Hydatid cyst of the pancreas: a report on seven cases

Primary hydatid cyst of the pancreas is rare, representing 0.2-2% of all human cases. It is usually single and located in the head of the pancreas. The aim of this study was to describe clinical, radiological and therapeutic aspects of hydatid cysts of the pancreas. This study was carried out in the Department of Digestive and General Surgery in Sahloul University Hospital, Sousse in Tunisia during the period 1993-2009. Seven patients were treated for hydatid cyst of the pancreas, three men and four women with an average age of 30 years. The clinical signs were variable according to size and location of the cyst within the pancreas and the degree of biliopancreatic involvement. The main symptoms were pain in left upper quadrant, jaundice, fever and epigastric and right upper quadrant pain. The preoperative diagnosis was established in six patients by ultrasonography and computed tomography [CT]. However, the diagnosis was established during laparotomy in one case. The echinococcal immunological test [ELISA] was positive in only two cases. Surgical treatment included resection of the prominent lump [cystectomy] in five cases, and distal pancreatectomy with splenic preservation in one case and with splenectomy in one case. The postoperative period was uneventful in six cases. Acute postoperative pancreatitis occurred in one case. The patients were free of symptoms and were followed up for 12 months without any recurrence as revealed by abdominal ultrasonography and CT scan. Hydatid cysts in the pancreas are rare. Even if rare, these should be considered in the differential diagnosis of cystic lesions of the pancreas. The surgical treatment is to be considered whenever possible

Liver metastasis of malignant fibrous histiocytoma: a case report

Malignant fibrous histiocytoma [MFH] is the most common soft-tissue sarcoma occurring in adult life. It is relatively uncommon in the head and neck area. Surgery is the most reliable treatment for MFH, but the 5-year survival rate for cases of this tumour in the head and neck region is low in comparison with MFH of the extremities and trunk. Most metastases occurred in the lungs [90%], followed by bone [8%]. Liver metastases of MFH are very rare [1%]. We report on a case of a 62-year-old woman undergoing repeat surgery for an MFH of the neck, with liver metastasis found 14 months after the first surgery. She underwent liver resection and the postoperative course was uneventful

[Indications and outcomes of surgical treatment of gastroduodenal ulcer in child and adolescent. about 45 cases]

The goal of this study was to determine the indications and assess the results of surgery in the treatment of gastro-duodenal ulcers in children and adolescents. This is a retrospective study of 45 patients operated for duodenal ulcer in Sahloul Teaching Hospital [Susa, Tunisia] over period of 14 years [1988 - 2001]. The study is about 41 boys and 4 girls aged between 8 and 18 years [mean age 15 1/2 years]. Surgery was undertaken in cases of bleeding ulcer [9 cases], perforation [26 cases], stenosis [7 cases], resistance to medical treatment [3 cases]. The after-effects were mild in 40 cases with an average hospital stay of 6 days. Later after-effects comprised ulcerous relapse [2 cases], stricture of the pyloroplasty [2 cases], an diarrhea following vagotomy combined with pyloroplasty in one case. Indications of surgical treatment of gastro-duodenal ulcers in children and adolescents are, nowadays, nearly limited to complicated forms of the illness. Outcomes of surgical treatment are globally satisfactory