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We conducted a study of 46 patients admitted to the Intensive Care Unit with postoperative peritonitis. The incidence of postoperative peritonitis in this setting was 2.7%. The average age of patients was 53.3 years, with a sex ratio of 1.2. Submesocolic surgery was the most common cause of postoperative peritonitis (65.2%), mainly occurring in the colorectal region (48%). Clinical signs were dominated by fever (78%), abdominal pain (57%) and extra-abdominal signs. The mean time between symptom onset and diagnosis was 7.3 days. Reoperation was performed on the basis of clinical and biological criteria in 56.5% of cases. Therapeutic management was based on perioperative reanimation, treatment of organ dysfunctions, probabilistic antibiotic therapy and middle laparotomy. The bacteriological profile was dominated by BGN (79%). The loosening of the anastomotic sutures was the direct cause of PPO in 57% of patients. Mortality rate was 60%. The main prognostic factors were: renal failure, the number of patients with organ failure, PT<50%, the need for ventilation and the use of catecholamines., Competing Interests: Les auteurs ne déclarent aucun conflit d'intérêts., (Copyright: Said Benlamkaddem et al.)

Paracetamol is the most widely drug involved in accidental paediatric exposures and deliberate self-poisoning cases because of its availability. N-acetyl cystein is the main treatment for this poisoning. We report a case of a 24-year-old Arab female who has deliberately ingested 100 tablets of 500 mg paracetamol each (50g). Her first examination was normal. She has received oral N-acetyl cystein (NAC) 6 hours after the ingestion. Serum paracetamol level done 18 hours post ingestion was 900 mg/l. On review the next days, she did not develop any symptoms of liver failure. However, due to the massive paracetamol ingestion associated with high serum paracetamol levels, oral NAC was continued for 3 days. The patient was discharged well on the fifth day of hospitalization. Our patient has ingested one of the highest paracetamol overdose (50g) with the highest paracetamol blood levels ever reported in medical literature. She was treated, six hours after ingestion, with oral NAC for 3 days without any side effects.

We report the case of a 78-year old patient, with no particular past medical history, who underwent transurethral resection of the prostate (50 g) under spinal anesthesia for benign hypertrophy. 90 minutes after the beginning of the procedure, the patient had nausea, vomiting, visual fog and bradycardia, suggesting TURP syndrome. Ionogramme objectified a serum sodium level of 118meq/L, hence the patient was treated with 3% hypertonic saline solution, with good evolution. This study describes a common but moderate occurrence of TURP syndrome whose management was facilitated by patient's alertness during spinal anesthesia.

Mucormycosis is an opportunistic fungal infection occurring in immunocompromised patients. It is a serious life threatening condition. Even though diagnosed early, mucormycosis has a mortality rate reaching 50%. We report the case of mucormycosis in a diabetic patient hospitalized in Intensive Care Unit for severe angiocholitis. Evolution was lethal., Competing Interests: Les auteurs ne déclarent aucun conflit d'intérêt.

We report a case of transurethral resection of prostate (TURP) syndrome. A 78-year-old man with prostatic hypertrophy was scheduled for transurethral resection of the prostate under spinal anesthesia. 30 minutes after the end of the surgery, the patient presented signs of TURP syndrome with bradycardia, arterial hypotension, cyanosis, hypoxemia and coma. The electrolytes analysis revealed an acute hyponatremia (sodium concentration 125 mmol/L). Medical treatment consisted of hypertonic saline solution 3%, volume expansion, intubation and ventilation. The presented case describes a typical TURP syndrome, which was diagnosed and treated early. The patient was discharged from hospital without any complications.