment may be complex because of the risk of a recurrence. We report the case of an enterocutaneous fistula developing in the short-term of an appendectomy at Mc Burney’s point associated with an abdominal tuberculosis. The treatment of the tuberculosis has been essential to ensure the success of the surgery. Keywords: Appendicitis, Enterocutaneous Fistula, Pathology, Surgery, Tuberculosis

Despite the tendency to westernize our way of life, the Malagasy culture keeps its peculiarities. We report the epidemiological features of patients with cholelithiasis in our population in order to raise hypothesis about their risk factors. This is a retrospective descriptive multicenter and analytical case-control study of patients with cholelithiasis as "cases" and non-carriers of cholelithiasis as "controls". The odds ratios (ORs) were calculated with a 95% confidence interval to verify the correlation between food consumption and the occurrence of cholelithiasis. 51 patients were respectively enrolled for both groups. Consumption of animal products and legumes, such as offal (OR 95% CI 3.23-1.36-7.67), chicken (OR 95% CI 8.85 [3.02-25.9]), peas (OR 95% CI 1.13 [0.43-2.95]) and Bambara peas (OR 95% CI 1.31 [0.57-3.01 ]) would expose the risk of occurrence of cholelithiasis. In contrast, whole milk (OR 95% CI 1.27 [0.58-2.77]), sweet potato (OR 95% CI 0.72 [0.23-2.25]) and cassava (OR 95% CI 0.83 [0.36-1.92]) would be a protective factor. To conclude, the diversification of our fruits and vegetables could be an asset to reduce the frequency of occurrence of cholelithiasis, giving priority to their consumption.

Despite the introduction of H2 receptor and proton pump antagonists into the therapeutic arsenal of the Peptic Ulcer Disease, gastric perforation remains the most common surgical emergery for the upper gastrointestinal tract. The present study aims to describe the particularities of the management of Perforated Peptic Ulcer which underwent surgery in the University Hospital Center Joseph Ravoahangy Andrianavalona Antananarivo (CHU-JRA) and to identify its morbidity and mortality factors. This is a retrospective analysis performed over a period of 33 months from January 2017 to September 2019 on Perforated Peptic Ulcer operated in CHU-JRA. Demographic, clinical and therapeutic parameters were studied and analyzed in relation to the morbidity and mortality rate. Altogether 158 patients operated for perforated Gastric or Duodenal Ulcer were included with an age ranging from 16 to 78 years old, a mean age of 39.05±15.03 years and a Sex Ratio estimated to 18.75. Repeated unexplored epigastralgia was noted in 70.89% of cases and 33.54% of patients used NSAIDs and/or corticosteroids before the onset of the pain. At admission, 9.4% of cases were immediately in shock. A laparotomy for exploration and repair was performed for a suspicion of a hollow-organ perforation on a X-ray of an Unprepared Abdomen. Antral perforation predominated in our serie (75.95%) and the main repair procedure consisted in a simple surgical suture. To conclude, our stude reflects the difficulty of the management of Peptic Ulcer Disease and its complications in our daily practice. Strenghtening the awareness of the population about the potiential severity of this disease is essential.