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El Bakouri A, El wassi A, Eddaoudi Y, Bouali M, EL Hattabi K, Bensardi F, Fadil A. Fortuitous discovery of an early neuroendocrine tumor during appendicular peritonitis. Ann Med Surg (Lond) 2022; 82:104735. [PMID: 36268349 PMCID: PMC9577830 DOI: 10.1016/j.amsu.2022.104735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/18/2022] [Accepted: 09/18/2022] [Indexed: 11/27/2022] Open
Abstract
Introduction Materials and methods Results Conclusion Neuroendocrine tumors of the small bowel are rare but represent the most frequent histological type at this level. Their incidence is increasing thanks to the evolution of diagnostic means. These tumors are most often diagnosed incidentally during the workup of aspecific digestive disorders or during hormonal hypersecretion syndrome or rarely by a complication.
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Eddaoudi Y, Fatine A, El Bakouri A, Bouali M, El Hattabi K, Bensardi F, Fadil A. Peritoneal hydatidosis: An exceptional case report. Ann Med Surg (Lond) 2022; 83:104606. [DOI: 10.1016/j.amsu.2022.104606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/02/2022] [Accepted: 09/04/2022] [Indexed: 11/16/2022] Open
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El Bakouri A, El Wassi A, Eddaoudi Y, Bouali M, ElHattabi K, Bensardi F, Fadil A. Early Discovery Of Small Bowel Adenocarcinoma In a Patient Admitted For 4 Acute Intestinal Intussusception case report. Ann Med Surg (Lond) 2022; 82:104776. [PMID: 36268363 PMCID: PMC9577972 DOI: 10.1016/j.amsu.2022.104776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 09/18/2022] [Accepted: 09/19/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Malignant tumours of the small bowel are uncommon in clinical practice. Adenocarcinoma is the most common of these tumours, accounting for approximately 35–45% of all tumours. It may occur sporadically, in association with familial adenomatous polyposis coli or Peutz-Jeghers syndrome or hereditary non-polyposis colorectal cancer, or in association with chronic inflammatory bowel changes (such as Crohn's disease or celiac disease). Materials and methods We report a case of Early Discovery Of Small Bowel Adenocarcinoma In A Patient Admitted For 4 Acute Intestinal Intussusception in the department of Emergency visceral surgery P35 of the ibn rochd hospital in casablanca. Results Our patient was admitted to the emergency room for sub-occlusive syndrome with generalized abdominal pain of chronic appearance dating back to one month before his admission With Abdominal and pelvic ultrasound showed: intestinal parietal thickening and minimal ascites (peritoneal and/or intestinal tuberculosis? Crohn's disease) The patient underwent an abdominal-pelvic CT scan which showed: Presence of diffuse small bowel thickening, involving several small intestines and the colonic angle with intestinal invaginations (at least 3) suspecting an inflammatory or tumoral origin? To be compared with histological data and infiltration of the mesenteric fat in the sub-umbilical region with a peritoneal effusion in the Douglas. the patient was operated on in the emergency room, approached by laparotomy and found on exploration: Presence of 3 invaginations in the small intestine located at 20cm and 90cm from the Duodenojejunal Angle (DIA) as well as at 25cm from the Last part of the small intestine (DAI), with Presence of a colonic invagination at the level of the left colonic angle. the patient underwent 3 small bowel resections and one segmental colonic resection including segmental small bowel resections: the 1st one of 30 cm taking away an invagination of the small intestine at 20cm from the ADJ, the 2nd one taking away 60cm of invaginated located at 90cm from the ADJ the 3rd one taking away 20cm of invaginated located at 25cm from the DAI and a 4th resection taking away an invagination of the left colonic angle with 3 Anastomosis of the T-T small intestine and a transverse Colostomy in Bouilley Volkman. On examination by the anapathomopathologist: consistent with a small bowel tumour: well-differentiated intestinal adenocarcinoma on degenerated adenomatous polyps measuring 2.5cm and 1.7cm with an estimated 10% mucinous component with no vascular emboli and no peri-nervous sheathing. TNM stage p: pT2 with healthy resection margins in the left colon: Presence of a tubular adenoma with low grade dysplasia. Conclusion The most common symptoms of adenocarcinoma of the small bowel are obstruction, overt or covert bleeding, weight loss and jaundice. Because the small bowel has long been relatively inaccessible to routine endoscopy, the diagnosis of small bowel adenocarcinoma was often delayed for several months after the onset of symptoms. Therefore, in case of suspicion of this type of cancer, a thorough evaluation should be undertaken. Nowadays, endoscopy of the small bowel is widely available, allowing an earlier non-invasive diagnosis. Acute Intestinal Intussusception as a cause of intestinal obstruction is often a diagnostic challenge mimicking a wide spectrum of diseases. Malignant tumours of the small bowel are uncommon in clinical practice. Adenocarcinoma is the most common of these tumours. Its diagnosis is still very difficult. The treatment of Acute Intestinal Intussusception is in most cases surgical. The diagnosis of Acute Intestinal Intussusception is histological.
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Bouali M, El Berni Y, Moufakkir A, El Bakouri A, El Hattabi K, Bensardi F, Fadil A. Value of Alvarado scoring system in diagnosis of acute appendicitis. Ann Med Surg (Lond) 2022; 77:103642. [PMID: 35637993 PMCID: PMC9142662 DOI: 10.1016/j.amsu.2022.103642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 04/13/2022] [Accepted: 04/15/2022] [Indexed: 12/29/2022] Open
Abstract
Introduction Methods Results Conclusion Acute appendicitis is one of the most common causes of acute abdomen in surgical patients. Various scoring systems are used for decision making in appendicitis. Alvarado score remains the most popular scoring system.
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Bouali M, Sylvestre K, ElBakouri A, El Hattabi K, Bensardi F, Fadil A. Mesenteric lipoma with small bowel volvulus: A rare cause of upper gastrointestinal obstruction (a case report and literature review). Int J Surg Case Rep 2022; 92:106875. [PMID: 35276430 PMCID: PMC8917277 DOI: 10.1016/j.ijscr.2022.106875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/14/2022] [Accepted: 02/22/2022] [Indexed: 11/26/2022] Open
Abstract
Introduction Small bowel volvulus due to mesenteric lipoma is a rare clinical entity. It poses both a diagnostic and therapeutic challenge. Small bowel mesenteric lipoma is a rare cause of small bowel obstruction. We present the case of a patient admitted to our emergency department for a small bowel volvulus due to a mesenteric lipoma with small intestine obstruction. Patient and method A 61 years old man, with diabetes since 25 years with antidiabetics oral medication, vaccinated against Covid 19 (two doses) who presented with peri-umbilical pain for two months, constipation and melaena, complicated 3 days before his admission by obstructive symptoms and vomiting with apyrexia and overall health state alteration. The physical examination noticed abdomen distension and the abdominal CT scan revealed a large fatty mass of the hypochondrium and left flank, roughly oval with regular borders, well limited measuring 124 × 86 mm of height of 126 mm thought to be a liposarcoma. The patient underwent enbloc resection of 20 cm of small bowel with the mass and end to end anastomosis of the ileo-ileum. The postoperative course was uneventful and he was been discharged from hospital on day 5. Discussion Mesenteric lipomas are diagnosed incidentally after laparoscopy or laparatomy. Ultrasound shows a well defined homogenous echogenic mass, and so can distinguish it from a mesenteric cyst. Computed Tomography (CT) is the standard imaging of diagnosis and shows homogenous tumor of adipose tissue. The treatment is surgery and the prognosis is better. Conclusion The mesenteric is an uncommon location of lipoma. When there is small bowel obstruction with intra-abdominal mass, the mesenteric lipoma could be recalled. Mesenteric lipoma is rare. Small bowel volvulus due to lipoma is a rare clinical entity. The diagnosis and management Although they are benign, the mesenteric lipomas discovered must be treated.
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Bouali M, Sylvestre K, Benghait H, El Bakouri A, El Hattabi K, Bensardi FZ, Fadil A. Small bowel adenocarcinoma a rare cause of upper gastrointestinal obstruction (a case report and literature review). Int J Surg Case Rep 2022; 91:106763. [PMID: 35030405 PMCID: PMC8760343 DOI: 10.1016/j.ijscr.2022.106763] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/27/2021] [Accepted: 01/06/2022] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Small bowel adenocarcinoma is a rare but increasing disease. It poses both a diagnostic and therapeutic challange. Small bowel adenocarcinoma is a rare cause of small bowel obstruction. We present the case of a patient admitted to our emergency department for a bowel obstruction due to a mass of the jejunum and whose anatomopathological diagnosis was adenocarcinoma. PATIENT AND METHOD It is a 62-year-old woman with unparticular history, admitted to the emergency of visceral surgery of Ibn Rochd University Hospital for subocclusive syndrome evolving for one year, with early postprandial vomiting becoming stenosing two months ago. The abdominal CT scan showed thickening jejunal wall of 46 mm with upstream distension. She underwent a segmental bowel resection of 50 cm of small bowel with 3 cm stenotic mass located at 40 cm from the duodenojejunal angle. The pathophysiology revealed an invasive liberkhunian adenocarcinoma. The postoperative follow-up was simple, feeding allowed at D4 with discharge allowed at D6 and functional improvement at the time of the control performed three months after the intervention. DISCUSSION Small bowel adenocarcinoma is rare and represents only 1-3% of all gastrointestinal cancers. The incidence of SBA is 24 to 66 times lower than that of colorectal cancer (CRC). Due to its non-specific clinical manifestation and less accessible location, SBA is diagnosed at an advanced stage, and often at specimen analysis. The treatment is resection and the overall survival is increased when diagnostic is early made. CONCLUSION Small bowel adenocarcinoma is a rare but increasing cause of gastrointestinal malignancy, being both a diagnostic and therapeutic challenge. In front of the occlusive syndrome of small bowel appearance, adenocarcinoma must be ruled out.
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Affiliation(s)
- M Bouali
- Service of Emergency of Visceral Surgery, Ibn Rochd University Hospital Center, Morocco; Department of General Surgery, Ibn Rochd University Hospital Center, Morocco
| | - K Sylvestre
- Department of General Surgery, Ibn Rochd University Hospital Center, Morocco; Hassan 2 University of Casablanca Morocco, Morocco.
| | - H Benghait
- Service of Emergency of Visceral Surgery, Ibn Rochd University Hospital Center, Morocco; Department of General Surgery, Ibn Rochd University Hospital Center, Morocco
| | - A El Bakouri
- Service of Emergency of Visceral Surgery, Ibn Rochd University Hospital Center, Morocco; Department of General Surgery, Ibn Rochd University Hospital Center, Morocco
| | - K El Hattabi
- Service of Emergency of Visceral Surgery, Ibn Rochd University Hospital Center, Morocco; Department of General Surgery, Ibn Rochd University Hospital Center, Morocco
| | - F Z Bensardi
- Service of Emergency of Visceral Surgery, Ibn Rochd University Hospital Center, Morocco; Department of General Surgery, Ibn Rochd University Hospital Center, Morocco
| | - A Fadil
- Service of Emergency of Visceral Surgery, Ibn Rochd University Hospital Center, Morocco; Department of General Surgery, Ibn Rochd University Hospital Center, Morocco
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Elhattabi K, Benghait H, Elbakouri A, Bouali M, Bensardi F, Fadil A. Total colectomy in Vascular Ehlers Danlos syndrome a case report and literature review. Ann Med Surg (Lond) 2021; 71:102948. [PMID: 34777791 PMCID: PMC8577335 DOI: 10.1016/j.amsu.2021.102948] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 11/22/2022] Open
Abstract
Introduction Ehlers Danlos syndromes (EDS) are a group of genetic disorders, characterized by skin hyperelasticity, joint hyperlaxity and tissue weakness. Vascular EDS is rare and is differs from other types of EDS by an inconsistent acrogenic morphotype and the occurrence of severe digestive and vascular complications, which can be lifethreatening. Case presentation We report the case of a 27-year-old man with a type IV vascular Ehlers-Danlos syndrome revealed by a colonic perforation after appendectomy for peritonitis secondary to appendicitis. The etiology of the perforation remained a challenge till a genetic research was carried out for COL3A1 gene mutation, which was positive in favor of vascular Ehlers Danlos disease. Then, a totalization of the colectomy with ileorectal anastomosis was performed. Discussion Vascular Ehlers Danlos syndrome (VEDS) is due to qualitative and quantitative abnormalities in the synthesis of type III collagen, which is a major constituent of the vessel wall, skin, joint capsules, uterus and gastrointestinal tract, particularly the colon. Colonic perforation, particularly sigmoidal perforation, is the most frequent complication in SEDV and most often precedes the molecular diagnosis. Colonic perforations are uncommon. The Hartmann procedure is a well-established surgical treatment modality, especially for emergency surgery. Given the iterative risk of colonic perforation and anastomotic leakage, preventive treatment by total colectomy with ileo-rectal anastomosis or definitive ileostomy is recommended by several authors. Conclusion SEDV is a rare pathology with a difficult diagnosis. However, it should be keeped in mind when there is any spontaneous colonic perforation in the young people. Ehlers danlos syndromes are a group of genetic disorders of the connective tissue. Life expectancy is reduced due to spontaneous vascular rupture or colonic perforation. Colonic perforations are uncommon. They occur in the context of diverticulitis in adults. The diagnosis is difficult because of the rarity of the pathology and the inaccessibility of genetic tests. The surgical management of colonic perforations in ehlers danlos syndromes is not codified.
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Affiliation(s)
- Khalid Elhattabi
- Departement of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco.,Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Hasna Benghait
- Departement of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco.,Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Abdelilah Elbakouri
- Departement of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco.,Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Mounir Bouali
- Departement of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco.,Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Fatimazahra Bensardi
- Departement of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco.,Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Abdelaziz Fadil
- Departement of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco.,Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
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Bensardi FZ, Hajri A, Kabura S, Bouali M, El Bakouri A, El Hattabi K, Fadil A. Fournier's gangrene: Seven years of experience in the emergencies service of visceral surgery at Ibn Rochd University Hospital Center. Ann Med Surg (Lond) 2021; 71:102821. [PMID: 34777789 PMCID: PMC8577414 DOI: 10.1016/j.amsu.2021.102821] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 07/29/2021] [Revised: 09/03/2021] [Accepted: 09/05/2021] [Indexed: 12/15/2022] Open
Abstract
Introduction This work aims to describe and discuss the epidemiological, clinical, therapeutic and evolution of Fournier's gangrene. Materials and methods Case series with retrospective data collection of patients treated for Fournier's gangrene between January 2010 and March 2017. The main etiologies, risk factors, postoperative complications outcomes and long term follow up results were analyzed. Results Eight four (84) patients were recruited. The average age of our patients was 49 years (with limits of 20–76), the male gender dominates our series (83.33%) with a sex ratio of 5 M/1W, the most frequently found risk factor was diabetes mellitus (37%). The most common etiology was anal abscesses (32%). The average time to consultation was 8 days (limits ranges from 3 to 30 days). All patients were admitted at a necrosis stage (100%). Anemia was identified in 85% of cases. The low platelets were noticed in 44.03% of cases. Hypoalbuminemia was found in 93% of cases. All patients (100%) benefited resuscitation initially and antibiotic therapy on their admission. They received emergency surgical debridement with a cleansing stoma. The average length of hospital stay was 13 days and complications occurred in 33% of cases. The mortality rate was 7.14%. Conclusion Fournier's gangrene is a medico-surgical emergency with a high morbidity and mortality rate. Early diagnosis as well as antibiotic therapy and the quality of debridement save the patients. Fournier's gangrene is a rare but severe disease. The diagnosis and treatment delay and lesions extension increase mortality. The treatment is multidisciplinary. Early diagnosis and treatment improve prognosis. Tobacco intoxication is suspected to be risk factor.
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Affiliation(s)
- F Z Bensardi
- Service of Emergency of Visceral Surgery, Ibn Rochd-Casablanca University Hospital Centre, Morocco.,Hassan II University of Casablanca, Medicine and Pharmacy Faculty, Morocco.,Department of Surgery, Ibn Rochd-Casablanca University Hospital Centre, Morocco
| | - A Hajri
- Hassan II University of Casablanca, Medicine and Pharmacy Faculty, Morocco.,Department of Surgery, Ibn Rochd-Casablanca University Hospital Centre, Morocco.,Service of Digestive Cancer Surgery and Liver Transplantation, Morocco
| | - Sylvestre Kabura
- Service of Emergency of Visceral Surgery, Ibn Rochd-Casablanca University Hospital Centre, Morocco.,Hassan II University of Casablanca, Medicine and Pharmacy Faculty, Morocco.,Department of Surgery, Ibn Rochd-Casablanca University Hospital Centre, Morocco
| | - M Bouali
- Service of Emergency of Visceral Surgery, Ibn Rochd-Casablanca University Hospital Centre, Morocco.,Hassan II University of Casablanca, Medicine and Pharmacy Faculty, Morocco
| | - A El Bakouri
- Service of Emergency of Visceral Surgery, Ibn Rochd-Casablanca University Hospital Centre, Morocco.,Hassan II University of Casablanca, Medicine and Pharmacy Faculty, Morocco
| | - K El Hattabi
- Service of Emergency of Visceral Surgery, Ibn Rochd-Casablanca University Hospital Centre, Morocco.,Hassan II University of Casablanca, Medicine and Pharmacy Faculty, Morocco
| | - A Fadil
- Service of Emergency of Visceral Surgery, Ibn Rochd-Casablanca University Hospital Centre, Morocco.,Hassan II University of Casablanca, Medicine and Pharmacy Faculty, Morocco.,Department of Surgery, Ibn Rochd-Casablanca University Hospital Centre, Morocco
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Hajri A, Fakhiri N, Bouali M, Elbakouri A, Elhattabi K, Bensardi F, Fadil A. [Strangulated hernia below the umbilicus containing the liver: a case report]. Pan Afr Med J 2021; 39:157. [PMID: 34539954 PMCID: PMC8434777 DOI: 10.11604/pamj.2021.39.157.30440] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 06/24/2021] [Indexed: 11/11/2022] Open
Abstract
Herniation of liver segments through defects in the anterior abdominal wall is rare. To our knowledge, only three cases have been described in the literature. This study reports the case of a 84-year-old man presenting to the emergency department with strangulated hernia of the linea alba showing dullness to percussion with protrusion of a sensitive and firm mass. Laboratory test results were normal. Abdominal CT scan showed herniation of liver segment through the linea alba with calculous cholecystitis. The patient underwent retrograde cholecystectomy with subhepatic Redon drain and repair of the herniation by overlapping suture, associated with two subcutaneous vacuum suction Redon drains. The post-operative suite was simple and the patient was discharged on the second post-operative day. Six months after surgery, our patient was healthy. Herniation of liver segments through defects in the anterior abdominal wall is rare. Patients usually show little evidence if clinical signs. Abdominal CT scan is essential to assess the viability of parenchymal liver cells. Patients´ management is studied on a case-by-case basis, it can be surgical or non-surgical. Herniation of liver segments is rare; few cases have been reported in the literature and, in these cases, patients showed little evidence of clinical signs. CT scan is essential to assess the viability of parenchymal liver cells.
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Affiliation(s)
- Amal Hajri
- Département des Urgences de la Chirurgie Viscérale, Université Hassan II de Casablanca, CHU Ibn Rochd, Casablanca, Maroc
| | - Nassima Fakhiri
- Département des Urgences de la Chirurgie Viscérale, Université Hassan II de Casablanca, CHU Ibn Rochd, Casablanca, Maroc
| | - Mounir Bouali
- Département des Urgences de la Chirurgie Viscérale, Université Hassan II de Casablanca, CHU Ibn Rochd, Casablanca, Maroc
| | - Abdelilah Elbakouri
- Département des Urgences de la Chirurgie Viscérale, Université Hassan II de Casablanca, CHU Ibn Rochd, Casablanca, Maroc
| | - Khalid Elhattabi
- Département des Urgences de la Chirurgie Viscérale, Université Hassan II de Casablanca, CHU Ibn Rochd, Casablanca, Maroc
| | - Fatimazahra Bensardi
- Département des Urgences de la Chirurgie Viscérale, Université Hassan II de Casablanca, CHU Ibn Rochd, Casablanca, Maroc
| | - Abdelaziz Fadil
- Département des Urgences de la Chirurgie Viscérale, Université Hassan II de Casablanca, CHU Ibn Rochd, Casablanca, Maroc
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Bensardi FZ, Kabura S, Layla E, El Bakouri A, Bouali M, El Hattabi K, Fadil A. Bartholin's gland abscess a rare cause of rectovaginal fistula: A case report and literature review. Int J Surg Case Rep 2021; 86:106344. [PMID: 34500248 PMCID: PMC8429961 DOI: 10.1016/j.ijscr.2021.106344] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/17/2021] [Accepted: 08/21/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction Rectovaginal fistula (RVF) is an abnormal communication between the vagina and the rectum. RVFs caused by Bartholin's gland infection are very rare. We present the case of recurrent rectovaginal fistula complicating a bartholin's gland abcess successfully treated with a Martius flap. The aim of this work is to demonstrate the possibility of complication of bartholin's gland infection by a rectovaginal fistula and the efficacy of Martius flap procedure for recurrent RVF of the low third part of the vagina. Observation It is a 30-year-old woman admitted to our department for recurrent RVF due to an abscess of the Bartholin's glands. She was previously treated with a vaginal advancement flap which failed with persistence of the fistula and its symptoms. The patient underwent a RVF repair by Martius flap with complete healing of the fistula. Discussion Rectovaginal fistula is a complex pathology with psycho-social, individual, family, religious and ethno-environmental repercussions. Its main aetiologies are obstetric, rectal surgery. Several techniques including the vaginal or anal advancement flap and the Martius flap are used for the treatment of rectovaginal fistulas. For recurrent fistulas, the Martius flap seems to be the most indicated with better results. Conclusion Rectovaginal fistula remain a challenge for surgeons and have major psycho-socio-economic repercussions for the patient. The complication of Bartholin's gland infection by rectovaginal fistula is rare. The Martius flap technique is the method of choice for recurrent rectovaginal fistulas of the lower third of the vagina or in association with other pathologies. Recovaginal fistula is a challenge for surgeons. The rectovaginale fistula due to Bartholin’s gland abcess is very rare Care must be taken during the management of this pathology which affetcs 2% of women during their life for avoiding that complication The Martius flap is the method of choice for the treatment of rectovaginale fistula of the low third inferior part of the vagina
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Affiliation(s)
- F Z Bensardi
- Service of Emergency of the Visceral Surgery, Ibn Rochd University Hospital Centre, Morocco; Hassan II University of Casablanca, Medicine and Pharmacy Faculty, Morocco; Department of Surgery, Ibn Rochd-Casablanca University Hospital Centre, Morocco
| | - S Kabura
- Service of Emergency of the Visceral Surgery, Ibn Rochd University Hospital Centre, Morocco; Hassan II University of Casablanca, Medicine and Pharmacy Faculty, Morocco; Department of Surgery, Ibn Rochd-Casablanca University Hospital Centre, Morocco
| | - ElAttar Layla
- Service of Emergency of the Visceral Surgery, Ibn Rochd University Hospital Centre, Morocco; Hassan II University of Casablanca, Medicine and Pharmacy Faculty, Morocco; Department of Surgery, Ibn Rochd-Casablanca University Hospital Centre, Morocco
| | - A El Bakouri
- Service of Emergency of the Visceral Surgery, Ibn Rochd University Hospital Centre, Morocco; Hassan II University of Casablanca, Medicine and Pharmacy Faculty, Morocco; Department of Surgery, Ibn Rochd-Casablanca University Hospital Centre, Morocco
| | - M Bouali
- Service of Emergency of the Visceral Surgery, Ibn Rochd University Hospital Centre, Morocco; Hassan II University of Casablanca, Medicine and Pharmacy Faculty, Morocco; Department of Surgery, Ibn Rochd-Casablanca University Hospital Centre, Morocco
| | - K El Hattabi
- Service of Emergency of the Visceral Surgery, Ibn Rochd University Hospital Centre, Morocco; Hassan II University of Casablanca, Medicine and Pharmacy Faculty, Morocco; Department of Surgery, Ibn Rochd-Casablanca University Hospital Centre, Morocco
| | - A Fadil
- Service of Emergency of the Visceral Surgery, Ibn Rochd University Hospital Centre, Morocco; Hassan II University of Casablanca, Medicine and Pharmacy Faculty, Morocco; Department of Surgery, Ibn Rochd-Casablanca University Hospital Centre, Morocco
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Bouali M, el attar L, Elhattabi K, Elbakouri A, Bensardi F, Fadil A. Strangulated Spiegel hernia: About a case and literature review. Ann Med Surg (Lond) 2021; 66:102453. [PMID: 34141424 PMCID: PMC8188248 DOI: 10.1016/j.amsu.2021.102453] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 05/23/2021] [Accepted: 05/23/2021] [Indexed: 11/10/2022] Open
Abstract
The anterolateral abdominal Hernias are a frequent reason for consultation; Spiegel's hernia is a rare spontaneous abdominal anterolateral hernia (0.12% of abdominal hernias) for patients between 40 and 70 years old, There are risk factors such as intra-abdominal hyperpressure secondary to morbid obesity, multiple pregnancies and chronic cough. The surgery is the standard treatment; whether by raphy or prosthetic mesch. We report the case of a 42 year old male admitted to the emergency room for an occlusion syndrome due to the strangulated spiegel hernia with caecal and appendicular contents.
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Affiliation(s)
- Mounir Bouali
- Visceral Surgical Emergency Department, Universitary Hospital Center Ibn Rochd, Casablanca, Morocco
- Faculty of Medicine and Pharmacy,Hassan II University, Casablanca, Morocco
| | - layla el attar
- Visceral Surgical Emergency Department, Universitary Hospital Center Ibn Rochd, Casablanca, Morocco
- Faculty of Medicine and Pharmacy,Hassan II University, Casablanca, Morocco
| | - Khalid Elhattabi
- Visceral Surgical Emergency Department, Universitary Hospital Center Ibn Rochd, Casablanca, Morocco
- Faculty of Medicine and Pharmacy,Hassan II University, Casablanca, Morocco
| | - Abdelilah Elbakouri
- Visceral Surgical Emergency Department, Universitary Hospital Center Ibn Rochd, Casablanca, Morocco
- Faculty of Medicine and Pharmacy,Hassan II University, Casablanca, Morocco
| | - Fatimazahra Bensardi
- Visceral Surgical Emergency Department, Universitary Hospital Center Ibn Rochd, Casablanca, Morocco
- Faculty of Medicine and Pharmacy,Hassan II University, Casablanca, Morocco
| | - Abdelaziz Fadil
- Visceral Surgical Emergency Department, Universitary Hospital Center Ibn Rochd, Casablanca, Morocco
- Faculty of Medicine and Pharmacy,Hassan II University, Casablanca, Morocco
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El Bakouri A, El Karouachi A, Bouali M, El Hattabi K, Bensardi FZ, Fadil A. Post-traumatic diaphragmatic rupture with pericardial denudation: A case report. Int J Surg Case Rep 2021; 83:105970. [PMID: 34029846 PMCID: PMC8163962 DOI: 10.1016/j.ijscr.2021.105970] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/02/2021] [Accepted: 05/08/2021] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Post-traumatic diaphragmatic rupture is a lesion of variable severity. It is a rare and difficult to diagnose pathology, it has been found in 0.4% of all traumatized patients and in 1.9% of blunt traumas. It can be associated with abdominal andthoracic lesions, particularly cardiac, which can be life-threatening. MATERIALS AND METHODS Our work is a retrospective case report with a descriptive aim concerning a patient operated for a post-traumatic diaphragmatic rupture within the department of general surgery of CHU Ibn Rochd Casablanca. This work has been reported in line with the SCARE 2020 criteria (17). CASE PRESENTATION A 60-year-old patient was admitted to the visceral surgical emergency department following a work accident (crushing between two carts) causing a thoraco-abdominal impact point trauma without initial loss of consciousness, nor externalized digestive hemorrhage or associated signs, but with a general condition alteration. The patient was conscious, dyspneic with a blood pressure of 100/50 mmHg and afebrile. Physical examination showed diffuse abdominal sensibility. The thoraco-abdomino-pelvic CT scan revealed the presence of a left thoracic hernia with gastric, colic and epiploic contents through a lateral defect of the left diaphragmatic dome. The decision was to directly send the patient to the operating room. Exploration found a large left diaphragmatic breach of 20 cm, a denudation of the pericardia, a medium-abundant hemoperitoneum and a hematoma of the right mesocolon. The procedure consisted of right hemicolectomy with ileocolic anastomosis, treatment of a diaphragmatic breach with a 2-silk raphia, thoracic drainage with a Joly drain, pericardial drainage with a Joly drain, pre-anastomotic drainage with 2 delbet slides, drainage of the Douglas and left subthreshold with 2 Salem catheters. The post-operative follow-up was simple. DISCUSSION Diaphragmatic rupture is a rare and difficult to diagnose condition. Traumatic diaphragmatic rupture (TDR) was found in 0.4% of all traumatized patients and in 1.9% of blunt trauma. Associated lesions of the spleen, liver and/or lungs were found in more than 30% of cases, with an overall mortality rate of 26.8% (1). Pericardial rupture following blunt chest trauma is rare and associated with a high mortality rate ranging from 30% to 64% (9). The physiopathology of this type of injury is not well understood, but the most accepted hypothesis describes an increase in intra-abdominal pressure due to a blunt creating a sufficiently high-pressure gradient between the chest and the abdomen to cause a diaphragmatic rupture. The common clinical symptoms of a diaphragmatic rupture are a marked respiratory distress and diffuse abdominal pain but it can be asymptomatic. Medical imaging exams visualize the ascended organs but it's more difficult to visualize the rupture itself. The chest X-ray is currently the first examination to be requested (4) and also helps in the diagnosis of injuries and diaphragm rupture (13). Surgical treatment includes the reduction of any visceral hernia, repair of the diaphragm and restoration of circulation, breathing and digestive functions. Laparotomy is generally used because of the complete exploration of the abdominal viscera, although it is easier to reduce herniated tissue and repair the diaphragm. CONCLUSION Diaphragmatic rupture with denudation of the heart is rare with poor prognosis and requires emergency surgery with close postoperative monitoring in the intensive care setting. SUMMARY Post-traumatic diaphragmatic rupture is a lesion of variable severity. It is a rare and difficult to diagnose pathology, it has been found in 0.4% of all traumatized patients and in 1.9% of blunt traumas. The lesions are more frequent in the left diaphragmatic dome compared to the right one, and exceptionally bilateral. Pericardial rupture following blunt chest trauma is rare and associated to a high mortality rate. It is often unrecognized and goes unnoticed in the acute phase. The most common clinical symptoms of diaphragmatic ruptures are respiratory distress and diffuse abdominal pain, as it can be asymptomatic. Its diagnosis is essentially radiological using CT scan, and requires emergency surgical treatment as soon as the diagnosis is suspected, in order to avoid the dreaded complications. Traumatic diaphragmatic rupture remains a diagnostic and therapeutic challenge. We report the case of a patient who presented a post-traumatic diaphragmatic rupture with pericardial damage operated in the visceral emergency department at the Ibn Rochd Hospital c in Casablanca, Morocco.
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Affiliation(s)
- A El Bakouri
- Visceral Surgery Emergency Department 35, University hospital center Ibn Rochd, Casablanca, Morocco; Faculty of Medicine and Pharmacy, Hassan 2 university, Casablanca, Morocco
| | - A El Karouachi
- Visceral Surgery Emergency Department 35, University hospital center Ibn Rochd, Casablanca, Morocco; Faculty of Medicine and Pharmacy, Hassan 2 university, Casablanca, Morocco.
| | - M Bouali
- Visceral Surgery Emergency Department 35, University hospital center Ibn Rochd, Casablanca, Morocco; Faculty of Medicine and Pharmacy, Hassan 2 university, Casablanca, Morocco
| | - K El Hattabi
- Visceral Surgery Emergency Department 35, University hospital center Ibn Rochd, Casablanca, Morocco; Faculty of Medicine and Pharmacy, Hassan 2 university, Casablanca, Morocco
| | - F Z Bensardi
- Visceral Surgery Emergency Department 35, University hospital center Ibn Rochd, Casablanca, Morocco; Faculty of Medicine and Pharmacy, Hassan 2 university, Casablanca, Morocco
| | - A Fadil
- Visceral Surgery Emergency Department 35, University hospital center Ibn Rochd, Casablanca, Morocco; Faculty of Medicine and Pharmacy, Hassan 2 university, Casablanca, Morocco
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Bouali M, Yaqine K, Elbakouri A, Bensardi F, Elhattabi K, Fadil A. Ischemic volvulus of the transverse colon caused by intestinal malrotation: A case report. Int J Surg Case Rep 2021; 83:105971. [PMID: 34023547 PMCID: PMC8163956 DOI: 10.1016/j.ijscr.2021.105971] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/29/2021] [Accepted: 05/08/2021] [Indexed: 12/05/2022] Open
Abstract
Introduction Congenital Intestinal malrotation is a complex disorder caused by incomplete or abnormal rotation of the intestine during fetal development. Volvulus of the transverse colon secondary to intestinal malrotation is a rare cause of acute abdomen in adults. It has a high risk of mortality, hence the need for an urgent diagnosis and surgical intervention. Case report We report an unusual case of volvulus of the transverse colon caused by intestinal malrotation. A 21-year-old women presented abdominal pain with nausea and vomiting. On clinical examination, the abdomen was tympanic to percussion with peritoneal sensitivity. The abdominal X-ray revealed a massive obstruction of the distended large intestine with a “U-shaped” loop. He underwent an exploratory laparotomy that revealed the diagnosis of transverse colon volvulus with intestinal malrotation. His condition was treated surgically by transverse colectomy with colostomy. The patient died on the second day following a hemodynamic instability. Conclusion Transverse colonic volvulus is a rare entity with a high mortality, so it requires urgent diagnosis and surgical intervention. Volvulus of the transverse colon secondary to intestinal malrotation is a rare cause of an acute abdomen in adults. Volvulus of the transverse colon has a high risk of mortality, so it requires urgent diagnosis and surgical intervention. The diagnosis of the volvulus of the transverse colon before surgery is rarely observed, it's most often made intraoperatively. The choice of a procedure depends on the general condition of the patient.
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Affiliation(s)
- Mounir Bouali
- Departement of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco; Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Karim Yaqine
- Departement of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco; Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco.
| | - Abdelilah Elbakouri
- Departement of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco; Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Fatimazahra Bensardi
- Departement of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco; Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Khalid Elhattabi
- Departement of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco; Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Abdelaziz Fadil
- Departement of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco; Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
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Elbakouri A, Yaqine K, Bouali M, Elhattabi K, Bensardi F, Fadil A. Fish bone perforation of the small bowel: A case report. Ann Med Surg (Lond) 2021; 65:102348. [PMID: 34007443 PMCID: PMC8111590 DOI: 10.1016/j.amsu.2021.102348] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/17/2021] [Accepted: 04/25/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Fish bone is one of the most common accidently ingested foreign bodies. Normally, it is eliminated from the gastrointestinal (GI) system without any symptomatology, only 1% of the cases will develop a perforation of the GI tract requiring surgical intervention. PRESENTATION OF CASE A 70-year-old man, presented with a 48h evolving abdominal pain, important abdominal distension, nausea, vomiting, and a last bowel movement reported 2 days ago, The abdomino-pelvic CT-scan objectified a distension of the terminal ileum measured at 30mm, The exploration revealed a sharp foreign body,at the 15 proximal centimeters of the terminal ileum, which penetrated through the wall of the ileum. The foreign body was removed and we noticed that it is a fish bone. The patient recovered well. DISCUSSION Clinical manifestations are determined by the location of the perforation and the preoperative diagnosis is always difficult to reach. Computed tomography (CT) scan is the indicated method to identify ingested foreign bodies and surgery is the treatment of choice. CONCLUSION Delay in diagnosis and treatment can be associated with significant morbidity and mortality.
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Affiliation(s)
- Abdelilah Elbakouri
- Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco
- Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Karim Yaqine
- Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco
- Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Mounir Bouali
- Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco
- Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Khalid Elhattabi
- Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco
- Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Fatimazahra Bensardi
- Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco
- Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Abdelaziz Fadil
- Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco
- Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
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Bouali M, Kabura S, El Bakouri A, El Hattabi K, Bensardi F, Fadil A. Acute pancreatitis associated with Cushing syndrome - A case report and literature review. Ann Med Surg (Lond) 2021; 65:102260. [PMID: 33898033 PMCID: PMC8058516 DOI: 10.1016/j.amsu.2021.102260] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/23/2021] [Accepted: 03/23/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Cushing's syndrome (CS) is a rare and severe disease. Acute pancreatitis is the leading cause of hospitalization. The association of the two disease is rare and uncommon. We report the case of a 37-year-old woman admitted in our service for acute pancreatitis and whose Cushing syndrome was diagnosed during hospiatilisation. The aim of this work is to try to understand the influence of de Cushing in acute pancreatitis and to establish a causative relationship between the two diseases. OBSERVATION It is a 37-year-old woman with a history of corticosteroid intake for six months, stopped three months ago who consulted for epigastralgia and vomiting. The physical exam found epigastric sensitivity with Cushing syndrome symptoms. A CT scan revealed acute edematous-interstitial pancreatitis stage E of Balthazar classification. 24 h free cortisol of 95 μg/24 h and cortisolemia of 3.4 μg/dl. The patient was treated symptomatically and referred after to endocrinology service for further treatment. CONCLUSION The association with acute pancreatitis and CS is rare and uncommon. Although detailed studies and evidence are lacking, it can therefore be inferred that CS is one of the risk factors for the onset of acute pancreatitis. The medical treatment and management of acute pancreatitis in those patients do not differ from other pancreatitis of any etiologies.
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Affiliation(s)
- M. Bouali
- Service of Emergency of Visceral Surgery, Ibn Rochd-Casablanca University Hospital Center, Morocco
- Department of General Surgery, Ibn Rochd-Casablanca University Hospital Center, Morocco
| | - S. Kabura
- Department of General Surgery, Ibn Rochd-Casablanca University Hospital Center, Morocco
- Hassan 2 University of Casablanca, Morocco
| | - A. El Bakouri
- Service of Emergency of Visceral Surgery, Ibn Rochd-Casablanca University Hospital Center, Morocco
- Department of General Surgery, Ibn Rochd-Casablanca University Hospital Center, Morocco
| | - K. El Hattabi
- Service of Emergency of Visceral Surgery, Ibn Rochd-Casablanca University Hospital Center, Morocco
- Department of General Surgery, Ibn Rochd-Casablanca University Hospital Center, Morocco
| | - F.Z. Bensardi
- Service of Emergency of Visceral Surgery, Ibn Rochd-Casablanca University Hospital Center, Morocco
- Department of General Surgery, Ibn Rochd-Casablanca University Hospital Center, Morocco
| | - A. Fadil
- Service of Emergency of Visceral Surgery, Ibn Rochd-Casablanca University Hospital Center, Morocco
- Department of General Surgery, Ibn Rochd-Casablanca University Hospital Center, Morocco
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Elbakouri A, El Azhary A, Bouali M, Bensardi F, Elhattabi K, Fadil A. Gastrointestinal manifestations related to infection with SARS-COV-2: Appendicular syndrome (A case report). Ann Med Surg (Lond) 2021; 65:102288. [PMID: 33868674 PMCID: PMC8043916 DOI: 10.1016/j.amsu.2021.102288] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 03/14/2021] [Revised: 04/04/2021] [Accepted: 04/04/2021] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION The clinical symptomatology of SARS-CoV-2 disease may manifest as an appendicular syndrome. The abdominal CT scan can be used to rule out or confirm the diagnosis of acute appendicitis and a chest CT scan can make the diagnosis of SARS-CoV-2 infection. OBSERVATION We report the observation of a 30-year-old patient, with no particular pathological history, who presented with appendicular syndrome without extra-digestive signs, and especially, without respiratory syndrome. The CRP was at 35mg/l. A thoracoabdominal CT scan was requested to detect an eventual appendicitis. With three straight frosted glass areas on the thoracic area suggesting COVID 19 infectious pneumopathy, a PCR was requested to detect a positive SARS-CoV-2 viral RNA, then the patient was appendectomized. Post-operative follow-up was simple and the patient was transferred to a department dedicated to covid-19-positive patients for further management. CONCLUSION CT scan is necessary before considering emergency surgery for acute appendicitis because it can change the patient's management circuit.
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Affiliation(s)
- Abdelilah Elbakouri
- Department of Visceral Surgical Emergency (P35), UHC Ibn ROCHD, Casablanca, Morocco
- Medicine and Pharmacy Faculty, University of Hassan II, Casablanca, Morocco
| | - Abdessamad El Azhary
- Department of Visceral Surgical Emergency (P35), UHC Ibn ROCHD, Casablanca, Morocco
- Medicine and Pharmacy Faculty, University of Hassan II, Casablanca, Morocco
| | - Mounir Bouali
- Department of Visceral Surgical Emergency (P35), UHC Ibn ROCHD, Casablanca, Morocco
- Medicine and Pharmacy Faculty, University of Hassan II, Casablanca, Morocco
| | - Fatimazahra Bensardi
- Department of Visceral Surgical Emergency (P35), UHC Ibn ROCHD, Casablanca, Morocco
- Medicine and Pharmacy Faculty, University of Hassan II, Casablanca, Morocco
| | - Khalid Elhattabi
- Department of Visceral Surgical Emergency (P35), UHC Ibn ROCHD, Casablanca, Morocco
- Medicine and Pharmacy Faculty, University of Hassan II, Casablanca, Morocco
| | - Abdelaziz Fadil
- Department of Visceral Surgical Emergency (P35), UHC Ibn ROCHD, Casablanca, Morocco
- Medicine and Pharmacy Faculty, University of Hassan II, Casablanca, Morocco
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El Hattabi K, Bouali M, Sylvestre K, Bensardi FZ, El Bakouri A, Khalid Z, Fadil A. Lactococcus lactis ssp lactis a rare cause of liver abscesses: A case report and literature review. Int J Surg Case Rep 2021; 81:105831. [PMID: 33887845 PMCID: PMC8027286 DOI: 10.1016/j.ijscr.2021.105831] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 03/21/2021] [Accepted: 03/21/2021] [Indexed: 11/30/2022] Open
Abstract
Lactococcus lactis is a rare cause of liver abscesses. Lactococcus lactis ssp lactis can cause liver abcesses in immunocompetent people. The exposition to unpasteurized dairy products may lead to liver abcess due to L. lactis ssp lactis. Young and immunocompetent people can develop liver abscesses, even for bacteria considered as non-pathogenic. Antibiotics and percutaneous drainage are the first line for treatment of liver abscesses and have improved the death rate.
Introduction We present a liver abscess due to Lactococcus lactis ssp lactis. Case presentation It is a 27-year-old male patient without history who presented the right hypochondrium pain over 10 days. The physical examination noted right hypochondrium pain and hépatomegally. The ultrasound showed hepatomegaly with liver abcess for the segments IV and V as well as VII and VIII measuring 13 × 8 cm and 7.6 × 4.3 cm respectively. A computed tomography (CT) revealed an abscess for segments IV and V and VI and VII measuring respectively 107 × 89 mm and 55 × 50 mm. He underwent a surgical drainage after a radiologic drainage and antibiotherapy failure with success. Discussion Liver abscesses are rare; affect men over 60 years with co-morbidities and those due to L. Lactis ssp lactis are exceptional. Their prevalence is 0.29–1.47% in series of autopsies and 0.008 to 0.16% in hospitalized patients. The most frequently found germs are gram-negative bacilli (40–60%) and anaerobic bacteria (40–50%). Ultrasound and CT scan make the diagnosis in 90% of cases and orients to the etiology. Percutaneous drainage is the first line for treatment, surgical drainage is reserved for percutaneous drainage failures. Conclusion Liver abscess due to Lactococcus lactis ssp lactis is very rare. The clinic, diagnostic methods and treatment of this abscess are identical to other abscesses due to other etiologies. The antibiotics and percutaneous drainage of abscesses have improved the death rate from 40% to 10%–25%.
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Affiliation(s)
- K El Hattabi
- Service of Emergency of the Visceral Surgery, Ibn Rochd University Hospital Centre, Morocco; Hassan II University of Casablanca, Medicine and Pharmacy Faculty, Morocco; Department of Surgery, Ibn Rochd-Casablanca University Hospital Centre, Morocco
| | - M Bouali
- Service of Emergency of the Visceral Surgery, Ibn Rochd University Hospital Centre, Morocco; Hassan II University of Casablanca, Medicine and Pharmacy Faculty, Morocco; Department of Surgery, Ibn Rochd-Casablanca University Hospital Centre, Morocco
| | - K Sylvestre
- Service of Emergency of the Visceral Surgery, Ibn Rochd University Hospital Centre, Morocco; Hassan II University of Casablanca, Medicine and Pharmacy Faculty, Morocco; Department of Surgery, Ibn Rochd-Casablanca University Hospital Centre, Morocco.
| | - F Z Bensardi
- Service of Emergency of the Visceral Surgery, Ibn Rochd University Hospital Centre, Morocco; Hassan II University of Casablanca, Medicine and Pharmacy Faculty, Morocco; Department of Surgery, Ibn Rochd-Casablanca University Hospital Centre, Morocco
| | - A El Bakouri
- Service of Emergency of the Visceral Surgery, Ibn Rochd University Hospital Centre, Morocco; Hassan II University of Casablanca, Medicine and Pharmacy Faculty, Morocco; Department of Surgery, Ibn Rochd-Casablanca University Hospital Centre, Morocco
| | - Zerouali Khalid
- Hassan II University of Casablanca, Medicine and Pharmacy Faculty, Morocco; Service of Bacteriology-Virology and Hygiene's Hospital Laboratory, Ibn Rochd University Hospital Centre, Morocco; Department of Microbiology, Ibn Rochd-Casablanca University Hospital Centre, Morocco
| | - A Fadil
- Service of Emergency of the Visceral Surgery, Ibn Rochd University Hospital Centre, Morocco; Hassan II University of Casablanca, Medicine and Pharmacy Faculty, Morocco; Department of Surgery, Ibn Rochd-Casablanca University Hospital Centre, Morocco
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El Hattabi K, Lafkih O, Bensardi F, Elbakouri A, Bouali M, Fadil A. Pneumatosis cystoides intestinalis with pneumoperitoneum secondary to stenosing pyloro-duodenal peptic ulcer: Case series of three patients and literature review. Int J Surg Case Rep 2021; 81:105772. [PMID: 33743257 PMCID: PMC8010462 DOI: 10.1016/j.ijscr.2021.105772] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/11/2021] [Accepted: 03/11/2021] [Indexed: 11/29/2022] Open
Abstract
Pneumatosis cystoides intestinalis (PCI) is a rare condition which can be associated to pneumoperitoneum without gastro-intestinal perforation. PCI is most often secondary to various diseases and the stenosing peptic ulcer is one of them. Careful correlation of the clinical presentation with corroborating biological tests should determine whether a conservative medical approach or emergency surgical exploration is appropriate. Knowledge of this pathology is important to avoid unnecessary exploratory laparotomy.
Introduction Pneumatosis cystoides intestinalis (PCI) is a rare condition, which can affect the entire gastro-intestinal tract. It can be idiopathic or most often secondary to various diseases. The causes remain multiple and the stenosing peptic ulcer is one of them. We report three case reports of pneumatosis cystoides with pneumoperitoneum intestinalis secondary to stenosing pyloro-duodenal peptic ulcer. Case presentation We report a case series of three patients with PCI that presented to the emergency department with a reassuring clinical picture with the discovery in imaging of a pneumoperitoneum. All our patients presented with a pyloro-duodenal stenosis secondary to a complicated peptic ulcer, one of which was treated surgically and the other two endoscopically. Discussion The objective of this report is to provide an update on pneumatosis cystoides intestinalis secondary to stenosing pyloro-duodenal peptic ulcer, by specifying its etiopathogenic, diagnostic and therapeutic characteristics. Conclusion Knowledge of this pathology is necessary in order to avoid unnecessary abusive surgery.
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Affiliation(s)
- Khalid El Hattabi
- Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco; Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Oussama Lafkih
- Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco; Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
| | - Fatimazahra Bensardi
- Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco; Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Abdelilah Elbakouri
- Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco; Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Mounir Bouali
- Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco; Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Abdelaziz Fadil
- Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco; Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
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El Bakouri A, El Karouachi A, Bouali M, Khouaja A, Elhattabi K, Bensardi F, Fadil A, Karkouri M. Acute colonic occlusion over endometriosis: About a case. Int J Surg Case Rep 2021; 80:105615. [PMID: 33592416 PMCID: PMC7893450 DOI: 10.1016/j.ijscr.2021.02.001] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/30/2021] [Accepted: 02/01/2021] [Indexed: 10/25/2022] Open
Abstract
The gastrointestinal tract is the most common site of extra pelvic endometriosis, with the rectum and sigmoid colon being the most frequently affected areas. Its diagnosis is still very difficult, especially when it manifests itself as an acute occlusion. We report the case of a patient admitted to the emergency room for an occlusive syndrome on a sigmoid process and who was operated on with colorectal resection and it was the anatomopathological examination that led to the diagnosis of endometriosis.
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Affiliation(s)
- Abdelilah El Bakouri
- Visceral Surgery Emergency Department, University Hospital Center Ibn Rochd, Casablanca, Morocco; Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Asmaa El Karouachi
- Visceral Surgery Emergency Department, University Hospital Center Ibn Rochd, Casablanca, Morocco; Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco.
| | - Mounir Bouali
- Visceral Surgery Emergency Department, University Hospital Center Ibn Rochd, Casablanca, Morocco; Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Ayoub Khouaja
- Anatomopathology Department, University Hospital Center Ibn Rochd, Casablanca, Morocco; Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Khalid Elhattabi
- Visceral Surgery Emergency Department, University Hospital Center Ibn Rochd, Casablanca, Morocco; Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Fatimazahra Bensardi
- Visceral Surgery Emergency Department, University Hospital Center Ibn Rochd, Casablanca, Morocco; Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Abdelaziz Fadil
- Visceral Surgery Emergency Department, University Hospital Center Ibn Rochd, Casablanca, Morocco; Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Mehdi Karkouri
- Anatomopathology Department, University Hospital Center Ibn Rochd, Casablanca, Morocco; Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
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Elbakouri A, Lafkih O, Abbad El Andaloussi Z, Bouali M, Elhattabi K, Bensardi F, Fadil A. Sub-acute transverse colon volvulus an exceptional cause of large bowel obstruction: Case report. Ann Med Surg (Lond) 2021; 63:102154. [PMID: 33659057 PMCID: PMC7890129 DOI: 10.1016/j.amsu.2021.01.102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 01/15/2021] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 11/01/2022] Open
Abstract
Introduction The sub-acute form of transverse colon volvulus manifests with signs and symptoms of large bowel obstruction. The diagnosis is most often done intraoperatively. We report a rare case of transverse colon volvulus in a 65-year-old female patient with no particular pathological or surgical history. Case presentation Sub-acute transverse colon volvulus in an elderly woman with no pathological or surgical history. Manifested with signs and symptoms of colonic obstruction. Surgically treated by a two-stage procedure with good postoperative outcomes. Discussion The transverse colon volvulus represents only 2-4% of all colonic volvulus. We discuss the diagnostic and therapeutic approach of our case of transverse colon volvulus through a literature review. Conclusion Transverse colon volvulus should be considered as a differential diagnosis in the face of large bowel obstruction. Early diagnosis and treatment improve the prognosis.
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Affiliation(s)
- Abdelilah Elbakouri
- Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.,Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco
| | - Oussama Lafkih
- Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.,Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco
| | - Zineb Abbad El Andaloussi
- Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.,Department of Radiology, University Hospital Centre Ibn Rochd, Casablanca, Morocco
| | - Mounir Bouali
- Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.,Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco
| | - Khalid Elhattabi
- Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.,Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco
| | - Fatimazahra Bensardi
- Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.,Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco
| | - Abdelaziz Fadil
- Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.,Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco
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21
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Bouali M, Ballati A, El Bakouri A, Elhattabi K, Bensardi F, Fadil A. Phytobezoar: An unusual cause of small bowel obstruction. Ann Med Surg (Lond) 2021; 62:323-325. [PMID: 33552491 PMCID: PMC7847810 DOI: 10.1016/j.amsu.2021.01.048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/29/2020] [Revised: 01/13/2021] [Accepted: 01/14/2021] [Indexed: 11/26/2022] Open
Abstract
Phytobezoars are concretions of indigested fruit and vegetables fibers in the gastrointestinal tract. The past of gastric surgery is most common risk factor of phytobezoar. We present the case of a 39-year-old female was admitted to the emergency department and who presented with small bowel obstruction due to phytobezoar, her past medical history was marqued by truncal vagotomy and simple suture recurrent perforated gastric ulcer 15 years earlier. Her postoperative recovery was uneventful.
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Affiliation(s)
- Mounir Bouali
- Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco
- Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Ahmed Ballati
- Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco
- Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Abdelilah El Bakouri
- Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco
- Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Khalid Elhattabi
- Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco
- Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Fatimazahra Bensardi
- Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco
- Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Abdelaziz Fadil
- Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco
- Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
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22
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El Bakouri A, Ballati A, Bouali M, Elhattabi K, Bensardi F, Fadil A. Primary appendiceal Burkitt's lymphoma presenting as acute appendicitis: An extremely rare case report and review of the literatture. Ann Med Surg (Lond) 2020; 61:16-18. [PMID: 33363721 PMCID: PMC7750439 DOI: 10.1016/j.amsu.2020.11.083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/19/2020] [Revised: 11/27/2020] [Accepted: 11/28/2020] [Indexed: 11/30/2022] Open
Abstract
Primary lymphomas of appendix are extremely rare tumors. The incidence is 0.015% out of all gastrointestinal lymphomas; furthermore, limited data is available in literature. The appendiceal neoplasms are most commonly presented as acute appendicitis followed intestinal obstruction, intussusception or perforation. We present a case of a 22 year-old male patient who presented with acute appenditis and underwent emergency laparotomy. On abdominal exploration, swollen and enlarged appendix measured 3cm was present for which appendectomy were performed. The histopathological examination of appendectomy specimen revealed a Burkitt's Lymphoma. The patient received R-COPADEM protocol of chemotherapy. Primary gastrointestinal lymphoma is a extremely rare neoplasm without guidelines for therapy. Burkitt lymphoma is an aggressive non-hodgkin b-cell lymphoma. The occurrence of primary Burkitt's lymphoma of appendix is extremely rare. The appendiceal neoplasms are most commonly presented as acute appendicitis. The diagnosis of kimura disease is confirmed by surgical biopsy. The diagnostic of Burkitt's lymphoma was only made after histopathological examination, so should be done. The surgery and chemotheray constitue a best traitement for burkitt's lymphoma of appendix presenting as acute appendicitis.
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Affiliation(s)
- Abdelilah El Bakouri
- Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco.,Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Ahmed Ballati
- Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco.,Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Mounir Bouali
- Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco.,Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Khalid Elhattabi
- Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco.,Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Fatimazahra Bensardi
- Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco.,Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Abdelaziz Fadil
- Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco.,Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
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Elhattabi K, Elbakouri A, Ouchane M, Bouali M, Bensardi F, Fadil A. Nutcracker syndrome due to aorto-mesenteric compression in adults: Case report and literature review. Int J Surg Case Rep 2020; 77:730-732. [PMID: 33395884 PMCID: PMC7718136 DOI: 10.1016/j.ijscr.2020.11.088] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 11/02/2020] [Accepted: 11/14/2020] [Indexed: 11/29/2022] Open
Abstract
Nutcracker syndrome is characterized by compression of the left renal vein between the abdominal aorta and the superior mesenteric artery, resulting in an obstruction of blood flow from the left renal vein into the inferior vena cava due to extrinsic compression. The management of nutcracker syndrome depends on the clinical presentation and severity of hypertension in the left renal vein, ranging from simple monitoring to nephrectomy. Surgical techniques used for the treatment of patients with severe symptoms.
Nutcracker syndrome is a rare entity that corresponds to an abdominal pain following compression of the left renal vein during its passage between the aorta and the superior mesenteric artery, with a peak prevalence in adults between 20 and 30 years old, The typical clinical presentation includes hematuria, orthostatic proteinuria with or without flank pain. doppler ultrasound has a sensitivity of 78% and specificity of 100%, Both CT and MRI can show the compression of the left renal vein between the aorta and the superior mesenteric artery. We report the case of a young patient admitted to the emergency room for abdominal pain mainly localized in the left hypochondrium, with microscopic hematuria, a CT scan was performed showing a reduced aorto mesenteric angle with a compression of the left renal vein and collateralization of venous circulation of left gonadal vein.
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Affiliation(s)
- Khalid Elhattabi
- Visceral Surgical Emergency Department, Faculty of Medicine and Pharmacy, Universitary Hospital Center Ibn Rochd, Hassan II University, Casablanca, Morocco
| | - Abdelilah Elbakouri
- Visceral Surgical Emergency Department, Faculty of Medicine and Pharmacy, Universitary Hospital Center Ibn Rochd, Hassan II University, Casablanca, Morocco
| | - Mohamed Ouchane
- Visceral Surgical Emergency Department, Faculty of Medicine and Pharmacy, Universitary Hospital Center Ibn Rochd, Hassan II University, Casablanca, Morocco.
| | - Mounir Bouali
- Visceral Surgical Emergency Department, Faculty of Medicine and Pharmacy, Universitary Hospital Center Ibn Rochd, Hassan II University, Casablanca, Morocco
| | - Fatimazahra Bensardi
- Visceral Surgical Emergency Department, Faculty of Medicine and Pharmacy, Universitary Hospital Center Ibn Rochd, Hassan II University, Casablanca, Morocco
| | - Abdelaziz Fadil
- Visceral Surgical Emergency Department, Faculty of Medicine and Pharmacy, Universitary Hospital Center Ibn Rochd, Hassan II University, Casablanca, Morocco
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Bakouri AE, Yamine OE, Bouali M, Bensardi FZ, Hattabi KE, Fadil A. Ansa pancreatica: a rare cause of acute recurrent pancreatitis. Pan Afr Med J 2020; 37:202. [PMID: 33505571 PMCID: PMC7813647 DOI: 10.11604/pamj.2020.37.202.23218] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 05/05/2020] [Indexed: 11/29/2022] Open
Abstract
Acute pancreatitis is an inflammation of the pancreas that can be caused in rare situations by ansa pancreatica, it is a rare anatomic variation of the pancreatic ducts. It is a communication between the main pancreatic duct (Wirsung) and the accessory pancreatic duct (Santorini). We report a case of the patient, in a 44-year-old, non-alcoholic, hospitalized for acute pancreatitis stage C of Baltazar. A magnetic resonance Cholangiopancreatography (MRCP) was performed which showed a gallstone and ansa pancreatica, than an endoscopic retrograde cholangiopancreatography (ERCP) revealed an ansa pancreatica with a common bile duct clear, a sphincterotomy of the major papilla was performed. It is still not clear whether the presence of these two pathologies is a coincidence or if the ansa pancreatica is the cause of acute pancreatitis. New studies are necessary to clarify these points.
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Affiliation(s)
- Abdelilah El Bakouri
- Service des Urgences Chirurgicales Viscérales, CHU Ibn Rochd, Université Hassane II, Faculté de Médecine et de Pharmacie (FMPC), Casablanca, Maroc
| | - Othmane El Yamine
- Service des Urgences Chirurgicales Viscérales, CHU Ibn Rochd, Université Hassane II, Faculté de Médecine et de Pharmacie (FMPC), Casablanca, Maroc
| | - Mounir Bouali
- Service des Urgences Chirurgicales Viscérales, CHU Ibn Rochd, Université Hassane II, Faculté de Médecine et de Pharmacie (FMPC), Casablanca, Maroc
| | - Fatima Zahra Bensardi
- Service des Urgences Chirurgicales Viscérales, CHU Ibn Rochd, Université Hassane II, Faculté de Médecine et de Pharmacie (FMPC), Casablanca, Maroc
| | - Khalid El Hattabi
- Service des Urgences Chirurgicales Viscérales, CHU Ibn Rochd, Université Hassane II, Faculté de Médecine et de Pharmacie (FMPC), Casablanca, Maroc
| | - Abdelaziz Fadil
- Service des Urgences Chirurgicales Viscérales, CHU Ibn Rochd, Université Hassane II, Faculté de Médecine et de Pharmacie (FMPC), Casablanca, Maroc
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Elhattabi K, Elyamine O, Bouali M, El Bakouri A, Bensardi F, Fadil A. Polysplenia with agenesis of the dorsal pancreas and preduodenal portal vein, about a case. Int J Surg Case Rep 2020; 76:357-360. [PMID: 33074136 PMCID: PMC7569255 DOI: 10.1016/j.ijscr.2020.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 07/18/2020] [Revised: 10/03/2020] [Accepted: 10/03/2020] [Indexed: 10/27/2022] Open
Abstract
PURPOSE OF THE STUDY Polysplenia is a complex polymalformative syndrome that is frequently accompanied by an inconsistent spectrum of visceral and vascular anatomical abnormalities and is extremely undiscovered in adulthood. The objective of this article is to limit the intraoperative risks generated by the lack of knowledge of these anatomical variations by insisting on the inconstancy of all these variations and the perfect knowledge of the reference anatomy and the exploration of the anatomical variations in imaging before the surgery. PATIENT AND METHODS The patient was 50-year-old who was hospitalized in our department for gastric adenocarcinoma. During her extension assessment, a polysplenia syndrome was accidentally discovered on the scan images, which showed an exceptional association between preduodenal portal vein, agenesis of the dorsal pancreas, and polysplenia. CONCLUSION There are neither specific clinical symptoms of the polysplenia syndrome, nor any biological sign; hence, the interest of recognizing this pathology is to avoid diagnostic errors, but also to guide the surgeon during the surgical act performed.
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Affiliation(s)
- Khalid Elhattabi
- Department of Visceral Surgical Emergencies, University Hospital Center Ibn Rochd, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
| | - Othmane Elyamine
- Department of Visceral Surgical Emergencies, University Hospital Center Ibn Rochd, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
| | - Mounir Bouali
- Department of General Surgery, University Hospital Center Ibn Rochd, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
| | - Abdelilah El Bakouri
- Department of Visceral Surgery, University Hospital Center Ibn Rochd, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
| | - Fatimazahra Bensardi
- Department of Visceral Surgery, University Hospital Center Ibn Rochd, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
| | - Abdelaziz Fadil
- Department of Visceral Surgery, University Hospital Center Ibn Rochd, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
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Lefryekh R, Bensaad A, Bensardi F, Elhattabi K, Bouali M, Daif B, Fadil A, Jaouhari Z, Hicham T, Hamdani A, Abdalaoui MS. Hepatic fascioliasis presenting with bile duct obstruction: a case report. Pan Afr Med J 2017; 28:44. [PMID: 29158867 PMCID: PMC5687870 DOI: 10.11604/pamj.2017.28.44.11532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 07/31/2017] [Indexed: 11/11/2022] Open
Abstract
Fascioliasis is a zoonotic infection caused by a liver trematode: fasciola hepatica; which commonly affects cattle and sheep, humans are accidental hosts. Several cases have been reported in the literature worldwide with a large geographical distribution. We present a case of bile duct obstruction due to a hepatic fascioliasis, successfully treated with both a combined surgical and medical approaches. A high index of suspicion should be kept in mind for all cases of obstructive jaundice, especially in areas in which human fascioliasis infection is repeatedly reported.
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Affiliation(s)
- Rachid Lefryekh
- Surgical Emergency Unit P35, University Teaching Hospital Ibn Rochd, Casablanca, Morocco
| | - Ahmed Bensaad
- Surgical Emergency Unit P35, University Teaching Hospital Ibn Rochd, Casablanca, Morocco,Corresponding author: Ahmed Bensaad, Surgical Emergency Unit P35, University Teaching Hospital Ibn Rochd, Casablanca, Morocco
| | - Fatimazahra Bensardi
- Surgical Emergency Unit P35, University Teaching Hospital Ibn Rochd, Casablanca, Morocco
| | - Khalid Elhattabi
- Surgical Emergency Unit P35, University Teaching Hospital Ibn Rochd, Casablanca, Morocco
| | - Mounir Bouali
- Surgical Emergency Unit P35, University Teaching Hospital Ibn Rochd, Casablanca, Morocco
| | - Bessam Daif
- Surgical Emergency Unit P35, University Teaching Hospital Ibn Rochd, Casablanca, Morocco
| | - Abdelaziz Fadil
- Surgical Emergency Unit P35, University Teaching Hospital Ibn Rochd, Casablanca, Morocco
| | - Zakaria Jaouhari
- Department of Parasitology, University Teaching Hospital Ibn Rochd, Casablanca, Morocco
| | - Tazi Hicham
- Department of Parasitology, University Teaching Hospital Ibn Rochd, Casablanca, Morocco
| | - Aziz Hamdani
- Department of Parasitology, University Teaching Hospital Ibn Rochd, Casablanca, Morocco
| | - Maha Soussi Abdalaoui
- Department of Parasitology, University Teaching Hospital Ibn Rochd, Casablanca, Morocco
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Touari I, Bouali M, Ouahchi A, Hamoud S, Djebbar A. Évolution des kystes hydatiques non opérés à propos de 39 cas. Rev Mal Respir 2015. [DOI: 10.1016/j.rmr.2014.10.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Bennafaa T, Bachir S, Abdeli I, Aoudia M, Bouali M, Bachir MA, Benbouzid T. Hématome extra-dural de la fosse cérébrale postérieure chez l’enfant. Neurochirurgie 2013. [DOI: 10.1016/j.neuchi.2013.10.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bouali M. [Etienne Burnet, man of science, man of letters, witness of his times]. Arch Inst Pasteur Tunis 1983; 60:235-9. [PMID: 6398678] [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: 01/20/2023]
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30
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Bouali M, Dehay C, Benajam A, Poirier JC, Degos L, Marcelli-Barge A. HLA-A,B,C, Bf and glyoxalase I polymorphisms in a sample of the Kabyle population (Algeria). Tissue Antigens 1981; 17:501-6. [PMID: 7336415 DOI: 10.1111/j.1399-0039.1981.tb00737.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
HLA (A,B and C) gene and haplotype frequencies were determined in 44 Berber families from the Kabyle tribe. The Bf and Glo polymorphisms were also defined and the haplotypes were deduced from these family data. The main association (A1, B8, BfS; A29, B12, Glo2, Aw33, B14, BfS, Glo1; Cw5, B18, BfF1; A1, Bw17) showed the relationship between the populations from the southwest of Europe, and this population. Another association, A11 and Bw21, was found also in Twareg, which are probably of the same origin.
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