Introduction. Gestational gigantomastia is a rare benign disease of unknown cause. We report a case of bilateral gigantomastia in pregnancy in order to locate the place of reductive surgery in its care which is quite controversial. Case. A 25-year-old woman gravida 2 para 1 was referred for an exaggerated bilateral breast enlargement at 32-week gestation. The examination showed bilateral giant breasts with collateral venous circulation and trophic changes marked by the necrosis of the distal third of the mammary skin involving the nipple-areolar complex. She underwent a biopsy of the ulcerative breast tissue, and the histology report did not show a malignant cell. After active foetal lung maturation and induced delivery, a breast reductive surgery with nipple plasty was performed 21 days postpartum. The postoperative course was marked by a period of lymphangitis. The cosmetic and psychological result was satisfactory at 6 months and at 18 months. Conclusion. Gestational gigantomastia is a benign disease that can simulate carcinomatous mastitis. The breast reductive plasty keeps its place in our context.

Crohn's disease is a chronic inflammatory bowel disease (IBD) that can affect all segments of the digestive tract. For long time, it is a pathology considered to be uncommon among African blacks. It constitutes a heterogeneous group both in its etiopathogenesis and in its clinical and progressive presentation. The pseudotumoral form remains exceptional. We report a case of this form, observed in a 44-year-old patient. The pseudotumoral form of colonic Crohn's disease was diagnosed based on morphological, histological and progression criteria. This illustrates the need for multiple and repeated biopsies to eliminate malignant tumor, tuberculosis, intestinal parasitosis and other causes of digestive granulomatosis.

Introduction Implantable cardioverter-defibrillators (ICDs) for cardiac resynchronization therapy (CRT-D) with the capability of LV sensing enable the assessment of interventricular delays in ventricular (VT) and supraventricular tachycardias (SVT). Methods and Results In total, 1078 EGM recordings of VT or VF episodes were investigated that have been transmitted via Home MonitoringⓇ. Only those EGM recordings showing the onset of the tachyarrhythmia were used for investigation. In the 623 cases eligible for evaluation left-sided VTs could be identified in 349 cases, right-sided VTs in 252 cases. SVTs with a 1:1 antegrade conduction were found in 22 cases. VT can present three different interventricular delays whereby the right-ventricular sensed event (RVs) is either preceding the left-ventricular sensed event (LVs), or the LVs is preceding RVs, or there can be a simultaneous occurrence of RVs and LVs. In SVTs, either the LVs events were delayed or occurred simultaneously with the RVs events. SVT cases with LVs preceding the RVs events were not found. Conclusion The LV-EGM channel enables to distinguish between left- and right-sided premature ventricular complexes. The assessment of the interventricular delay in VTs is useful to differentiate between a possible apical-, left- or right-sided origin of the VT but not to identify SVTs. Key Words Implantable Cardioverter Defibrillator (ICD), Cardiac resynchronization therapy (CRT), LV sensing, RV sensing, Ventricular tachycardia, Supraventricular tachycardia, Left bundle branch block, Heart failure, Interventricular conduction delay