A renal artery aneurysm is a dilated segment of the renal artery that is larger than twice the diameter of a normal renal artery. Despite its rarity, the diagnosis and incidence of this entity have been steadily increasing as a result of the widespread use of cross-sectional imaging. Renal artery aneurysms can be clinically significant and potentially fatal in some cases. However, knowledge of their occurrence, natural history and prognosis, whether treated or not, is limited. We present a case of a renal artery aneurysm complicated by hypertension that did not respond to medical treatment and was treated with simple nephrectomy.

Introduction: Xanthogranulomatous pyelonephritis is a rare and unusual form of chronic pyelonephritis, characterized by the destruction of the renal parenchyma and its replacement by granulomas, abscesses and lipid-laden macrophage collections. Despite clinical and radiological knowledge, it remains a surprise for the surgeon. We are reporting through these two observations the diagnostic difficulties of this condition would lead to an inappropriate treatment as well as to a more severe disease. Observations: Two patients (52 and 57 years old), one of whom is followed fortype 2 diabetes mellitus , were hospitalized for pyonephrosis due to obstructive pyelic and ureteral lithiasis. The pyonephrosis was revealed by a chronic loin pain in a febrile context and confirmed by urogramme showing a destruction of the renal parenchyma, dilated pyelocaliceal cavities with rounded formations of pseudo-tumoral appearance on the lithiasis obstacles. Our initialtreatment consisted of percutaneous nephrostomy under antibiotic covering and secondarily of nephro-ureterectomy without bladder flange performed six weeks later. Histopathology studies showed diffuse xanthogranulomatous pyelonephritis. The postoperative follow up was simple in both cases. Conclusion: Xantogranulomatous pyelonephritis is a rare, severe and chronic form of pyelonephritis whose diagnosis is always histological. Its clinical picture is no specific, hence the problem is that it poses achalleng of differential diagnosis with renal tumors and urogenital tuberculosis. Its treatment is based on nephrectomy.

Isolated vaginal agenesis is a rare malformation of the genital tract. It is characterized by the absence of the vagina, or the presence of a vaginal dimple measuring less than 5 cm. We report the case of a 21-year-old married patient who presents with primary amenorrhea, an inability to have sexual intercourse due to isolated vaginal aplasia.