ABSTRACT
Squamous cell carcinoma of the colon is a rare tumor and primary cecal localization is unusual. This malignant condition is marked by a worst prognosis due to early local invasion. We report a case of a 46-year-old female patient admitted to the emergency department with symptoms of peritonitis. CT scan showed a cecal tumor perforated in the retroperitoneal space. The patient underwent right hemicolectomy with D2 lymphadenectomy without intestinal anastomosis. The diagnosis of squamous cell carcinoma was confirmed by histopathological examination. Squamous cell carcinoma is a malignant tumor with poor prognosis, hence, the interest of early diagnosis and management.
ABSTRACT
Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis and remains a health problem, especially in developing countries. Abdominal location represents 5 to 10% of all locations. The clinical symptoms are not very specific, and the discovery of an abdominal mass in a context of deterioration of general state may wrongly lead to the diagnosis of a tumor. Radiological explorations remain sensitive in the detection of abdominal masses but they cannot prejudge their etiology. Surgical exploration is sometimes the only recourse either for diagnostic purposes or complications, and the diagnosis can only be confirmed by bacteriological and histological examinations of the surgical specimen. We report the case of abdominopelvic mass and lymph nodes revealing tuberculosis.
ABSTRACT
Mixed neuroendocrine-non neuroendocrine neoplasm (MiNENs) is a rare gastrointestinal neoplasm that has been redefined by the World Health Organization (WHO) in 2017 as the association of two types of components, neuroendocrine and non-neuroendocrine, each of them present in at least 30% of the tumour mass. Small case reports and case series have demonstrated the occurrence of this neoplasm in the colon. We here report the case of a 47-year-old man undergoing colonscopy for anemia. This showed impassable polypoidal tumor budding in the right colic flexure. Computerized tomography (CT) scan and magnetic resonance imaging (MRI) showed the presence of liver metastases. As the tumor was hemorrhagic, right hemicolectomy with lymph node dissection was performed. The histological examination showed MiNEN of the ascending colon. The patient received adjuvant chemotherapy.
Subject(s)
Colonic Neoplasms , Gastrointestinal Neoplasms , Neuroendocrine Tumors , Colon/pathology , Colonic Neoplasms/diagnosis , Humans , Lymph Node Excision , Male , Middle Aged , Neuroendocrine Tumors/diagnosis , Neuroendocrine Tumors/pathologyABSTRACT
Non-cirrhotic portal hypertension was first described by Guido BANTI in 1898 as a condition characterized by the association of portal hypertension with splenomegaly, anemia and healthy liver. The diagnosis was based on abdominal ultrasound, splenoportography and liver biopsy. Our study aimed to evaluate the role of splenectomy in non-cirrhotic portal hypertension. We conducted a retrospective study of 3 patients (2 women and 1 man) treated by our staff over the period January 2010 -September 2016. The diagnosis of idiopathic portal hypertension was based on the following criteria: portal hypertension, the presence of oesophageal varices associated with splenomegaly, the absence of cirrhosis or of other liver disorders responsible of portal hypertension. All patients underwent splenectomy. Outcome after splenectomy was marked by the standardization of clinical, radiological and biological signs of this disease associated with the absence of oesophageal varices recurrence. Splenectomy associated with ligation of oesophageal varices may be sufficient to treat this syndrome and especially its consequences without using splenorenal bypass.
Subject(s)
Esophageal and Gastric Varices/etiology , Hypertension, Portal/surgery , Liver Cirrhosis/surgery , Pancytopenia/surgery , Splenectomy/methods , Splenomegaly/surgery , Adult , Female , Humans , Hypertension, Portal/diagnosis , Hypertension, Portal/physiopathology , Liver Cirrhosis/diagnosis , Liver Cirrhosis/physiopathology , Male , Pancytopenia/diagnosis , Pancytopenia/physiopathology , Retrospective Studies , Splenomegaly/diagnosis , Splenomegaly/physiopathology , Treatment Outcome , Young Adult , Idiopathic Noncirrhotic Portal HypertensionABSTRACT
INTRODUCTION: Giant inguinoscrotal hernias are extremely rare nowadays, but they may still be encountered after years or even decades of neglect. Such hernias containing both bowel loops and urinary bladder have not been reported in the medical literature to date, to the best of our knowledge. CASE PRESENTATION: We report a case of a 65-year-old Moroccan man who presented with giant right-sided and long-standing inguinoscrotal hernia with compromised quality of life due to walking difficulties and sexual discomfort. Computed tomography revealed a voluminous hernia sac containing small and large bowel loops, greater omentum, and urinary bladder. Surgical repair was done through the classical inguinal incision using the Lichtenstein tension-free hernioplasty technique. No debulking or abdominal enlargement procedure had to be performed, apart from a partial omentectomy. CONCLUSIONS: Giant inguinoscrotal hernia containing intestinal segments and urinary bladder is a challenging surgical disease. A Lichtenstein tension-free technique seems to be the best surgical procedure for both the patient and the operating surgeon. It should be used whenever possible in such cases.
Subject(s)
Hernia, Inguinal/diagnostic imaging , Hernia, Inguinal/surgery , Herniorrhaphy/methods , Intestines/surgery , Urinary Bladder/surgery , Aged , Humans , Male , Quality of Life , Surgical Mesh , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: Insulinomas are rare pancreatic endocrine tumors. Most are benign and solitary. However, the nonspecific symptoms and small size of these tumors led to difficulties of diagnosis and localization. CASE PRESENTATION: We present two Arab patients with pancreatic long-standing insulinoma. Both patients presented episodic hypoglycemic symptoms respectively during 10 and 2 years. Biochemical and morphological workup detected localized pancreatic insulinoma. Open procedure surgery was done for the two patients and insulinomas were successfully removed by enucleation. CONCLUSION: Insulinoma remains a diagnostic challenge to practitioners. Diagnosis of suspected cases is easily confirmed by standard endocrine tests, especially the supervised fasting test. Accurate preoperative localization is essential for more effective and safest surgery.