[A periarteritisnodosa presenting as bilateral sub-acute limb ischemia of the legs]. / Ischémie subaiguë bilatérale des membres inférieurs, une présentation rare de périartérite noueuse.

STUDY'S GOAL: As there are no guidelines. This short report shows our experience in management of sub-acute limb ischemia with polyarteritisnodosa. INTRODUCTION: Acute limb ischemia is rarely seen in periarteritisnodosa. CASE REPORT: Here, we present a case with peripheral vascular disease of both lower limbs leading to foot claudication and then a subacute limb ischemia with large necrotic plaques on the lower limb. Angioscan showed occlusion of both superficial femoral arteries. Angiographic imaging showed abnormalities in medium-sized arteries. Pathological study of biopsy from the artery, vein, nerve and skin of the amputated leg confirm the diagnosis of periarteritisnodosa. She benefited from femoral popliteal bypass in both legs, anticoagulant drug and steroids. The non-amelioration of the left leg led to his amputation. The right leg was healed.

Calcific pancreatitis uncovering a multiple endocrine neoplasia type 1: A case report in compliance with the scare guidelines.

INTRODUCTION: Chronic pancreatitis are mostly linked to alcoholic consumption or biliary lithiasis; and Primary hyperthyroidism (PHPT) is still a very rare association and the exact physiopathology is yet to be fully unveiled to the human knowledge. We present the first case report of a calcific pancreatitis associated with not only PHPT but a multiple endocrine neoplasia (MEN) type 1. CASE PRESENTATION: We report the case of a 52 years old woman suffering from mellitus diabetes consulting the emergency rooms for acute pancreatitis with hyperlipasemia and hypercalcemia whom final imaging discovered a pituitary gland adenoma, a left surrenal adenoma, and a parathyroid adenoma, and for the pancreas it reveiled an acute mild pancreatitis with a background of calcifications, no gallstones, no bone or renal abnormalities; and the parathyroidectomy was performed following the minimally invasive selective technique. DISCUSSION: Calcemia levels testing routinely performed help discover hyperparathyroidism. The associations of chronic pancreatic inflammation to hyperparathyroidism needs to be studied, even if hypercalcemia is prooven to be a risk factor of pancreatitis; the mechanism behind this association is brievely described. parathyroidectomy is the definitive cure for hyperparathyroidism, the technique advances has shown effective localization of the responsible adenoma and the intraoperative testing of parathormon levels after resection decreasing is a very reliable extemporaneous sign for the success of the procedure. CONCLUSION: The endocrine system is synchronized; meaning the injury of one gland should start the search for others. In our case, the first main lead should not have been the acute pancreatitis but her diabetes. In the future we suggest that diabetes primary explorations may need a pancreatic imaging and endocrine explorations even though it could get pricier for the healthcare system, but giving the complications that we could prevent; it is to be considered.

Gastric duplication cyst in an adult with autoimmune hemolytic anemia: a case report and review of the literature.

BACKGROUND: Gastric duplication cysts are uncommon congenital anomalies found primarily in children and rarely seen in the adult population. Accurate diagnosis of cysts before resection is difficult even using the most advanced imaging techniques. CASE PRESENTATION: In this report, we describe a 28-year-old Moroccan patient with a history of autoimmune hemolytic anemia who presented with an asymptomatic abdominal cystic mass detected during abdominal computed tomography performed before splenectomy. Magnetic resonance imaging performed for accurate characterization showed a high-signal-intensity cystic mass on T2-weighted images, located between the patient's stomach and spleen. The patient underwent a complete cyst resection during exploratory laparotomy. The histological examination showed a cyst lined by three different epithelia with bundles of smooth muscle, which suggested a gastric duplication cyst. CONCLUSIONS: We report a case of gastric cyst duplication in an adult with autoimmune hemolytic anemia, and we discuss this rare association, radiological findings, and the unique histological findings of this case.