Although hepatic tuberculosis is not a rare disease entity,tubercular liver abscess (TLA) is extremely rare.It is usually associated with foci of infection either in the lung and/or gastrointestinal tract or with an i...Although hepatic tuberculosis is not a rare disease entity,tubercular liver abscess (TLA) is extremely rare.It is usually associated with foci of infection either in the lung and/or gastrointestinal tract or with an immunocompromised state.An isolated or primary TLA with no evidence of tuberculosis elsewhere is even rarer.We report on a 28 year old man who developed an isolated tuberculous liver abscess not associated with lung involvement.Ultrasonography and computed tomography of the abdomen showed the abscess lesions in the liver but the diagnosis of tuberculosis was conf irmed by histological examination of the wall of the abscess after surgical drainage.Although tuberculous liver abscess is very rare,it should be included in the differential diagnosis of abscess and unknown hepatic mass lesions.展开更多
Annular pancreas is a rare congenital anomaly characterized by the presence of ectopic pancreatic tissue surrounding the duodenum. This malformation is usually asymptomatic in adults, but can manifests as pancreatitis...Annular pancreas is a rare congenital anomaly characterized by the presence of ectopic pancreatic tissue surrounding the duodenum. This malformation is usually asymptomatic in adults, but can manifests as pancreatitis, duodenal stenosis, or duodenal or gastric ulceration. We report the case of a young patient of 18 years old hospitalized for epigastric pain and vomiting, in whom radiological investigations showed an annular pancreas. At operation, a complete obstruction of the duodenum between its first and second parts was found, caused by an annular pancreas. No other congenital anomaly of the intra abdominal organs was noted. A gastroenterostomy was performed. Both the rarity of this congenital abnormality and its successful correction by surgical means have prompted us to make the following presentation.展开更多
Intussusception in adults is rare and accounts for 1% to 5% of cases of acute bowel obstruction. Moreso, colic intussusception remains exceptional in adults and is usually secondary to an endoluminal lesion. Abdominal...Intussusception in adults is rare and accounts for 1% to 5% of cases of acute bowel obstruction. Moreso, colic intussusception remains exceptional in adults and is usually secondary to an endoluminal lesion. Abdominal intestinal lipomas are rarely responsible for colonic invagination. They are often located on the caecum or the ascending colon and rarely on the left colon. We report the case of colo-colic invagination on a descending colon lipoma in a 50-year-old woman.展开更多
The interposition of the colon or the small intestine between the liver and the diaphragm otherwise called Chilaiditi syndrome remains a rare condition. Its incidence varies between 0.025% and 0.28% according to recen...The interposition of the colon or the small intestine between the liver and the diaphragm otherwise called Chilaiditi syndrome remains a rare condition. Its incidence varies between 0.025% and 0.28% according to recent literature and is only found incidentally on diagnostic imaging. Hence, it constitutes a classic pitfall in the diagnosis of false right pneumoperitoneum. We deem interesting to report a case of Chilaiditi syndrome in a 44-year-old patient with no significant history who was admitted at emergency department for abdominal trauma following a road accident.展开更多
Cystic dilatation of the common bile duct constitutes a rare congenital malformation prevalent in people of Asian origin with a female predominance. Its classification follows that of Todani. The commonest form, found...Cystic dilatation of the common bile duct constitutes a rare congenital malformation prevalent in people of Asian origin with a female predominance. Its classification follows that of Todani. The commonest form, found in 80% of cases, is type I. Common bile duct cysts are often diagnosed in 2 out of 3 cases, during childhood with adult forms often rare. We hereby report the case of a cystic dilatation of the bile duct in a 75-year-old patient without significant history of disease.展开更多
Hepatic hydatid cyst is a rare parasitic affection which constitutes a major health problem in countries endemic to hydatidosis. Rupture of hydatid cyst into gallbladder is an exceptional complication first described ...Hepatic hydatid cyst is a rare parasitic affection which constitutes a major health problem in countries endemic to hydatidosis. Rupture of hydatid cyst into gallbladder is an exceptional complication first described in 1952 by Atlas and Kamenear. We report the case of a hepatic hydatid cyst rupture into gallbladder in a 31-year-old patient with no history of disease.展开更多
Background: The anorectal location of melanomas is extremely rare (1% - 3% of all melanomas), and the prognosis remains poor because of the aggressiveness and the high metastatic potential of those tumors. The discove...Background: The anorectal location of melanomas is extremely rare (1% - 3% of all melanomas), and the prognosis remains poor because of the aggressiveness and the high metastatic potential of those tumors. The discovery that the KIT oncogene may be aberrantly activated in a subset of patients with anorectal melanoma creates a realm of possibility for the development of targeted molecular therapy. Aim: to show the epidemiologic, clinico-radiological, histological features and treatment management especially in patients with over-expression of C-KIT treated by Imatinib. Methods: It is a retrospective study conducted in the department of medical oncology at Hassan II University Hospital between January 2007 and January 2012, including all patients with histologically proven melanoma of the anorectal area. Results: 11 cases were collected, with slight female predominance. Nine patients were metastatic at the moment of diagnosis, and only two with local stage, but evolution was marked by local and distant recurrence less than 12 months after abdo-minoperineal resection. First line of chemotherapy was based mainly on paclitaxel, carboplatine and dacarbazine. Response was modest with only 3 partial responses, 4 patients with disease stability, and 4 patients with disease progression. Two patients, with over expression of C-KIT, received Imatinib as second line of treatment with significant improvement of symptoms and radiological response reaching 50%. Seven patients died with a median survival of 11 months from diagnosis to the date of death. Conclusion: Primary anorectal melanomas are very rare, with high aggressiveness and poor prognosis. Treatment management is still a big challenge given to the modest efficacy of conventional chemotherapy. Better understanding of carcinogenesis and signaling pathways will allow development of new targeted therapies.展开更多
Neuroendocrine tumors (NET) of the gallbladder are a rare entity with only 0.2% of all NET located in the gall bladder. Well-differentiated NETs occur at a relatively lower age group unlike other gallbladder tumors, w...Neuroendocrine tumors (NET) of the gallbladder are a rare entity with only 0.2% of all NET located in the gall bladder. Well-differentiated NETs occur at a relatively lower age group unlike other gallbladder tumors, whereas neuroendocrine carcinoma (NEC) occurs in an older category of patients. The aim of our study is to discuss the current level of evidence regarding this pathological entity by means of a rare case report on a neuroendocrine carcinoma of the gall bladder in a 63-year-old patient with a history of diabetes. Patient underwent cholecystectomy for acute cholecystitis. Pathology findings on surgical specimen came back for neuroendocrine tumour.展开更多
Gastrointestinal stromal tumors are rare. They are a subject of controversy. We have reported 64 cases of gastrointestinal stromal tumor diagnosed in the surgery department of CHU Hassan II of FES between January 2014...Gastrointestinal stromal tumors are rare. They are a subject of controversy. We have reported 64 cases of gastrointestinal stromal tumor diagnosed in the surgery department of CHU Hassan II of FES between January 2014 and December 2018. The study involved 64 patients (34 men and 30 women) with an average age of 56. The circumstances of findings were dominated by abdominal pain (48 cases), vomiting 16 case followed by transit disorder with 9 cases. The tumor locations were mainly the stomach (n = 31), the small intestine (n = 28), the duodenum (n = 3), and the colon (n = 2). Ultrasound, endoscopy and CT were the main additional tests to detect tumor syndrome. 55 patients were treated by complete surgical excision. Tumor size ranged from 4cm to 18cm. Histologically, the spindle cell type was predominant in 88.91% of cases;epithelioid type was present in 7.81% of cases, while the mixed type was found in 3.6%. The analysis of the expression of CD 117 marker was present in 95.31%, while immunostaining with this marker returned negative in 3 cases;i.e. 5% whose c-kit was positive. Imatinib was indicated in 44 patients (63.60%), with 9 indications for metastatic tumor. As a neoadjuvant, imatinib was indicated in 5 patients, with remission in 28 patients (50.9%), stabilization in 4 patients (7.2%), 2 cases of tumor recurrence and 7 cases of death.展开更多
Necrosis of the stomach is rare. It occurs when there is vascular anomalies, gastric volvulus or her-niation and in infectious gastritis. We report a case in which infectious gastritis leads to a necrotiz-ing gastriti...Necrosis of the stomach is rare. It occurs when there is vascular anomalies, gastric volvulus or her-niation and in infectious gastritis. We report a case in which infectious gastritis leads to a necrotiz-ing gastritis that is treated with urgent gastrectomy.展开更多
Necrotizing fasciitis is an infection of the skin and deep subcutaneous tissue. It is caused by bacteria (group A streptococcus), but may also be idiopathic ora secondary complication of surgery. We report a case of n...Necrotizing fasciitis is an infection of the skin and deep subcutaneous tissue. It is caused by bacteria (group A streptococcus), but may also be idiopathic ora secondary complication of surgery. We report a case of necrotizing fasciitis of the abdominal wall fostering a decompressive cranial flap in a 39-year-old patient.展开更多
Hemobilia is the result of a pathological communication between bile duct and intra or extrahepatic vessel. 40% to 60% of the haemobilia cases are Iatrogenic, and the other causes are either vascular malformations or ...Hemobilia is the result of a pathological communication between bile duct and intra or extrahepatic vessel. 40% to 60% of the haemobilia cases are Iatrogenic, and the other causes are either vascular malformations or hepatic blunt trauma. We describe the case history of a patient in which laparoscopic cholecystectomy was complicated 3 months later by massive hemobilia. The cause of haemorrhage was a fistula between the principal bil duct and the right hepatic artery. This complication was successfully managed by surgery and angiographic embolization with full recovery of the patient.展开更多
Exocrine pancreatic tumors are dominated by adenocarcinomas that have a poor prognosis. Squamous Cell Carcinoma of the pancreas is rare. We report a case of squamous cell carcinoma of the pancreas in a 75-year-old pat...Exocrine pancreatic tumors are dominated by adenocarcinomas that have a poor prognosis. Squamous Cell Carcinoma of the pancreas is rare. We report a case of squamous cell carcinoma of the pancreas in a 75-year-old patient admitted to the emergency ward with acute cholangitis.展开更多
Introduction: Acute mesenteric ischemia due to an embolism of the superior mesenteric artery (SMA) is associated with a high mortality rate. Over twenty per cent of acute mesenteric embolism cases consist of multiple ...Introduction: Acute mesenteric ischemia due to an embolism of the superior mesenteric artery (SMA) is associated with a high mortality rate. Over twenty per cent of acute mesenteric embolism cases consist of multiple emboli. Case Presentation: We present a rare case of a 62-year-old man admitted with acute abdominal pain and signs of intestinal occlusion related to an acute mesenteric ischemia due to superior mesenteric arterial embolism. It was associated with a synchronous acute bilateral lower limb ischemia due to embolic arterial occlusion. He underwent an emergency explorative laparotomy with proximal jejunal resection, and the patient made an excellent recovery. As for the acute limb ischemia, it was treated by efficient anticoagulation allowing limb salvage. Conclusion: When treating a superior mesenteric arterial embolism, the possibility of recurrent or multiple arterial thromboembolic events should be considered. A prompt diagnosis, aggressive surgical treatment and intensive care could improve the prognosis.展开更多
Retro peritoneal smooth muscle tumors of uncertain malignant potential (STUMP) are rare and often misdiagnosed as leiomyosarcoma. We hereby report the case of a retroperitoneal STUMP diagnosed on a surgical specimen i...Retro peritoneal smooth muscle tumors of uncertain malignant potential (STUMP) are rare and often misdiagnosed as leiomyosarcoma. We hereby report the case of a retroperitoneal STUMP diagnosed on a surgical specimen in a 44-year-old woman without any history of disease.展开更多
Colic tuberculosis is rare even in countries endemic to Mycobacterium spp. Its incidence seems to be increasing over the last decade. Presentation in the form of abdominal mass is exceptional and often misdiagnosed as...Colic tuberculosis is rare even in countries endemic to Mycobacterium spp. Its incidence seems to be increasing over the last decade. Presentation in the form of abdominal mass is exceptional and often misdiagnosed as gastrointestinal tumor. The possibility of a colic involvement of this infection needs to be considered given the broad spectrum of clinical manifestations of TB infection. We present a case of pseudo colic tuberculosis in a 58-year-old patient with no history of disease.展开更多
文摘Although hepatic tuberculosis is not a rare disease entity,tubercular liver abscess (TLA) is extremely rare.It is usually associated with foci of infection either in the lung and/or gastrointestinal tract or with an immunocompromised state.An isolated or primary TLA with no evidence of tuberculosis elsewhere is even rarer.We report on a 28 year old man who developed an isolated tuberculous liver abscess not associated with lung involvement.Ultrasonography and computed tomography of the abdomen showed the abscess lesions in the liver but the diagnosis of tuberculosis was conf irmed by histological examination of the wall of the abscess after surgical drainage.Although tuberculous liver abscess is very rare,it should be included in the differential diagnosis of abscess and unknown hepatic mass lesions.
文摘Annular pancreas is a rare congenital anomaly characterized by the presence of ectopic pancreatic tissue surrounding the duodenum. This malformation is usually asymptomatic in adults, but can manifests as pancreatitis, duodenal stenosis, or duodenal or gastric ulceration. We report the case of a young patient of 18 years old hospitalized for epigastric pain and vomiting, in whom radiological investigations showed an annular pancreas. At operation, a complete obstruction of the duodenum between its first and second parts was found, caused by an annular pancreas. No other congenital anomaly of the intra abdominal organs was noted. A gastroenterostomy was performed. Both the rarity of this congenital abnormality and its successful correction by surgical means have prompted us to make the following presentation.
文摘Intussusception in adults is rare and accounts for 1% to 5% of cases of acute bowel obstruction. Moreso, colic intussusception remains exceptional in adults and is usually secondary to an endoluminal lesion. Abdominal intestinal lipomas are rarely responsible for colonic invagination. They are often located on the caecum or the ascending colon and rarely on the left colon. We report the case of colo-colic invagination on a descending colon lipoma in a 50-year-old woman.
文摘The interposition of the colon or the small intestine between the liver and the diaphragm otherwise called Chilaiditi syndrome remains a rare condition. Its incidence varies between 0.025% and 0.28% according to recent literature and is only found incidentally on diagnostic imaging. Hence, it constitutes a classic pitfall in the diagnosis of false right pneumoperitoneum. We deem interesting to report a case of Chilaiditi syndrome in a 44-year-old patient with no significant history who was admitted at emergency department for abdominal trauma following a road accident.
文摘Cystic dilatation of the common bile duct constitutes a rare congenital malformation prevalent in people of Asian origin with a female predominance. Its classification follows that of Todani. The commonest form, found in 80% of cases, is type I. Common bile duct cysts are often diagnosed in 2 out of 3 cases, during childhood with adult forms often rare. We hereby report the case of a cystic dilatation of the bile duct in a 75-year-old patient without significant history of disease.
文摘Hepatic hydatid cyst is a rare parasitic affection which constitutes a major health problem in countries endemic to hydatidosis. Rupture of hydatid cyst into gallbladder is an exceptional complication first described in 1952 by Atlas and Kamenear. We report the case of a hepatic hydatid cyst rupture into gallbladder in a 31-year-old patient with no history of disease.
文摘Background: The anorectal location of melanomas is extremely rare (1% - 3% of all melanomas), and the prognosis remains poor because of the aggressiveness and the high metastatic potential of those tumors. The discovery that the KIT oncogene may be aberrantly activated in a subset of patients with anorectal melanoma creates a realm of possibility for the development of targeted molecular therapy. Aim: to show the epidemiologic, clinico-radiological, histological features and treatment management especially in patients with over-expression of C-KIT treated by Imatinib. Methods: It is a retrospective study conducted in the department of medical oncology at Hassan II University Hospital between January 2007 and January 2012, including all patients with histologically proven melanoma of the anorectal area. Results: 11 cases were collected, with slight female predominance. Nine patients were metastatic at the moment of diagnosis, and only two with local stage, but evolution was marked by local and distant recurrence less than 12 months after abdo-minoperineal resection. First line of chemotherapy was based mainly on paclitaxel, carboplatine and dacarbazine. Response was modest with only 3 partial responses, 4 patients with disease stability, and 4 patients with disease progression. Two patients, with over expression of C-KIT, received Imatinib as second line of treatment with significant improvement of symptoms and radiological response reaching 50%. Seven patients died with a median survival of 11 months from diagnosis to the date of death. Conclusion: Primary anorectal melanomas are very rare, with high aggressiveness and poor prognosis. Treatment management is still a big challenge given to the modest efficacy of conventional chemotherapy. Better understanding of carcinogenesis and signaling pathways will allow development of new targeted therapies.
文摘Neuroendocrine tumors (NET) of the gallbladder are a rare entity with only 0.2% of all NET located in the gall bladder. Well-differentiated NETs occur at a relatively lower age group unlike other gallbladder tumors, whereas neuroendocrine carcinoma (NEC) occurs in an older category of patients. The aim of our study is to discuss the current level of evidence regarding this pathological entity by means of a rare case report on a neuroendocrine carcinoma of the gall bladder in a 63-year-old patient with a history of diabetes. Patient underwent cholecystectomy for acute cholecystitis. Pathology findings on surgical specimen came back for neuroendocrine tumour.
文摘Gastrointestinal stromal tumors are rare. They are a subject of controversy. We have reported 64 cases of gastrointestinal stromal tumor diagnosed in the surgery department of CHU Hassan II of FES between January 2014 and December 2018. The study involved 64 patients (34 men and 30 women) with an average age of 56. The circumstances of findings were dominated by abdominal pain (48 cases), vomiting 16 case followed by transit disorder with 9 cases. The tumor locations were mainly the stomach (n = 31), the small intestine (n = 28), the duodenum (n = 3), and the colon (n = 2). Ultrasound, endoscopy and CT were the main additional tests to detect tumor syndrome. 55 patients were treated by complete surgical excision. Tumor size ranged from 4cm to 18cm. Histologically, the spindle cell type was predominant in 88.91% of cases;epithelioid type was present in 7.81% of cases, while the mixed type was found in 3.6%. The analysis of the expression of CD 117 marker was present in 95.31%, while immunostaining with this marker returned negative in 3 cases;i.e. 5% whose c-kit was positive. Imatinib was indicated in 44 patients (63.60%), with 9 indications for metastatic tumor. As a neoadjuvant, imatinib was indicated in 5 patients, with remission in 28 patients (50.9%), stabilization in 4 patients (7.2%), 2 cases of tumor recurrence and 7 cases of death.
文摘Necrosis of the stomach is rare. It occurs when there is vascular anomalies, gastric volvulus or her-niation and in infectious gastritis. We report a case in which infectious gastritis leads to a necrotiz-ing gastritis that is treated with urgent gastrectomy.
文摘Necrotizing fasciitis is an infection of the skin and deep subcutaneous tissue. It is caused by bacteria (group A streptococcus), but may also be idiopathic ora secondary complication of surgery. We report a case of necrotizing fasciitis of the abdominal wall fostering a decompressive cranial flap in a 39-year-old patient.
文摘Hemobilia is the result of a pathological communication between bile duct and intra or extrahepatic vessel. 40% to 60% of the haemobilia cases are Iatrogenic, and the other causes are either vascular malformations or hepatic blunt trauma. We describe the case history of a patient in which laparoscopic cholecystectomy was complicated 3 months later by massive hemobilia. The cause of haemorrhage was a fistula between the principal bil duct and the right hepatic artery. This complication was successfully managed by surgery and angiographic embolization with full recovery of the patient.
文摘Exocrine pancreatic tumors are dominated by adenocarcinomas that have a poor prognosis. Squamous Cell Carcinoma of the pancreas is rare. We report a case of squamous cell carcinoma of the pancreas in a 75-year-old patient admitted to the emergency ward with acute cholangitis.
文摘Introduction: Acute mesenteric ischemia due to an embolism of the superior mesenteric artery (SMA) is associated with a high mortality rate. Over twenty per cent of acute mesenteric embolism cases consist of multiple emboli. Case Presentation: We present a rare case of a 62-year-old man admitted with acute abdominal pain and signs of intestinal occlusion related to an acute mesenteric ischemia due to superior mesenteric arterial embolism. It was associated with a synchronous acute bilateral lower limb ischemia due to embolic arterial occlusion. He underwent an emergency explorative laparotomy with proximal jejunal resection, and the patient made an excellent recovery. As for the acute limb ischemia, it was treated by efficient anticoagulation allowing limb salvage. Conclusion: When treating a superior mesenteric arterial embolism, the possibility of recurrent or multiple arterial thromboembolic events should be considered. A prompt diagnosis, aggressive surgical treatment and intensive care could improve the prognosis.
文摘Retro peritoneal smooth muscle tumors of uncertain malignant potential (STUMP) are rare and often misdiagnosed as leiomyosarcoma. We hereby report the case of a retroperitoneal STUMP diagnosed on a surgical specimen in a 44-year-old woman without any history of disease.
文摘Colic tuberculosis is rare even in countries endemic to Mycobacterium spp. Its incidence seems to be increasing over the last decade. Presentation in the form of abdominal mass is exceptional and often misdiagnosed as gastrointestinal tumor. The possibility of a colic involvement of this infection needs to be considered given the broad spectrum of clinical manifestations of TB infection. We present a case of pseudo colic tuberculosis in a 58-year-old patient with no history of disease.
