Iatrogenic colorectal Kaposi's sarcoma complicating a refractory ulcerative colitis in a human immunodeficiency negative-virus patient.

Kaposi sarcoma is an unusual tumor associated to a human herpes virus-8 infection involving the skin or internal organs. Iatrogenic Kaposi's sarcoma often occurs in patients receiving immunosuppressive therapy. So far, a few Kaposi's sarcoma cases have been reported in the literature associated with inflammatory bowel diseases. We report a 53-year-old male diagnosed with a severe refractory ulcerative colitis who was treated with corticosteroids and azathioprine. The patient underwent a colectomy after the failure of medical treatment. Histological examination of the colon showed findings suggestive of Kaposi's sarcoma. Immunohistochemistry for human herpes virus-8 was positive in the colonic lesions. Correspondence.

An unusual case of gallbladder cancer.

Pure squamous cell carcinoma (SCC) of gallbladder is a very rare tumour and is responsible for only 3% of the malignant neoplasm of this organ. We report a case of SCC of gallbladder in a 58-year-old woman. Through this new observation, we propose to study the clinicopathologic features, pathogeny and treatment of this rare entity.

[Role of laparoscopy in the diagnosis of peritoneal tuberculosis in endemic areas]. / Intérêt de la laparoscopie dans le diagnostic de la tuberculose péritonéale en zones endémiques.

The aim of our study is to demonstrate the difficulties of diagnosis of peritoneal tuberculosis in endemic areas and the value of laparoscopy for diagnostic confirmation. We report a retrospective study of 60 cases of peritoneal tuberculosis, collected from January 2004 to December 2009. The patients' median age was 41 years, and the sex ratio 0.4. The dominant reasons for consultation were pain and abdominal distension. Abdominal ultrasound found ascites in all patients. Computed tomography (CT) was performed in 30 patients and confirmed the ultrasound data. Paracentesis of the ascites took place in all patients, collecting exudative fluid in all cases; lymphocytes predominance in 83%. Screening for Mycobacterium tuberculosis in the ascites on direct examination and after culture was performed in 43 cases and negative in all of them. Surgical biopsy was performed laparoscopically in 29 patients and by laparotomy in 31 patients. Histological examination of the peritoneal biopsies confirmed the diagnosis of peritoneal tuberculosis in all cases.

Ileal pouch-anal anastomosis: Points of controversy.

Restorative proctocolectomy with ileal pouch-anal anastomosis has become the most commonly used procedure for elective treatment of patients with ulcerative colitis and familial adenomatous polyposis. Since its original description, the procedure has been modified in order to obtain optimal functional results with low morbidity and mortality, and yet provide a cure for the disease. In this review of the literature of restorative proctocolectomy with ileal pouch-anal anastomosis, we discuss these technical modifications, limiting our discussion to the current points of controversy. The current "hot topics" for debate are: indications for ileal pouch-anal or ileo-rectal anastomosis, indications for pouch surgery in the elderly, indeterminate colitis and Crohn's disease, the place of the laparoscopic approach, transanal mucosectomy with hand-sewn anastomosis vs. the double-stapled technique, the use of diverting ileostomy and the issue of the best route for delivery of pregnant women. Longer follow-up of patients and increased knowledge and experience with pouch surgery, coupled with ongoing prospective evaluation of the procedure are required to settle these issues.

[Rectal stromal tumor: about a case]. / Tumeur stromale rectale: à propos d'une observation.

Gastro-intestinal stromal tumors are uncommon mesenchymal tumors. There are localized preferentially in the stomach. The rectal localization is exceedingly rare. Through a new case of rectal stromal tumour as well as a review of the literature, we propose to focus on clinical, radiological and therapeutic particularities of this rare entity.