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Tarchouli M, Elabsi M, Njoumi N, Essarghini M, Echarrab M, Chkoff MR. Liver trauma: What current management? Hepatobiliary Pancreat Dis Int 2018; 17:39-44. [PMID: 29428102 DOI: 10.1016/j.hbpd.2018.01.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 11/02/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND The liver is the most commonly damaged organ in abdominal trauma. The management of liver trauma has experienced many changes over the last two decades. Currently there is a trend toward a non-operative treatment warranted by the successful pediatric experience and better results recorded in many trauma centers worldwide. This study aimed to evaluate outcomes of operative and non-operative management of liver trauma in our institution over the last five years. METHODS The patients with a diagnosis of blunt or penetrating liver injuries, admitted and managed in our hospital from January 2012 to December 2016 were retrospectively studied. The patients were divided into 2 groups, operated and non-operated groups, according to the initial management considered appropriate at the time of patient admission. Clinical features and outcomes were analyzed. RESULTS The study involved 83 patients, with a mean age of 33 years and a marked male predominance (85.5%). The most common type of lesions was blunt trauma and the main cause was road traffic accidents. Sixty-eight liver injuries (81.9%) were of low severity (grades I, II, III), while 15 (18.1%) were of high severity (grade IV or greater). Fifty-six patients (67.5%) had multiple injuries. Surgical treatment was performed in 26 (31.3%) patients. Non-operative management was undertaken in 57 cases (68.7%). The morbidity and mortality rates were clearly lower in non-operative patients compared to those in the operated group. CONCLUSIONS Careful non-operative management is an adequate therapeutic strategy for the patients suffering from liver trauma with stable hemodynamics. Patients with complex hepatic trauma and especially those with other organ injuries continue to have significantly higher mortality.
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Affiliation(s)
- Mohamed Tarchouli
- Department of Digestive Surgery, Mohammed V Military Hospital, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fes, Morocco.
| | - Mohamed Elabsi
- Department of Visceral Surgical Emergency, Ibn Sina Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Noureddine Njoumi
- Department of Digestive Surgery, Mohammed V Military Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Mohamed Essarghini
- Department of Digestive Surgery, Mohammed V Military Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Mahjoub Echarrab
- Department of Visceral Surgical Emergency, Ibn Sina Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Mohamed Rachid Chkoff
- Department of Visceral Surgical Emergency, Ibn Sina Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
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Lachhab I, Traoré BZ, Saoud O, Khedid YZAA, Zouaidia F, Echarrab M, Chkoff MR. Small bowel volvulus with intussusception: an unusual revelation of neuroendocrine tumor. Pan Afr Med J 2015; 22:6. [PMID: 26600906 PMCID: PMC4643153 DOI: 10.11604/pamj.2015.22.6.7132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 06/07/2015] [Indexed: 11/20/2022] Open
Abstract
The primary malignant tumors of the small bowel are rare, representing 1 to 1.4% of all gastrointestinal tumors. We report a case of a 33 year-old women, admitted to our emergency department of visceral surgery for acute abdomen. The clinical examination revealed diffuse abdominal distension, defenseless, the hernia orifices were free and the rectal examination was normal. The biological test showed no hydro electrolytic disorders with normal hemoglobin and normal renal function. The abdominal CT-Scan showed signs of bowel obstruction due to a volvulus with intussusception without ischemia. The patient was operated urgently; the exploration has revealed a small bowel obstruction in the ileum with volvulus, an intussusceptum associated with a retractile mesenteritis, and the hepatic exploration found no metastases. The patient underwent a bowel resection taking away the intussusceptum with the infiltrated mesentery. The postoperative course was uneventful. The pathological result has proved a well-differentiated neuroendocrine tumor with five free nodes. Through this observation, we aim to highlight that an obstruction of small bowel with volvulus and intussusception could be exceptionally due to a neuroendocrine tumor, this complication has enabled a relatively early diagnosis in the absence of metastases and a 6-month follow-up without recurrence is a demonstration.
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Affiliation(s)
- Imad Lachhab
- Departement of Visceral Surgical Emergency, IBN Sina University Hospital, Rabat, Morocco
| | - Boubacar Zan Traoré
- Departement of Visceral Surgical Emergency, IBN Sina University Hospital, Rabat, Morocco
| | - Omar Saoud
- Departement of Visceral Surgical Emergency, IBN Sina University Hospital, Rabat, Morocco
| | | | - Fouad Zouaidia
- Department of Pathology, IBN Sina University Hospital, Rabat, Morocco
| | - Mahjoub Echarrab
- Departement of Visceral Surgical Emergency, IBN Sina University Hospital, Rabat, Morocco
| | - Mohamed Rachid Chkoff
- Departement of Visceral Surgical Emergency, IBN Sina University Hospital, Rabat, Morocco
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Njoumi N, Elabsi M, Attolou G, Elouazzani H, Elalami FH, Chkoff MR. Solitary preperitoneal neurofibroma: a case report. BMC Res Notes 2015; 8:115. [PMID: 25879938 PMCID: PMC4384358 DOI: 10.1186/s13104-015-1098-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 03/26/2015] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Neurofibroma is a rare benign tumor. The isolated presence of such lesions in the preperitoneal space with no evidence of systemic disease has never been reported in the literature. CASE PRESENTATION A 29-year-old white man presented with a 12 months history of progressive abdominal distension. Clinical examination revealed a bulky hypogastric mass. Abdominal computed tomography and pelvic magnetic resonance imaging showed a large, well defined preperitoneal tumor measuring 18 x 17 cm extending in the pelvis. A computed tomography guided biopsy was performed which revealed a neurofibroma. Exploratory laparotomy showed a well encapsulated elastic soft tumor in the preperitoneal space which measured 17 x 18 cm and weighted 2 Kg. The tumor was completely excised. No recurrence occurred after one year of follow-up. CONCLUSION Solitary preperitoneal neurofibroma is an extremely rare benign tumor. Its clinical and radiological signs are nonspecific. Preoperative histology can be useful to guide the surgical approach which is the only curative treatment.
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Affiliation(s)
- Noureddine Njoumi
- Department of Visceral Surgical Emergency, Ibn Sina Hospital, Rabat, Morocco.
| | - Mohamed Elabsi
- Department of Visceral Surgical Emergency, Ibn Sina Hospital, Rabat, Morocco.
| | - Gilles Attolou
- Department of Visceral Surgical Emergency, Ibn Sina Hospital, Rabat, Morocco.
| | - Hafsa Elouazzani
- Department of Anatomical Pathology, Ibn Sina Hospital, Rabat, Morocco.
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Njoumi N, Elalami FH, Attolou G, Saoud O, Elabsi M, Echarrab M, Elouannani M, Errougani A, Amraoui M, Chkoff MR. Undifferentiated pancreatic carcinoma with osteoclast-like giant cells: a case report. J Gastrointest Cancer 2014; 45 Suppl 1:96-8. [PMID: 24382600 PMCID: PMC4292047 DOI: 10.1007/s12029-013-9572-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Noureddine Njoumi
- Department of Visceral Surgical Emergency, Ibn Sina Hospital, CHU Ibn Sina, Rabat, Morocco,
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5
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Yamou R, Najih M, Absi M, Ouanani M, Echerrab M, EL Alami H, Amraoui M, Errougani A, Chkoff MR. [Primitive peritonitis: real entity but difficult to diagnose]. Pan Afr Med J 2012; 12:83. [PMID: 23077704 PMCID: PMC3473969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2012] [Accepted: 07/16/2012] [Indexed: 11/08/2022] Open
Abstract
Les péritonites primitives sont rares chez des patients sans facteurs de risques. Elles simulent les péritonites secondaires. C'est pourquoi leur diagnostic ne peut être que peropératoire. Nous rapportons deux cas de péritonites primitives dans le but de discuter leurs aspects diagnostique et thérapeutiques.
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Affiliation(s)
- Rajae Yamou
- Service des urgences chirurgicales viscérales, Hôpital Ibn Sina, Rabat, Maroc,Corresponding author: Rajae Yamoul, Service de chirurgie viscérale, Hôpital militaire d'instruction Mohammed V, Rabat, Maroc. Adresse: Service de chirurgie viscérale, Hôpital militaire d'instruction Mohammed V, Rabat, Maroc
| | - Mohammed Najih
- Service des urgences chirurgicales viscérales, Hôpital Ibn Sina, Rabat, Maroc
| | - Mohamed Absi
- Service des urgences chirurgicales viscérales, Hôpital Ibn Sina, Rabat, Maroc
| | - Mohamed Ouanani
- Service des urgences chirurgicales viscérales, Hôpital Ibn Sina, Rabat, Maroc
| | - Mahjoub Echerrab
- Service des urgences chirurgicales viscérales, Hôpital Ibn Sina, Rabat, Maroc
| | - Hassan EL Alami
- Service des urgences chirurgicales viscérales, Hôpital Ibn Sina, Rabat, Maroc
| | - Mohamed Amraoui
- Service des urgences chirurgicales viscérales, Hôpital Ibn Sina, Rabat, Maroc
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Balafrej S, Echarrab EM, el Ounani M, Mdaghri J, Amraoui M, el Alami FH, Errougani A, Benchekroun BA, Chkoff MR. [Treatment of bleeding duodenal ulcer. A study of mortality and indication of surgical treatment. Apropos of 557 cases]. J Chir (Paris) 1998; 134:406-9. [PMID: 9682756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
From 1986 to 1996, 557 patients are treated for acute ulcer bleeding. The sex ratio is five to one for men, the average age is 40 years old. The duodenal ulcer is revelated by haemorrhage in 25.8%. 181 patients underwent a surgical operation (32%). This percentage is higher that those encountered in the literature, due probably to our specific context (patients from low socioeconomic level, can not afford medical treatment, medical surveillance or control, lack of blood products in emergency. The most practiced surgical treatment is weinberg operation: "Troncular Vagotomy" with "pyroloplasty" and "ulcer sean" practiced in 86.1% of the cases; "Troncular Vagotomy" with "Gastro-intestinal anastomosis" is operated in 7.7% of the cases; "Superselective Vagotomy" and "Seromyotomy" is practiced in 3.8%, with the "Antroduodenectomy" is practiced in 1.1% of the cases. The overall death rate observed is about 4% this value increase to 11% after surgical treatment. This death rate is lower than the literature, that's probably anociated the fact that most of our patients are young and do not hold severe weaknesses. This study indicates that mortality was related to the patient's age, the patient's condition and recurrent haemorrhages.
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Affiliation(s)
- S Balafrej
- Service des Urgences Chirurgicale Viscérale, CHU Ibn Sina, Rabat, Maroc
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el Alami el Faricha EH, Lekhal B, Mohsine R, Louchi A, Ismail F, Echarrab M, Errougani A, Chkoff MR, Benche-Kroun BA, Balafrej S. [A rare etiology of an abscess of the psoas: brucellosis. Apropos of 2 cases]. J Chir (Paris) 1995; 132:414-5. [PMID: 8550703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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8
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Amraoui M, Bougtab A, Alami H, Errougani A, Benchekroun A, Chkoff MR, Balafrej S. [An unusual cause of colonic perforation: sinus haemophagocyte histiocytosis]. J Chir (Paris) 1994; 131:158-9. [PMID: 8071409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The authors report about one case of colic perforation due to sinus histiocytosis with massive lymphadenopathy. This observation has permitted us to give a point of view about this uncommon affection with unknown cause.
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Affiliation(s)
- M Amraoui
- Service des Urgences Chirurgicales Viscérales, CHU Avicenne, Rabat, Maroc
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9
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el Allame L, Belkhayat S, Chkoff L, Mechatt F, Chkoff MR, Benchkroun BA, Assem A, Balafrej A, Sebti F, Balafrej S. [Spontaneous hemoperitoneum complicating intraperitoneal paraganglioma]. J Chir (Paris) 1989; 126:242-7. [PMID: 2659610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A young man of 27 years was admitted to the medical ward because of increasing ascites over 3 months. There were no signs of portal hypertension and a diagnostic tap produced hemorrhagic liquid. Ultrasound confirmed ascites associated with an abdomino-pelvic mass. Anemia progressed and right aorto-iliac axis arteriography was carried out and demonstrated a poorly vascularised mass. Emergency surgery was carried out and demonstrated an encapsulated firm and cystic abdomino-pelvic mass of 23/18 cm with a rich vascular supply from the greater omentum and a hemoperitoneum of 7 litres secondary to rupture of this pseudo-lymphangiomatous mass. Besides large vessels from the and some loose fibrous adhesions in the pouch of Douglas there was no true implantation site attaching this mass to retroperitoneal structures, gastrointestinal tract or bladder. After ligation of the vessels the entire mass was easily resected. The post-operative course was uncomplicated. Pathological examination confirmed a paraganglioma. A full clinical pathogenic, therapeutic and evolutive study is described.
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Affiliation(s)
- L el Allame
- Urgences Chirurgicales Viscérales, C.H.U., Hôpital Avicenne, Rabat - Maroc
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10
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Tounsi A, Chkoff MR, Foucou B, Halhal A, Hamdouch Z, Housni K, Mjahed A, Oudanane M. [Reflections on the post-cholecystectomy syndrome]. Ann Gastroenterol Hepatol (Paris) 1987; 23:89-92. [PMID: 3592604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
To look for the explanation about the post-cholecystectomy syndrome, the authors study 637 liver's biopsies during cholecystectomy for cholelithiasis. 373 liver's biopsies showed hepatic lesions (58.5 per cent). The post-cholecystectomy syndrome is observed in 36 per cent of patients who had hepatic lesions, and only 13 per cent of patients with normal liver biopsies.
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11
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M'Jahed A, Hamdouch Z, Halhal A, Oudanane M, Chkoff MR, Foucou B, Tounsi A. [Bilio-biliary fistulas (apropos of 8 cases)]. Maghrib Tibbi 1986; 8:422-8. [PMID: 3613667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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M'Jahed A, Hamdouch Z, Hahal A, Oudanane M, Chkoff MR, Foucou B, Housni K, Tounsi A. [Hemorrhagic bilio-digestive fistulas (apropos of a new case)]. Maghrib Tibbi 1986; 8:391-6. [PMID: 3497318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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13
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Tounsi A, Hamdouch Z, Halhal A, M'Jahed A, Oudanane M, Chkoff MR, Foucou B. [Primary megaesophagus in the adult. Apropos of 50 cases]. Maghrib Tibbi 1986; 8:275-9. [PMID: 3613654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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14
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Tounsi A, Chkoff MR, Foucou B, Halhal A, Hamdouch Z, Housni K, Mjahed A, Oudanane M, Hachimi EL. [Postcholecystectomy syndrome]. Bull Acad Natl Med 1985; 169:835-43. [PMID: 3910183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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