Amoeboma cecal

Inflammatory pseudotumor uncommon parasite colon, the amoeboma cecal is a rare complication of intestinal amebiasis . Its clinical symptoms are nonspecific and a diagnosis problem. We report a case of a 61 years old patient, who had the right flank pain associated to a dysentery syndrome, the physical examination revealed a mass of the right flank. The abdominal scan showed an extra luminal tissue process of the right colon. The colonoscopy objective an extrinsic compression of the right colon obstructing the colonic lumen. The evolution was marked by the occurrence of an occlusive syndrome and the patient was operated urgently and a right colectomy was performed. Histological examination was in favor of a cecal amoebome. The postoperative course was uneventful and the evolution one year is favorable. The amoebome is difficult to diagnose, its radiological and endoscopic appearance can simulate colon cancer and lead to improper surgical treatment. Positive serology is the diagnosis and allows to initiate effective medical treatment. The amoebome should be considered in a process without extrinsic evidence confirming neoplasia, the diagnosis confirmed by serology avoids surgery

[Hydatid cust of the spigelian lobe of the liver: diagnosis and treatment]

Surgery of the hepatic of hygdated cysts is a current practical procedure in Marocco due to the endemic context it is generally simple, and the surgical technique is viell cadified. Nevertheless certain hepatic localization like segment I may engeder difficulties and operatory complications that the surgeon must know for a better management. This is a retrospective study over ten years, it concerns ten patients with hydatid cyst affecting the Spigelian lobe with or without other localization. There is a female predominance the mean age is 43 years. Four patients were already operated on for liver hydatid cyct: two had involvement of caudal lobe. The clinical symptoms were not specific. Diagnostic imaging is mainly based on ultrasound and CT. All the patients were operated by laparotomy. Five patients had an hydatid cyst in caudal lobe only, four other associated hepatic lesions, and one case had a peritoneal hydatid disease. Type I was found in 2cases, type III in 5, type IV in one case and infected cyst in 2 cases. At surgical exploration it was found that caudael lobe cyst was intimatel anterioly with the hilum and the hepatic pedicle and with the inferior vena cava retrohepatic posterioly and at the right sue. We performed resection of the prominent dome ; the residual cavity was treated with hydrogen peroxide and systematically drained. The immediate postoperative were simple, the postoperative hospital stay was between 8 and 18 days. The surgical treatment of segment I hepatic hydatid cyst obyes the principals of hydated surgery and involues an important large vascular or buliarg wound risk. The resection of the prominent dome is an intervention simple, rapid and hemorrhagic with low mortality, but fails to eluminate a residual cavity may be ne seat of callection. Conservative treatment remains the gold standard, provided that there is a good postoperative monitoring and adequate management of biliary complications or infection

[Post hemorroidal anal stenosis]

Anal stenosis represents a rare post hemorroidectomy complication which is difficult to manage. We report a series of eight cases, five male and three female, aged 29 to 67 years old, through a period of 12 years, in whom anal stenosis occurred 2 to 16 months after hemorroidectomy, which was of pedicular type in 5 cases, circular in one case and of a non precise type in 2 cases. We performed three sphincterotomy with anoplasty, two dilatations associated with lateral sphincterotomy, one Bellan's anoplasty and an Y-V flap's anoplasty. All our patients regained their proper anal diameter, with amelioration of the discriminatory sensibility, the medium recurrence time was three years and half [maximum 9 month and 7 years]. The anoplasties provide good results. The best treatment is prophylaxis done by choosing the safety technic and respecting the rules of hemorroidectomy

Leiomyoma of the colon [report of a case]

Leiomyoma of the colon is an extremely rare tumor. Reports are those of sessil intraluminal lesions. We report a case of extraluminal leiomyoma of the transverse colon. The diagnosis is suspected at laparotomy and confirmation of the precise nature of the neoplasm by histologic examination

Pilonidal sinus

Pilonidal sinus is a frequent benign disease, with a localization often sacrococcygeal. Its etiopathogensis is still badly clarified. Diagnosis is generally easy in typical forms: purulent flow by an opening situated at the level of inter gluteal furrow and containing some hairs. Some diagnosis traps secondary to aberrant localizations should be known. Open surgical excision and cicatrizationnn is the treatment of choice. To this effect, we report 29 cases of pilonidal sinus operated on by this method between 1990 and 1999. This pathology occupies the fourth place of proctological diseases 75% of the patients are young, aged between 20 and 40 years. Male predominance is clear with a sex ratio H/F=1,9. Chronic purulent flow is the main symptom found in 82,23 of cases. After a retreat of one to 10 years, a case of fake recurrence has been noted. A second resection without closure has been successfully done

Leiomyoblastome gastrique [a props d'un cas]

Gastric leiomyoblastoma is a rare tumor: 8 to 15% of muscular tumors its development is often exogastric. We report one case of endogastric leiomyoblastoma with mucus ulceration revealed by a high digestive hemorrhage. Pre-operatory diagnosis is gastric adenocarcinoma. Surgical intervention has allowed to draw diagnosis and to fulfill total gastrectomy. The rarity of this tumor, the difficulty of its diagnosis and the choice of the type of surgical excision are defined