Left Sided Acute Appendicitis: Radiological Aspects

Left sided appendicitis is a rare pathology. Two situations may explain the occurrence of the disease: situs inversus or midgut malrotation. Its diagnosis is based on clinical presentation but confirmed by radiological examination. Our observation is based on a left-sided acute appendicitis with a midgut malrotation in a 31-year-old patient with no clinical history.

Retroperitoneal Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP): Case Report

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.

Liposarcoma of the Spermatic Cord

Few cases of Liposarcoma of the spermatic cord have been reported in the literature. This rare tumor represents 7% of malignant tumors of the spermatic cord. We report a case of an unusual liposarcoma of the spermatic cord, with respect to its sclerosing variant, occurring in a healthy looking 42 years old man. A wide local excision of the tumor was performed. Adjuvant radiotherapy may sometimes be effective on local recurrence. Even though this tumor evolves slowly, a prolonged follow up is required because of the risk of late recurrence.

Inoperable Pancreatic Metastasis of Renal Cell Carcinoma: A Case Report and a Review of Literature

Renal cell carcinoma (RCC) is a common cancer, but its pancreatic metastasis is unusual. We report a case of a 50-year-old male who was under the first line of treatment for a metastatic RCC since 2009. In August 2015, he showed up to the day unit with a cholestatic jaundice, and the investigations led to the discovery of a liver function alteration and a pancreatic mass. The biopsy of the inoperable mass revealed a RCC metastasis. The localization of this metastasis complicated the management of the disease due to haemorrhage and anemia. An embolization was performed to control the local complications. The patient was commenced on everolimus but with modest results forcing us to start exclusive palliative care.

Rupture of Liver Hydatid Cyst into Gall Bladder

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.

Fasciitis on Abdominal Craniectomy Implantation

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.

Squamous Cell Carcinoma of the Pancreas

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.

Spontaneous Cholecystocutaneous Fistula of Anterior Abdominal Wall with Subcutaneous Gallstones: About a Rare Case and Review of the Literature

Spontaneous cholecystocutaneous fistula is a rare complication of chronic calculous cholecystitis, because currently gallstones are diagnosed and treated at an early stage. This occurrence is possible even if it seems actually to be rare. We report a case of spontaneous cholecystocutaneous fistula of Anterior Abdominal Wall with subcutaneous gallstones admitted in the medical oncology unit of HASSAN II University Hospital. An 64-year-old woman, presented with a large subcutaneous abscess in the right subcostal area with swelling. An abdominal computed tomography scan showed a subcutaneous gallstone and communication between the abscess and the gallbladder. Cholecystectomy was performed and the abdominal wall abscess was drained externally. This case report demonstrates that maintaining a high degree of suspicion of this rare entity is helpful in achieving correct preoperative diagnosis, and that computed tomography scan should be performed in all cases of unexplained abdominal wall suppuration.

Jejunojejunal Intussusception following Jejunostomy

Intussusception is an invagination of a segment of the gastrointestinal tract into an adjacent one. Jejunojejunal intussusception is a rare complication of jejunostomy tube placement with an incidence of 1%. We are reporting a case of 35-year-old man who was suffering from severe oral, lesions due to Ingestion of acide agents. He received Witzel jejunostomy for early feeding. Ileus developed postoperatively and plain X-ray of the abdomen showed distended small bowel loop. Abdominal computed tomography revealed target sign as well as the feeding tube in a dilated jejunum and intussusception was diagnosed. Exploratory laparotomy was required due to failure of expectant therapy. Reduction of intussusception was done during exploratory laparotomy. The jejunostomy feeding was continued and the postoperative course was uneventful.

Hydatid Cyst of the Psoas: A Rare Location

Hydatid cyst of the psoas is rare even in countries endemic to hydatidosis. We hereby report a case of hydatid cyst of the psoas in a 69 years old patient with a history of hypertension and had received left nephrectomy due to a renal abscess 2 years prior to his admission.

Adenocarcinoma of the Appendix

Objective: To report the experience of our department on adenocarcinoma of the appendix through a series of six (6) cases. Materials and Methods: This is a retrospective study carried out from January 2010 to June 2015 collating all cases of adenocarcinoma of the appendix diagnosed at the department of visceral surgery B in Hassan II University Hospital in Fez. Results: Six cases of adenocarcinoma of the appendix were recorded during the determined period of study. The mean age was 54.67 ± 16.99 years with the extreme ages ranging from 28 to 78 years. There was a female predominance with a sex ratio of 2. All patients had no specific medical history. The revealing symptoms were the following: appendicitis syndrome (1 case), bowel obstruction (1 case), psoas abscess (1 case) and fortuitous discovery during laparotomy for another problem (3 cases). The following histological types found were: colloid adenocarcinoma (3 cases), mucinous adenocarcinoma (2 case), mucinous cystadenocarcinoma associated with a moderately differentiated adenocarcinoma of the appendix (1 case). The surgical procedure consisted of a right hemicolectomy in 3 patients. Appendectomy followed by a right hemicolectomy and drainage of psoas abscess was performed in two patients. Palliative ileocecal resection and Bouilly-Volkmann ileocolostomy was performed in one patent who had carcinosis. All patients received adjuvant chemotherapy. The following occurred during follow-up: carcinosis (2 patients), a locoregional recurrence (2 patients). Two patients never returned for follow-up. Conclusion: Tumor of the appendix is a rare and exceptional pathology. These tumors are generally discovered fortuitously or during histology of appendectomy specimens. The treatment is usually surgical.

A Rare Cause of Gastrointestinal Bleeding: Cholecystoenteric Fistula

A 60-year-old woman presented to the emergency department of our university hospital for several episodes of upper gastro-intestinal bleeding (hematemesis and melena). The endoscopic examination (Figure 1) showed a large ulcer at the front of the bulb, with a calculation within it and a visible vessel on the banks of the ulcer treated by putting two clips. Computer tomography (CT), demonstrated a sclerotic, atrophic and multi gallstone gallbladder, with a calculation protruding in the duodenum. The patient underwent surgery which consisted on partial cholecystectomy with duodenal suture and closing of cystic duct.