Prostate carcinoma mimicking rectal cancer: a case report.

In the pre-prostate specific antigen era, patients with prostate cancer (PC) commonly presented with symptoms. Currently, most PC are diagnosed at an asymptomatic stage with abnormal digital rectal examination or raised prostate specific antigen. In rare cases, PC may infiltrate the rectum and cause symptoms mimicking rectal cancer. It is difficult to differentiate between the two based on clinical features alone. We here report our experience in managing an 86-year-old male, with no significant personal pathological history, who presented with diarrhea and occasional rectal bleeding without any lower urinary tract symptoms. Investigations concluded to a PC invading the rectum and the patient was referred to urology department.

Gastrojejunocolic fistula: a rare complication of peptic ulcer surgery.

Gastrojejunocolic fistula (GJF) is a very rare complication of peptic ulcer surgery. Patients with this condition often present with diarrhea, fecal vomiting as well as weight loss. Here, we report a case of 62-year-old male with a GJF complicating upper gastrointestinal surgery.

Overlap syndrome of primary biliary cholangitis and primary sclerosing cholangitis: two case reports.

BACKGROUND: Overlap syndrome between primary biliary cholangitis and primary sclerosing cholangitis is an extremely rare condition that has been reported in only few published cases so far in the literature. We highlight here the rarity of this condition and indicate the importance of its recognition. CASE PRESENTATION: We report two cases showing the manifestations of both primary biliary cholangitis and primary sclerosing cholangitis in two Tunisian female patients aged 74 and 42 years, respectively. The first case is a woman who was initially diagnosed with decompensated cirrhosis. Magnetic resonance cholangiopancreatography showed multiple strictures of the common bile duct, and histological findings led to the diagnosis of primary biliary cholangitis/primary sclerosing cholangitis. She was successfully treated with ursodeoxycholic acid. The second case is a middle-aged woman, suffering from primary biliary cholangitis and who was treated with ursodeoxycholic acid. At her 12 month follow-up appointment, she presented with a partial clinical and biochemical response. Tests showed normal thyroid function, liver autoimmune tests for autoimmune hepatitis were negative, and celiac disease markers were also negative. The diagnosis of overlap syndrome of primary biliary cholangitis/primary sclerosing cholangitis was finally made on the results of magnetic resonance cholangiopancreatography that showed multiple strictures of the common as well as intrahepatic bile ducts. The patient was put on ursodeoxycholic acid at a higher dose. CONCLUSIONS: Our cases raise awareness for this rare condition and indicate the importance of recognizing a possible overlap syndrome, especially in patients with primary biliary cholangitis, to optimize treatment. We suggest considering the overlap syndrome of primary biliary cholangitis/primary sclerosing cholangitis when a patient presents with the diagnostic criteria of both diseases.

Adenocarcinoma of the small bowel revealing celiac disease in an adult: case report.

Cancer of the small bowel is a rare malignancy. With an incidence of less than one per 100 000 people, it makes up only 5% of all gastrointestinal tract cancers. Celiac disease is a relatively common pathology and is often associated with the development of small bowel lymphoma. However, it is also a known risk factor for small bowel adenocarcinoma. The authors are reporting a case of a patient with recurrent bowel obstruction found to have a small bowel adenocarcinoma and an underlying celiac disease.

Cannabinoid Hyperemesis Syndrome: A Case Study in a Tunisian Young Man.

The increasing prevalence of cannabis use in the world requires awareness of cannabis-related disorders such as cannabinoid hyperemesis syndrome. This syndrome includes cyclic episodes of nausea, vomiting, and the learned behavior of hot bathing in individuals with chronic cannabis use. We present the case of a suspected cannabinoid hyperemesis syndrome that required a review of the literature to retain the diagnosis. The following case illustrates how cannabinoid hyperemesis syndrome awareness may lead to the diagnosis.

Intrahepatic cholangiocarcinoma mimicking a liver abscess.

Intrahepatic cholangiocarcinoma masquerading as liver abscess, and presenting with fever, is a very rare situation and should be considered in nonresolving liver abscess. Only few cases were reported in the literature. This entity is characterized by late diagnosis and poor prognosis.

Hepatocellular carcinoma arising from hepatic adenoma in a young woman.

Hepatocellular carcinoma (HCC) arising from hepatic adenoma is an infrequent situation. Only a few cases were reported in the literature. We present a rare case of hepatocellular carcinoma arising from HA in a young woman with no medication history of oral contraceptives. Surgical resection is the only available treatment.

Isoniazid-induced pellagra in a patient with Crohn's disease.

Isoniazid preventive therapy in malnourished patients with Crohn's disease has a potential of inducing pellagra but still a very rare situation. No cases of isoniazid-induced pellagra in patients with Crohn's disease were reported in the literature. Pellagra can be easily treated if timely diagnosed.

Hepatitis viruses take advantage of traditional practices to increase the burden of hepatocellular carcinoma in Tunisia.

Hepatocellular carcinoma (HCC) is a major public health issue in Africa. In Tunisia, hepatitis B virus (HBV) is known to be an important risk factor for HCC in the south of the country, but the role played by hepatitis C virus (HCV) still remains unclear. The aim of the current case-control study was to identify risk factors for HCC development in the northern part of the country. Clinical and biological data including viral hepatitis status (serological and molecular) and non-infectious risk factors from 73 patients with HCC and 70 control subjects without hepatic diseases were collected. The mean age of the patients was 63 ± 10 years, and the ratio of males to females was 1.1. HCC occurred in cirrhotic liver in 72.0% of the cases. HCV infection was the dominant risk factor (64.3% of cases); the presence of HBV was observed in 53.4% of the cases. Occult hepatitis B and C were implicated, respectively, in 30.1% and 9.6% of the cases. HCV genotype 1b was predominant. Patients originating from western Tunisia formed a homogeneous group, characterized by significantly higher rates of tattoos or scarifications (83%) and HCV infection (80%) than those from other parts of the country. Chronic HCV infection is currently the primary risk factor for HCC in Tunisia; HBV infection remains frequent in its overt or occult infection forms. Traditional esthetic practices apparently contribute to increasing the burden of terminal liver diseases in western Tunisia.