Achalasia is a rare esophageal motility disorder, with unknown etiology. It is characterized by an esophageal aperistalsis, and a failure of relaxation of the lower esophageal sphincter in response to swallowing. The clinic, the barium swallow and endoscopy suggest the diagnosis; that is confirmed by manometry. Surgical treatment, palliative, provides excellent results in terms of dysphagia but increases gastroesophageal reflux risk. The combination of Heller myotomy and a fundoplication is used to prevent postoperative gastroesophageal reflux, but the results remain controversial. Our study aims to compare the postoperative results in terms of gastroesophageal reflux in both groups of patients who underwent the Heller myotomy with and without fundoplication, in order to challenge the interest of the systematic association of the fundoplication. Among the 34 patients in the study, 7 have benefited of the Heller myotomy with fundoplication, and 27 have benefited from the Heller myotomy without fundoplication. Our results showed that clinical gastroesophageal reflux occurred for 14% of patients with fundoplication and 18,5% of patients without fundoplication. On the other hand, the pH reflux occurred for 80% of patients with fundoplication and 69.2% of patients without fundoplication. The pH measurement analysis after the surgery showed an average GERD rate in a standing position of 1.9% in the group of patients with fundoplication and 7.2% in the group of patients without fundoplication. The same analysis showed an average rate of gastroesophageal reflux in a lying position of 30% for both groups. We concluded that there is no difference between using the fundoplication or not to prevent postoperative GERD, so it should be dedicated to specific cases such as hiatal hernia.

Schwannoma is a benign nervous tumor arising swhan cells with a difficult preoperative diagnosis. The retroperitoneal localization is exceptional and its occurrence during Von Recklinghausen’s disease is rare. Von Recklinghausen’s disease is an evolutionary pathology characterized by the involvement and impairment of several organs deriving from the neural crest. Some complications can be seen, but the most serious complication is the degeneration of neurofibromas. We report the case of a 28 years old patient, who consulted for left low back pain, CT scan has revealed a cystic mass behind the left hepatic lobe, and MRI was in favor of a remanied bilary cyst. a laparoscopy for diagnostic and therapeutic purposes has been proposed, and has objective a retroperitoneal cystic mass, that doeas not depend on the liver or the pancreas, pathologic examination after total excision of the tumor, conclude with a benign schwannoma, subsequently the diagnosis of the associated Von Recklinghausen disease was established before the combination of diagnostic criteria. Complete surgical excision of the tumor the reference treatment. Recurrence and transformation, altrough rare after surgery, requires post-operative monitoring by an annual CT scan.

We illustrate a rare association of a primitive cancer of the breast and the lung primitive cancer by the case of a 67-year-old woman, a fortuitous discovery during a balance sheet operating meadow in particular of extension of a nodule of the left breast classified radiologically BIRADS 4. This exceptional known association imposes a search for the genetic factors, and the factors which favor the arisen of the cancer. But especially, she requires a multidisciplinary coverage seen the difficulty of the therapeutic decision.

Conjoined twins (JC) represent a malformative abnormality that concerns monozygotic twin pregnancies, it is a rare entity that poses a real diagnostic and therapeutic challenge. We report a case of Conjoined twins through which we will expose the various difficulties encountered during the management of this type of anomalies.

Ovarian pregnancy (GO) is rare. Unlike other types of GEU, GO remains an isolated and exceptional phenomenon in a woman's life, independent of the usual risk factors and the exact mechanism leading to a GO remains poorly understood. The anatomopathological study authenticates the diagnosis, sometimes referred to intraoperatively. . We report the case of ovarian pregnancy met at the Souissi maternity hospital in Rabat and the different stages of care.

2nd women cancer in Morocco, cervical cancer is a public health problem. Mortality from this cancer has declined remarkably thanks to screening programs, which are still lacking in several countries. Targeting criteria vary from one population to another and the means depend greatly on the socio-economic level. We conducted a 3-year retrospective study at the Souissi maternity clinic in Rabat, between 2013 and 2016, including 1599 women, which aims to identify the interest of colposcopy as a screening tool. diagnosis that is part of the global gynecological-oncological approach to prevent cervical cancer.

The diagnosis of rectal cancer during pregnancy remains difficult today. This association is rare. the diagnostic problem is mainly therapeutic and is not yet the subject of a consensus. Indeed, the care need a multidisciplinary team to be able to remedy this pathological situation. We report two cases of rectal cancer discovered during pregnancy, with the management of the disease, the outcome of the patients, and a review of the literature.