Parietal mass caused by a fish bone: case report.

It is a great challenge to distinguish the parietal inflammation, centered on the foreign body that pierced the digestive tract and remained in the wall before surgery, because of its atypical clinical nature. Ingestion of foreign bodies is not uncommon. Fish bones are particularly notorious culprits; however, most will pass through the gastrointestinal tract uneventfully. Patients and Methods: The authors report a case of a patient who presented with periumbilical abdominal pain and a computed tomography (CT) scan that revealed the presence of periumbilical fat infiltration on a foreign body admitted on the Department of Digestive Cancer Surgery and Liver Transplantation, Casablanca, Morocco. An exploratory laparotomy revealed a parietal mass centered by a fish bone. Results: Accidental ingestion of foreign bodies is common in clinical practice. However, perforation of the intestine by a foreign body is less common because the majority of foreign bodies pass without incident into the feces and only 1% of them (the sharpest and most elongated objects) will perforate the gastrointestinal tract, usually at the level of the ileum.CT, especially multidetector CT, is considered the method of choice for preoperative diagnoses of ingested foreign bodies and their complications due to its high-quality multiplanar capabilities and high resolution.Foreign body ingestion usually goes unnoticed, but the complications of this incident can be severe. Conclusion: This case report highlights the fact that intestinal perforation caused by an ingested foreign body is a difficult diagnosis that should always be suspected in an attack of abdominal pain. Frequently, the clinical diagnosis is difficult, and recourse to imaging is sometimes necessary. Most of the time, the treatment is only surgical.

Abdominal textiloma mimicking as gastrointestinal stromal tumor: A case report.

INTRODUCTION AND IMPORTANCE: Gossypiboma or textiloma is a mass comprising of cotton matrix within the body left accidentally during a surgical procedure. The body may react to this foreign body through an exudative inflammatory reaction or an aseptic fibrotic reaction in order to encapsulate the cotton material and result into a mass. CASE PRESENTATION: We report a case of 65-year-old female. She was referred to our department due to 2 episodes of nausea and vomiting. She had history of open cholecystetomy 29 years ago, then cure for eventration one year after. On exploratory laparotomy there was a mass measuring 6 cm axis at the expense of segment 3 of the liver coming into intimate contact with the duodenum. Atypical segmental hepatectomy of segment 3 of liver was performed, and the histological report confirmed necrotic textiloma. CLINICAL DISCUSSION: Textiloma represents a complication of all forms of surgery. It is a real, serious but preventable surgical complication, and could present with various complaints. Prevention of this condition can be achieved by meticulous count of surgical materials. CONCLUSION: The embarrassment faced by the surgeon and the medico legal implications of this iatrogenic complication are tremendous and all preventive measures should be taken to avoid this as no excuse is justifiable.

Solid pseudopapillary neoplasm of the head of the pancreas: A case report.

INTRODUCTION: and importance: Solid pseudopapillary tumor of the pancreas (SPN) or Frantz's tumor is a rare tumor of low malignant potential common in young women. The aim of this paper is to present and discuss a case of a solid pseudopapillary tumor of the pancreas occurring in a 19-year-old female. CASE PRESENTATION: A 19-year-old girl presented to our department with epigastric pain for two months, she had no clinical findings on physical examination. Abdominal Computed tomography scan (CT scan) showed the presence of a well-defined tumor arising from the pancreatic head measuring 9,1 × 8.1 × 8.5 cm, heterogeneous and with solid and necrosis components. The patient was subjected to surgery and histopathological examination confirmed the diagnosis of a pseudopapillary tumor of the pancreas. CLINICAL DISCUSSION: This is an interesting case report of a rare tumor, in so far as without any adjuvant chemotherapy Prognosis of the tumor is better than other pancreatic tumors. surgical resection seems to be the best strategy in the management of SPT. CONCLUSION: Close follow up is necessary for early detection of the recurrence and metastasis.

Helicobacter pylori co-infection with Epstein-Barr virus and the risk of developing gastric adenocarcinoma at an early age: Observational study infectious agents and cancer.

BACKGROUND: Gastric cancer (GC) is one of the leading causes of morbidity and mortality worldwide. The onset and progression of gastric cancer are attributed to numerous triggers, these triggers may be infection of the gastric epithelium by Helicobacter pylori (H. pylori), or by Epstein-Barr virus (EBV). Both agents can establish a lifelong persistent infection in the host, leading to chronic inflammation, which also contributes to cancer development. Objective: The objective of this study is to present the status of co-infection with H. pylori and EBV and the risk of developing adenocarcinoma at an early age in the population of Grand Casablanca. METHODS: In this study, 100 gastric tissue samples from patients with gastric cancer were examined for detection of H. pylori and EBV in tumor tissue using PCR techniques, and the clinical relevance was statistically analyzed. RESULTS: Results revealed an individual Epstein-Barr virus (EBV) infection observed in (40 %) of gastric carcinoma cases. Furthermore, the frequency of EBV infection was significantly different with intestinal and diffuse gastric cancer types [15 % vs. 85 %; <0.05]. The prevalence of individual H. pylori infections was 34 %, while the frequency of co-infection was 16 %. Moreover, no significant association was found between co-infection and sex, tumor grade, stage, and lymph node metastasis, but there was a significant association between co-infection and the age of GC patients. CONCLUSION: Thus understanding the status of co-infection could clarify the process of gastric carcinogenesis, and application of this knowledge for clinical purposes could facilitate diagnosis, risk management, and prevention.

[Retrorectal stromal tumor: macroscopic entity and surgical difficulties]. / Tumeur stromale à localisation rétro-rectale: entité macroscopique et difficultés chirurgicales.

Gastrointestinal stromal tumors are uncommon mesenchymal tumors that very rarely occur in the rectum. They pose preoperative diagnostic and therapeutic problems. We report the case of retrorectal stromal tumor in order to highlight the clinical, radiological and therapeutic features of this rare entity.

[Laparoscopic cholecystectomy in a patient with situs inversus]. / Cholécystectomie laparoscopique sur situs inversus.

Coelio-surgery is the gold standard treatment for symptomatic gallbladder lithiasis. Until now, only 42 cases of laparoscopic cholecystectomy in patients with situs inversus have been published. We here report a new case of a patient followed up for complex congenital single ventricle heart disease with situs inversus and dextrocardia. The patient was admitted for the surgical treatment of symptomatic gallbladder lithiasis. Laparoscopic cholecystectomy was performed. Disposal of trocars and surgical approach were completely inverted and symmetric compared to standard laparoscopy.

Endocrine gland-derived vascular endothelial growth factor (EG-VEGF) and its receptor PROKR2 are associated to human colorectal cancer progression and peritoneal carcinomatosis.

BACKGROUND: The highest risk factor for mortality among malignant tumors is metastasis. Endocrine gland-derived vascular endothelial growth factor (EG-VEGF) is an angiogenic factor which biological activity is mediated via two G protein-coupled receptors, prokineticin receptor1 (PROKR1) and PROKR2. Recent studies suggested that EG-VEGF expression is deregulated in multiple cancers including colorectal cancer (CRC). METHODS: Using distinctive CRC and peritoneal carcinomatosis (PC) cohorts and a corresponding control cohort, we determined the circulating levels of EG-VEGF and its in situ expression, and that of its related receptors. RESULTS: Circulating EG-VEGF levels were significantly increased in patients with metastatic PC compared to CRC and control patients (p< 0.05). Furthermore, according to clinicopathologic examinations, local EG-VEGF expression correlated with higher tumor and nodal stages (p< 0.001) of CRC. EG-VEGF and PROKR2 were highly expressed in colorectal primary lesions compared to positive controls. PROKR1 expression was lower and did not change in tumor specimens. Also, EG-VEGF and its receptor PROKR2 were differentially expressed in the colorectal primary lesions and in the control groups. CONCLUSION: Altogether these findings suggest that EG-VEGF/receptors system might be an important actor in the CRC progression into PC and might be involved in the ability of tumor cells to invade other organs. Circulating EG-VEGF could be proposed as a prognostic marker in human CRC and its progression into PC.

[Descriptive epidemiology of peritoneal carcinosis of gastrointestinal origin at the Ibn Rochd University Hospital, Casablanca (2008-2010)]. / Épidémiologie descriptive de la carcinose péritonéale d'origine digestive à l'Hôpital Universitaire Ibn Rochd de Casablanca (2008-2010).

INTRODUCTION: Peritoneal carcinosis is characterized by ineluctably terminal diffuse spread of abdominal cancer. It is the sign of an advanced disease or a re-emerging disease most often associated with a dark prognosis. Approximately two thirds of all peritoneal carcinomas are of gastrointestinal origin and one third are of non-digestive origin. METHODS: We conducted a retrospective descriptive study between January 2008 and December 2010 in order to establish epidemiological features and risk factors of peritoneal carcinosis of gastrointestinal origin at the Ibn Rochd University hospital, Casablanca. RESULTS: Forty-seven cases of peritoneal carcinosis of gastrointestinal origin were recorded (22 women, 25 men), corresponding to a prevalence of 6.19% and to a mean number of 15.6 cases per year. Age was the major risk factor in our case series (with an average age of 55.55 ± 12.32 years). Even family history was a risk factor to consider. CONCLUSION: This study concluded that the major risk factors for peritoneal carcinosis of digestive origin are age and family history at the Ibn Rochd University hospital, Casablanca (2008-2010).

Risk of colorectal cancer and clotting factor gene polymorphisms in Moroccan Population.

BACKGROUND: Venous thrombosis has been described as a common complication for cancer patients. The association between clotting factor gene polymorphisms and the risk of colorectal cancer has been evidenced. The aim of the present study was to investigate the association of G20210A factor II prothrombin (FII) and factor V Leiden ( FVL) G1691A with the risk of colorectal cancer(CRC). METHODS AND RESULTS: Genotyping of FVL and G20210A FII was performed using the polymerase chain reaction restriction fragment length polymorphism method on a sample of 76 patients with CRC as well as 182 controls. No significant difference in FVL gene variations was observed between cases and controls. However, with regard to the G20210A FII, the homozygous mutated genotype AA was associated with an increased risk of CRC. A significant association between the G20210A FII mutation and the risk of CRC was identified using recessive (OR=57.63, 95% CI: 3.33-997.26, P=0.0053), dominant (OR=27.87, 95% CI: 12.67 -61.28, P<0, 0001) and additive (OR=21.24, 95% CI: 10.45-43.16, P<0, 0001) models. No statistical difference was observed in parameters such as sex, age and positive family history for cancer. CONCLUSION: Our results did not support an effect of FVL gene on CRC risk and suggested that the G20210A FII prothrombin gene variant may be a risk factor for CRC in Moroccan population.