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Beji H, Bouassida M, Chtourou MF, Zribi S, Laamiri G, Kallel Y, Mroua B, Mighri MM, Touinsi H. Predictive factors of bowel necrosis in patients with incarcerated femoral hernia. Hernia 2023; 27:1491-1496. [PMID: 36943519 DOI: 10.1007/s10029-023-02776-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/12/2023] [Indexed: 03/23/2023]
Abstract
PURPOSE Intestinal necrosis is a frequent complication in patients with incarcerated femoral hernias (IFH). Knowing the low incidence of IFH, few series with large samples studied predictive factors of intestinal necrosis. The main objectives of our study were to determine the predictive preoperative factors of intestinal necrosis in patients with IFH and to compare its morbidity with that related to incarcerate inguinal hernias (IIH). METHODS We conducted a retrospective observational cohort study in which we included patients with incarcerated groin hernias (IGH). This is a single-center study between January 2004 and December 2021. Patients were divided into two groups: group A (admitted for IFH) and group B (admitted for IIH). Intestinal necrosis was confirmed intraoperatively. RESULTS 383 patients with IGH were included in the study: 91 patients had IFH (23.76%) and 282 patients had IIH (76.24%). In patients with IFH, the median age was 67 years. We had 60 females (66%) and 31 males (34%). Bowel ischemia was present in 29 patients (32%). Bowel necrosis was present in 14 patients (16%). We identified three independent variables predicting bowel necrosis in patients with IFH: Duration from symptoms to surgery, NLR (Neutrophil to Lymphocyte ratio), and urea. Bowel ischemia and bowel necrosis were significantly higher in patients with IFH compared to those with IIH. CONCLUSIONS In summary, we found that duration from symptoms to surgery, NLR, and urea were significantly predictive of intestinal necrosis in patients with IFH.
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Affiliation(s)
- H Beji
- Department of General Surgery, Mohamed Tahar Maamouri Hospital, Nabeul, Tunisia.
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.
| | - M Bouassida
- Department of General Surgery, Mohamed Tahar Maamouri Hospital, Nabeul, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - M F Chtourou
- Department of General Surgery, Mohamed Tahar Maamouri Hospital, Nabeul, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - S Zribi
- Department of General Surgery, Mohamed Tahar Maamouri Hospital, Nabeul, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - G Laamiri
- Department of General Surgery, Mohamed Tahar Maamouri Hospital, Nabeul, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Y Kallel
- Department of General Surgery, Mohamed Tahar Maamouri Hospital, Nabeul, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - B Mroua
- Department of General Surgery, Mohamed Tahar Maamouri Hospital, Nabeul, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - M M Mighri
- Department of General Surgery, Mohamed Tahar Maamouri Hospital, Nabeul, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - H Touinsi
- Department of General Surgery, Mohamed Tahar Maamouri Hospital, Nabeul, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
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Beji H, Chtourou MF, Zribi S, Kallel Y, Bouassida M, Touinsi H. Are biopsies during endoscopic ultrasonography necessary for a suspected esophageal leiomyoma? Is laparoscopy always feasible? World J Clin Cases 2023; 11:2116-2118. [PMID: 36998946 PMCID: PMC10044951 DOI: 10.12998/wjcc.v11.i9.2116] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/18/2023] [Accepted: 03/03/2023] [Indexed: 03/16/2023] Open
Abstract
The present letter to the editor is related to the work entitled “Large leiomyoma of lower esophagus diagnosed by endoscopic ultrasonography-fine needle aspiration: A case report.” Although endoscopic ultrasonography seems necessary in a suspected leiomyoma of the esophagus, the performance of biopsies via fine needle aspiration is controversial as it increases the risk of complications such as bleeding, infection, and intraoperative perforations. Laparoscopy is the best treatment strategy for small tumors. Laparotomy with tumor enucleation or esophageal resection can be considered in large leiomyomas.
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Affiliation(s)
- Hazem Beji
- Department of General Surgery Hospital Mohamed Taher Maamouri Nabeul, University of Tunis El Manar-Faculty of Medicine of Tunis, Nabeul 8000, Tunisia
| | - Mohamed Fadhel Chtourou
- Department of General Surgery Hospital Mohamed Taher Maamouri Nabeul, University of Tunis El Manar-Faculty of Medicine of Tunis, Nabeul 8000, Tunisia
| | - Slim Zribi
- Department of General Surgery Hospital Mohamed Taher Maamouri Nabeul, University of Tunis El Manar-Faculty of Medicine of Tunis, Nabeul 8000, Tunisia
| | - Yassine Kallel
- Department of General Surgery Hospital Mohamed Taher Maamouri Nabeul, University of Tunis El Manar-Faculty of Medicine of Tunis, Nabeul 8000, Tunisia
| | - Mahdi Bouassida
- Department of General Surgery Hospital Mohamed Taher Maamouri Nabeul, University of Tunis El Manar-Faculty of Medicine of Tunis, Nabeul 8000, Tunisia
| | - Hassen Touinsi
- Department of General Surgery Hospital Mohamed Taher Maamouri Nabeul, University of Tunis El Manar-Faculty of Medicine of Tunis, Nabeul 8000, Tunisia
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Chtourou MF, Beji H, Zribi S, Kallel Y, Bouassida M, Touinsi H. Spontaneous rupture of an infected pseudocyst of the pancreas: A case report. Int J Surg Case Rep 2023; 105:107987. [PMID: 36934651 PMCID: PMC10033984 DOI: 10.1016/j.ijscr.2023.107987] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/01/2023] [Accepted: 03/16/2023] [Indexed: 03/19/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE A pancreatic pseudocyst is a known complication of acute and chronic pancreatitis. A pseudocyst rupture into the abdomen causes peritonitis, which can be fatal if surgical treatment is delayed. Here in we report the case of a 46-year-old woman presenting with a pancreatic pseudocyst doubly complicated with infection and rupture causing sepsis shock. CASE PRESENTATION A 46 year-old-woman, with a history of chronic pancreatitis four years prior complicated with a pancreatic pseudocyst of 3 cm, presented to our emergency department with clinical signs of generalized peritonitis. After a brief resuscitation, we performed a midline laparotomy. It showed purulent peritonitis due to a rupture of an infected pseudocyst of the pancreas. We performed an abundant peritoneal toilet with drainage. The patient was discharged after 25 days. In the one month follow-up, there were no unfavourable outcomes. CLINICAL DISCUSSION In presence of ruptured and infected pancreatic pseudocyst, surgical treatment should be performed as soon as possible after brief resuscitation. Laparotomy is the gold standard treatment. The main objective of surgical treatment is to perform abundant peritoneal toilet with large external drainage. In our case, the pancreatic pseudocyst didn't communicate with the Wirsung duct allowing us to withdraw the drainage. Otherwise, the drainage should be retained longer to treat the pancreatic leakage. CONCLUSION Rupture and infection of pancreatic pseudocysts is a rare situation. Diagnosis is assessed via computed tomography scan. Emergency laparotomy should be performed timely to make the peritoneal toilet and drain the pancreatic pseudocyst.
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Affiliation(s)
- Mohamed Fadhel Chtourou
- Department of general surgery, Hospital Mohamed Taher Maamouri, Nabeul, Tunisia; University Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
| | - Hazem Beji
- Department of general surgery, Hospital Mohamed Taher Maamouri, Nabeul, Tunisia; University Tunis El Manar, Faculty of Medicine of Tunis, Tunisia.
| | - Slim Zribi
- Department of general surgery, Hospital Mohamed Taher Maamouri, Nabeul, Tunisia; University Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
| | - Yassine Kallel
- Department of general surgery, Hospital Mohamed Taher Maamouri, Nabeul, Tunisia; University Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
| | - Mahdi Bouassida
- Department of general surgery, Hospital Mohamed Taher Maamouri, Nabeul, Tunisia; University Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
| | - Hassen Touinsi
- Department of general surgery, Hospital Mohamed Taher Maamouri, Nabeul, Tunisia; University Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
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Beji H, Kallel Y, Mroua B, Zribi S, Bouassida M, Touinsi H. Cystic mass with arteriovenous malformations of the lesser omentum. ANZ J Surg 2023; 93:722-723. [PMID: 35876717 DOI: 10.1111/ans.17926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 07/13/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Hazem Beji
- Department of general surgery Hospital Mohamed Taher Maamouri Nabeul, University of Tunis El Manar, Tunis, Tunisia
- Department of General Surgery, Hospital Mohamed Taher Maamouri Nabeul, Tunis, Tunisia
| | - Yassine Kallel
- Department of general surgery Hospital Mohamed Taher Maamouri Nabeul, University of Tunis El Manar, Tunis, Tunisia
- Department of General Surgery, Hospital Mohamed Taher Maamouri Nabeul, Tunis, Tunisia
| | - Bassem Mroua
- Department of general surgery Hospital Mohamed Taher Maamouri Nabeul, University of Tunis El Manar, Tunis, Tunisia
- Department of General Surgery, Hospital Mohamed Taher Maamouri Nabeul, Tunis, Tunisia
| | - Slim Zribi
- Department of general surgery Hospital Mohamed Taher Maamouri Nabeul, University of Tunis El Manar, Tunis, Tunisia
- Department of General Surgery, Hospital Mohamed Taher Maamouri Nabeul, Tunis, Tunisia
| | - Mahdi Bouassida
- Department of general surgery Hospital Mohamed Taher Maamouri Nabeul, University of Tunis El Manar, Tunis, Tunisia
- Department of General Surgery, Hospital Mohamed Taher Maamouri Nabeul, Tunis, Tunisia
| | - Hassen Touinsi
- Department of general surgery Hospital Mohamed Taher Maamouri Nabeul, University of Tunis El Manar, Tunis, Tunisia
- Department of General Surgery, Hospital Mohamed Taher Maamouri Nabeul, Tunis, Tunisia
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Beji H, Bouassida M, Kallel Y, Tormane MA, Mighri MM, Touinsi H. Leiomyoma of the esophagus: A case report and review of the literature. Int J Surg Case Rep 2022; 94:107078. [PMID: 35439728 PMCID: PMC9027349 DOI: 10.1016/j.ijscr.2022.107078] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 02/20/2022] [Revised: 03/17/2022] [Accepted: 04/10/2022] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Benign tumors represent less than 1% of esophageal neoplasms. Esophageal leiomyoma is a very rare tumor that arises from mesenchymal tissue. We present here a case of leiomyoma of the esophagus which was revealed by dysphagia and vomiting that was treated by surgical enucleation. PRESENTATION OF CASE This report illustrates the case of a female who presented with dysphagia and vomiting. Imageology demonstrated an esophageal mass which was treated with surgical enucleation. Histopathology confirmed the diagnosis of leiomyoma. CLINICAL DISCUSSION Benign esophageal tumors are rare. Leiomyoma commonly presents as a single lesion in the middle or lower third of the esophagus. Leiomyomas located in the proximal and middle third of the esophagus can be operated on by right thoracotomy. Surgical treatment varies from enucleation to esophageal resection depending on the size and location of the mass. In our case, the tumor was enucleated by a right posterolateral thoracotomy. CONCLUSION Esophageal leiomyoma is a benign and generally asymptomatic tumor. Surgery is the pillar of treatment. Enucleation should be performed whenever possible to avoid esophagectomy and thus decrease morbidity and mortality.
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Affiliation(s)
- Hazem Beji
- Department of General Surgery, Hospital Mohamed Taher Maamouri, Nabeul, Tunisia; University Tunis El Manar, Faculty of Medicine of Tunis, Tunisia.
| | - Mahdi Bouassida
- Department of General Surgery, Hospital Mohamed Taher Maamouri, Nabeul, Tunisia; University Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
| | - Yassine Kallel
- Department of General Surgery, Hospital Mohamed Taher Maamouri, Nabeul, Tunisia; University Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
| | - Mohamed Amine Tormane
- Department of General Surgery, Hospital Mohamed Taher Maamouri, Nabeul, Tunisia; University Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
| | - Mohamed Mongi Mighri
- Department of General Surgery, Hospital Mohamed Taher Maamouri, Nabeul, Tunisia; University Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
| | - Hassen Touinsi
- Department of General Surgery, Hospital Mohamed Taher Maamouri, Nabeul, Tunisia; University Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
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Gargouri M, Abid K, Kallel Y, Rhouma SB, Chelif M, Nouira Y. Severe sepsis secondary to emphysematous cystitis. African Journal of Urology 2015. [DOI: 10.1016/j.afju.2014.11.001] [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] Open
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Gargouri M, Kallel Y, Chehida MB, Chelif M, Sellami A, Rhouma SB, Nouira Y. Surrénalectomie cœlioscopique : étude comparative entre la voie transpéritonéale et la voie rétropéritonéale. Prog Urol 2014; 24:885. [DOI: 10.1016/j.purol.2014.08.221] [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: 11/16/2022]
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Gargouri M, Boulma R, Kallel Y, Chelif M, Rhouma S, Nouira Y. Conservative management of emphysematous pyelonephritis in a horseshoe kidney. African Journal of Urology 2014. [DOI: 10.1016/j.afju.2014.03.001] [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: 10/25/2022] Open
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Hidoussi A, Jaidane M, Hamida W, Kallel Y, Salama A, Ben Sorba N, Mosbah A. UP-3.153: Factors Affecting the Outcome of Ureteroscopy in the Management of Ureteric Stones in Children. Urology 2009. [DOI: 10.1016/j.urology.2009.07.158] [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: 11/25/2022]
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Hidoussi A, Jaidane M, Hamida W, Kallel Y, Slama A, Ben Sorba N, Mosbah A. MP-20.06: Bladder Cancer after Managing Upper Urinary Tract Transitional Cell Carcinoma: Incidence and Predictive Factors. Urology 2009. [DOI: 10.1016/j.urology.2009.07.767] [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: 10/20/2022]
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Nouira Y, Feki W, Kallel Y, Mekni A, Haouet S, Horchani A. [Ureteric valves: a report of two cases]. Ann Chir 2006; 131:567-70. [PMID: 16643840 DOI: 10.1016/j.anchir.2006.03.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2004] [Accepted: 03/21/2006] [Indexed: 05/08/2023]
Abstract
Ureteric valves are a rare cause of ureteric obstruction. Fifty cases have been described in the literature. We report two new cases. The first is of a 12-year-old child with left multiple ureteric valves associated to bilateral vesico-ureteric reflux. The patient was treated by uretero-ileoplasty with unfavourable evolution to renal failure. The second case is that of a proximal ureteric valve discovered in a 30-year-old woman who had postpartum acute pyelonephritis. Treatment consisted in ureteric resection-anastomosis with favourable outcome. Based on a review of the literature, we discuss epidemiologic, etiologic, diagnostic and therapeutic aspects of this malformation.
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Affiliation(s)
- Y Nouira
- Service d'urologie, hôpital La Rabta, Tunis, Tunisie.
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Abstract
Inguinal hernia of the bladder is uncommon. The diagnosis is frequently done during surgery. It can be evoked before surgery when the patient presents with irritative and obstructive lower urinary tract symptoms. Retrograde urethrocystography or computerized tomography confirm the diagnosis. We report a case of bilateral inguinal hernia involving the bladder at the right side in a 87 years old man who had a surgical history of transvesical adenomectomy of the prostate. The diagnosis was done on the retrograde urethrocystography. We performed bilateral herniorrhaphy with herniated bladder reduction. The postoperative history was uneventful.
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Affiliation(s)
- M Blah
- Service d'urologie, hôpital La Rabta, Tunis, Tunisie
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Andrianne R, Kallel Y. [Erectile dysfunction]. Rev Med Liege 2005; 60:505-8. [PMID: 16035318] [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: 05/03/2023]
Abstract
Diabetes is a frequent aetiology of erectile dysfunction. The prevalence of erectile dysfunction in diabetics is three times higher than in the general population. Erectile dysfunction in diabetics is multifactorial. Phosphodiesterase type 5 inhibitors represent the treatment of first intention.
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