Synovial sarcoma in the buttocks: an exceptional location - case report according to SCARE guidelines.

Pelvic pain is a frequent reason for consultation; the management is complex, given the differences in symptomatic and anatomical orientation. We present an exceptional case of intergluteal synovial sarcoma rarely described in the literature, with an incidence of about 1/1 000 000 and less than 10 cases of intergluteal location are published. Case Presentation: Through this publication, we present a very exceptional case of synovial sarcoma. It concerns a 44-year-old male followed for probable intergluteal lipoma for 3 months and admitted for intergluteal mass bleeding. The clinical examination revealed an intergluteal tumor mass, and the surgical resection was in favor of a synovial sarcoma.The objectives of this work are threefold: to enrich the poor literature with this new case; to underline the importance of multidisciplinary management; to recommend the obligation of anatomopathological evidence to make the diagnosis of lipoma in front of a soft tissue tumor. Discussion and Conclusion: Our case enriches the poor literature on intergluteal synovial sarcoma, where less than 10 similar reports are available. We hope through our presentation to highlight this exceptional etiology of gluteal tumor and to recall that there is no relationship between the name of this tumor and the synovium as an anatomical entity.

Screw Impingement Causing Massive Swelling of the Sciatic Nerve: A Case Report.

Sciatic nerve (SN) injuries after hip fracture dislocation are described and are not uncommon. Several factors can lead to SN injury after hip surgery; among other factors, screw plates of synthesis materials can immigrate and lead to nerve impingement. We report a case of a 22-year-old male with a history of posterior wall fracture and hip dislocation after a motorway accident. Ultrasonography showed massive swelling of the SN with a cross-sectional area measured at 1.50 cm2 upstream to screw impingement. The reoperation option was judged too risky by the orthopedic surgeons; currently, the patient is undergoing platelet-rich plasma (PRP) injections around the nerve swelling and to the lifter muscles of the foot.

An Exceptional Clinical Presentation associating an occipital stroke, a Superior and Inferior Mesenteric Thrombosis following Covid 19 disease, case report.

INTRODUCTION: The Covid 19 pandemia since the first reported case in 2019 had a direct socioeconomic impact related to morbi-mortality and indirect in response to protection and isolation strategies. To our knowledge thrombo-embolic complications can be a mode of revelation complicating the management. CASE PRESENTATION: We present an exceptional case of a patient with a history of Covid 19,admitted 21 days later for disturbed consciousness, in whom an ischemic occipital stroke ,intestinal and colonic ishemia had been objectified. Our objective through this presentation is to remind the thrombo-embolic particularity of Covid 19, to take the viral attack as a serious antecedent in the periods following theinfection and to put the point on the primordial place of early rehabilitation in patients with stroke. DISCUSSION AND CONCLUSION: We discuss through this report the recommendations of anticoagulation in Covid 19 patients and the place of early rehabilitation in patients with stroke. We also report a new case among the rare cases described in the literature that associates several thrombo-embolic manifestations secondary to Covid 19, in particular the neurological and digestive association.

Strangled gravidic uterus, an exceptional complication of umbilical hernia during pregnancy, a case report.

INTRODUCTION: Strangulated pregnancy is a very rare presentation in which the intra umbilical strangulated form is exceptional. To our knowledge, we report the first Moroccan case and one of less than 10 cases published in the literature of a strangulated gravid uterus; in a woman admitted for treatment of umbilical pain. CASE PRESENTATION: Through this presentation, we report a sporadic case of hernial strangulation during pregnancy containing an evolving pregnancy in the umbilical harness bag. The suspicion of this diagnosis was clinical and the confirmation made by ultrasound and abdominal MRI for confirmation. The objectives of this publication are threefold: i), to report this new exceptional case ii), to highlight the place of imaging in the management of hernial pathology iii), and to recommend surgical treatment of umbilical hernias in women of childbearing age in order to avoid surgical complications and maternal and fetal morbidity and mortality. CONCLUSION: Our case report shows that we should consider this very rare presentation of strangulated pregnancy. Our work also reports another new case to the poor published literature on this subject and emphasizes the importance of surgical management of parietal pathology by focusing on the parietal impact of physiological change during pregnancy.

Acute Intestinal Invagination: An Exceptional Method of Revealing Crohn's Disease.

Crohn's disease presents a public health problem. The clinical presentation is variable with gastrointestinal and extra gastrointestinal manifestations. The management is multidisciplinary while patients with Crohn's disease rarely require surgery. We present a rare case of a 57-year-old patient followed for 10 years for ankylosing spondylitis and admitted for abdominal pain on intussusception caused due to Crohn's disease which was probably symptomatic but not understood by your patient.

Rectorrhagia revealing colonic metastasis from an ovarian primary, an exceptional case report.

INTRODUCTION: Ovarian cancer is a gynecological cancer with a very poor prognosis despite the improvement of therapeutic means, of which metastases at the colic level are exceptional. We report an exceptional case which makes it possible to enrich the poor literature published on the subject. CASE PRESENTATION: Through this article, we present a very rare case of colonic metastases from ovarian cancer. Biological monitoring and rectal bleeding allowed this rare secondary location to be discovered. Resection then anastomosis allowed our patient to heal. The objectives of this work are threefold: i), to report this very rare case ovarian metastasis ii), to highlight nulliparity as a risk factor in our patient iii), to report that our therapeutic management interrupted and delayed because of COVID 19. DISCUSSION AND CONCLUSION: Our case report shows that we have to take into consideration this very rare presentation and this even in the absence of true clinical sign. Our work reported also another case of colonic metastasis of a primary ovarian in the very rare case described in the literature and emphasizes the importance of surgical management.

First case report of horseshoe appendix in Morocco according according to SCARE guidelines.

INTRODUCTION: The appendix duplication is a sporadic malformation in which the horseshoe form is the uncommon described variant. To our knowledge, we report the first Moroccan case of a horseshoe appendix in a girl admitted to managing of pain at the right iliac fossa. CASE PRESENTATION: Through this article, we present a very rare case of appendicular duplication. It has not been objectified in radiological exploration and discovered by chance during the operation. Resection then closure of the appendicular bases allowed our patient to heal. The objectives of this work is threefold: i) to report this sporadic case of horeshoe appendix, ii) to emphasize the importance of suspicion of appendicular duplication in appendicular syndrome and iii) to recommend the exploration of the ileoceacal region to avoid surgical complications and medicolegal problems. CONCLUSION: Our case report shows that we have to take into consideration this sporadic presentation of appendicular syndrome and this even in the absence of radiological signs. Our work brings enriched the literature by a new case of horseshoe appendicitis highlighting the importance of surgical treatment.

Pseudotumoral Actinomycosis Mimicking Malignant Colic Disease: A Case Report and Literature Review.

Abdominal actinomycosis is a rare, chronic, and often unrecognized suppurative disease. It is caused by an anaerobic gram-positive bacterium, most commonly Actinomyces israeli. Colonic actinomycosis is rarely reported and may be responsible for a pseudotumoral syndrome leading, in the suspicion of malignancy, to a large and mutilating excisional surgery. It is usually the histopathological examination of the surgical specimens that accurately corrects the diagnosis. Here, we report a rare case of a colic actinomycotic involvement taking a pseudotumoral form. The diagnosis was made based on the pathological examination of the surgical piece. Intravenous and then adjuvant oral penicillin G treatment has allowed a favorable clinical evolution. This observation illustrates the preoperative diagnostic difficulties of this rare disease.