An uncommon liver abscess secondary to an ingested foreign body: A case report.

Introduction: This article discusses a case study involving a unique occurrence of a hepatic abscess caused by the presence of an ingested foreign body. Hepatic abscesses, characterized by pus accumulation within liver tissue, often result from various infections, with some cases having unidentified origins. Case presentation: This study focuses on a 75-year-old man who presented at an emergency department with persistent pain in the right upper abdomen and fever for ten days. Diagnostic tests revealed a low-density, multiloculated mass in the liver and a hyperdense linear structure near the duodenum, indicating a hepatic abscess originating from duodenal perforation due to a foreign body that had migrated from ingestion. The patient underwent antibiotic treatment and a surgical procedure involving laparotomy to extract the foreign object and drain the abscess. Conclusion: this case study underscores the rare occurrence of hepatic abscesses caused by ingested foreign bodies. Swift and accurate diagnosis, along with appropriate treatment involving foreign body removal and abscess drainage, are pivotal for favorable patient outcomes. The choice of treatment strategy impacts hospital stay duration, and understanding potential complications from foreign body ingestion enhances patient management and care.

Severe Hypernatremia During Hydatid Cyst Surgery: An Anusual Cause Of Acute Abdomen.

Treatment of liver hydatid cysts is still in most cases surgical. To avoid the recurrence of hydatid cysts injection of scolicidal products inside the cystic cavity is an important step in the surgical procedure. Many scolicidal solutions are used. Hypertonic Saline Solution (HSS) is widely used by surgeons; however, there is a risk of hypertonic saline resorption and acute hypernatremia. Iatrogenic hypernatremia can be life-threatening. We report three cases of hypernatremia secondary to HSS injection for hydatid cyst disease treatment. The objective of this study was to discuss the clinical features, and treatment of this rare complication.

A case report of a large Splenic epidermoid cyst treated with partial splenectomy.

Introduction and importance: Splenic epidermoid cysts are rare primary congenital cysts composed of an epithelial lining that represent a small proportion of nonparasitic splenic cysts. Despite their infrequency, there is a lack of uniform diagnostic and treatment guidelines for these cysts, emphasizing the need for further research and standardized reporting. Case presentation: A 45-year-old female presented with left upper quadrant abdominal pain, characterized by a pressing sensation. Physical examination revealed a palpable mass in the upper left quadrant. Laboratory test results were normal. Abdominal ultrasonography and CT tomography confirmed a large splenic unilocular cyst consistent with an epidermoid cyst. Surgical intervention involved aspiration of the cystic fluid, partial splenectomy, and pathological examination. The patient's postoperative recovery was uneventful. Clinical discussion: The origin of splenic epidermoid cysts remains unclear, with theories suggesting entrapment of mesothelial cells during embryonic development. The clinical presentation varies with cyst size, often causing abdominal pain and a palpable mass. Diagnostic modalities include ultrasonography and CT scans. Surgical intervention is recommended for symptomatic or suspicious cysts to prevent complications. The chosen approach depends on cyst characteristics and patient factors. This case highlights the challenges and considerations in managing splenic epidermoid the cysts and emphasizes the need for individualized treatment approaches. Conclusion: This case contributes to the understanding of splenic epidermoid cysts and demonstrates a successful subtotal splenectomy as a treatment approach. Further research and standardized guidelines are essential to improve the management of these rare lesions and to provide better insights into their etiology and optimal treatment strategies.

Small Intestine Gastrointestinal Clear Cell Sarcoma: A Case Report and Review of the Literature.

Gastrointestinal clear cell sarcoma (GICCS)/malignant gastrointestinal neuroectodermal tumor (GNET) is an extremely rare form of cancer with aggressive clinical behavior. It has distinct pathological, immunohistochemical, ultrastructural, and molecular features. Herein, we present the case of a 20-year-old woman with no notable medical history who presented to the outpatient department with complaints of abdominal pain and vomiting. Symptoms had been evolving for 3 months. The physical examination revealed slight abdominal tenderness and melena. Biological investigations revealed iron-deficiency anemia. The upper and lower endoscopies showed no abnormalities. Magnetic resonance enterography revealed small bowel wall thickening of 15 mm × 2 mm. Exploratory laparotomy revealed an ileal mass with mesenteric lymphadenopathy. A wide resection of the mass was then performed. The final pathological report confirmed the diagnosis of small bowel GICCS/GNET. After 11 months of follow-up, the patient presented with mesenteric lymph node metastases.

A case report of abdominal wall hydatidosis: An uncommon location.

Liver hydatid cyst fistulized in the abdominal wall is rare. The clinical symptoms were often misleading. It often poses a problem of seat diagnosis rather than a problem of its hydatid nature despite the great contribution of modern imagery. We reported this uncommon case to highlight the difficulties of preoperative diagnosis and a better operative approach. 46-year-old men consulted for right flank pain. The clinical exam revealed a right flank subcutaneous mass. An abdominal CT scan showed multicystic lesions on the right flank. The MRI showed multiple cystic lesions on the right flank with several endophytic and exophytic daughter cysts. The patient was operated on. A wide excision was adopted to remove all the cystic lesions. The postoperative follow-up was uneventful. Abdominal subcutaneous hydatid cysts cause a diagnostic problem and the treatment is controversial. Surgery remains the only curative treatment. It avoids the risk of complications such the fistula, infection, and rupture.

Post-traumatic lateral abdominal wall hernia: a case report.

Traumatic abdominal wall hernia (TAWH) also known as blunt abdominal TAWH is uncommon. The clinical diagnosis is difficult. The authors present a case report of posthigh-energy abdominal blunt trauma causing a TAWH. Case presentation: A 36-year-women, with unremarkable past medical history, was presented to the Emergency Department after a stuck in high-speed two automobiles. She was hemodynamic, respiratory, and neurologically stable. The BMI was 36 kg/m². The abdomen was not distended with an ecchymotic lesion on the right flank. The thoracic abdominal and pelvic computed tomography (CT) scan revealed a rupture in the lateral abdominal wall muscles with a TAWH in the location of the skin ecchymoses. There was no visceral lesion or intraperitoneal fluid. A conservative treatment was indicated. The follow-up was uneventful, with hematoma resorption and no cellulitis or abscess. The patient was discharged after 1 week. An abdominal repair will be planned using a mesh. Clinical discussion: TAWH is a rare entity. The best imaging modality for diagnosis is the CT scan allowing classification of the hernia and a screen for other injuries. The presence of an isolated TAWH must lower the threshold to closely monitor or to operatively explore, given the high rate of false-negative findings at imaging features. Conclusion: TAWH should be suspected behind any blunt abdominal trauma with high energy. CT scan and ultrasound were helpful for diagnosis and the only curative treatment is surgery to avoid complications.

Upper gastrointestinal haemorrhage caused by duodenal metastasis from primary lung cancer: A case report.

Duodenal metastases from primary lung carcinoma are uncommon. They usually occur in terminal-stage disease. Bleeding, as the first presentation of duodenal metastases, is rare. This case reports a rare mechanism of upper gastrointestinal bleeding due to a metastatic involvement of the duodenum and gastroduodenal artery. A 58-year-old man with a past medical history of pulmonary carcinoma presented an episode of hematemesis of great abundance with melena. On physical examination, he was afebrile and pale. The biological data found an anaemia with haemoglobin at 6 g/dL. The upper gastrointestinal endoscopy revealed a congestive duodenal lesion with signs of recent bleeding. An angio CT scan localized the bleeding from the gastroduodenal artery. A few hours later, the patient presented a recurrent episode of hematemesis with deglobalization. So we performed a radiologic embolization of the gastroduodenal artery. Haemorrhage as the first presentation of small bowel metastases is rare, especially when these are located in the duodenum, with a poor prognosis. Radiological embolisation could be the best choice for treatment.

Management of liver hydatid cyst with cystobiliary communication and acute cholangitis: a 27-year experience.

PURPOSE: The rupture of the hydatid cyst into the bile ducts is a common and serious complication. The rupture can be latent or revealed after a complication such as acute cholangitis. The objective of this study was to discuss the clinical features, radiographic findings, and surgical treatment of this rare complication. METHODS: A retrospective analysis of patients operated for acute cholangitis caused by hydatid cyst between January 1990 and May 2016 was conducted. RESULTS: Our study included 55 cases of acute cholangitis caused by ruptured hydatid cyst: 35 were men and 20 were women. Five patients had medical history of hydatid cyst. On imaging, all patients had a dilated bile duct. In 51 cases, there was a single hydatid cyst. Hydatid cysts with fistula were located in the right lobe of the liver in 49 cases and in the left lobe in 6 cases. Seven patients underwent an emergency surgery after admission, while others were operated after 3-8 days. A conservative procedure associated with drainage was applied in 49 cases. Endoscopic treatment was performed in four cases which failed in two cases. Twenty-eight cases developed postoperative complications, among which the most common complication was biliary fistula (n - 17). There were eight cases of postoperative deaths (14.5%). CONCLUSIONS: Liver hydatid cyst with cystobiliary communication and superadded acute cholangitis is a serious clinical problem requiring the early diagnosis and surgery in the absence of endoscopic therapy.

Adenosquamous carcinoma of the right colon: A case report and review of the literature.

INTRODUCTION: Adenosquamous carcinoma is a rare colorectal tumor with both an adenocarcinoma and a squamous cell carcinoma component. To the best of our knowledge, only few cases have been reported in the literature. CASE PRESENTATION: We report a case of a 46-year-old woman, hospitalized for large bowel obstruction syndrome. Computed tomography scan showed an irregular mass of the right colic angle, responsible for an occlusive syndrome with distension of the right colon, the appendix and the terminal ileum. The patient underwent right hemicolectomy with D2 lymphadenectomy. Histopathological examination revealed mixed adenocarcinoma and squamous carcinoma. Adjuvant chemotherapy was prescribed for the patient. DISCUSSION: Adenosquamous carcinoma is a rare colorectal neoplasm revealed by non-specific complaints. Its clinicopathology is not yet understood. Preoperative diagnosis is often difficult. Surgical resection remains the mainstay of treatment. CONCLUSION: Adenosquamous carcinoma is a malignant tumor with poorer prognosis than adenocacinomas.