Review of 32 gastro-intestinal stromal tumours with CD117

The Aim of this study is to review clinical data, histological and immunohistochemical findings and prognosis of stromal gastrointestinal tumors. A retrospective Study of 32 cases of stromal gastrointestinal tumors diagnosed in the Department of Pathology of Mongi Slim Hospital of Tunis from 1991 a 2004. The average age of the patients was of 54, 4 years, equal for sex. Tumors were essentially gastric [50%] and of the small intestine [37, 5%]. All the patients had surgical treatment. Gastro-intestinal Stromales Tumors or GIST represent the most frequent stromale tumor with 56, 2% of cases. After immunohistochimestry study, using CD117, this revision allows better management of GIST. Glivec +/- is the standard treatment of advanced GIST

results of Laparoscopic treatment of the gallbladder lithiasis about 500 cases

Laparoscopic cholecystectomy is at present the gold st and ard treatment of gallbladder lithiasis. Assesment of Laparoscopic cholecystectomy. Through a retrospective series of 500 laparoscopic cholecystectomies during a period going from January 1996 to March 2000, we tried to evaluate our experience by comparing our results to the literature data. There were 420 women and 80 men with a sex ratio of 0.19. Average age was 50 years. 16.2% of our patients were obese. 13 patients had a history of respiratory disease and 122 history of a cardiovascular pathology essentially arterial hypertension. All our patients benefited from at least one hepatobiliary ultrasound examination before the intervention. Antibioprophylaxy was administrated in 93.8% of cases. In 23 cases [4.6%], a conversion was necessary for different causes. We noted 11 surgical complications [2.2%] among which 2 required a surgical resumption, and 11 medical complications dominated by broncho-pulmonary infections. We had no death

[Retro-Peritoneal liposarcoma. About 5 cases and revue of literature]

Liposarcomas are malignant mesenchymatous tumors developed from elements constituting the greasy tissue in various stages of differentiation. It is one of the most frequent mesenchymatous sarcomas. Retro-peritoneum is a privileged site of development in 12 to 15% of cases. During 9 years, from 1994 till 2002, we have colligated and operated 5 cases of retro-peritoneal liposarcomas. Average age was 50 years [extremes 34 to 79 years] with a sex-ratio of 1.5. Diagnosis was late beyond 6 months. Abdominal pain and the appearance of an enormous mass [20 cm] were the revealing signs. No imagery method allowed to evoke the diagnosis. The cyto-puncture realized once, was not able to determine with precision the histological type. Immunohistochimy occupies nowadays an important place to classify a sarcoma. Large surgical resection realized in 5 cases did not allowed the complete ablation of the tumour in 3 cases considering the advanced loco-regional extension, which was at the origin of 3 recurrencs. Well differentiated histological type was noted in 3 cases, myxoid type in a case and not differentiated type in a case

traumatismes doudeno-pancreatiques, a propos de 14 cas

Through a series of 14 cases brought over a period of 12 years, we realized a retrospective, analytical and descriptive study of these traumata. We aimed to release recommendations to improve their management. It was 2 women and 12 men, whose mean age was 24.4 years [extremes: 50 and 60 years], divided into 10 pancreatic injuries, 2 duodenal injuries and 2 duodeno-pancreatic injuries. Etiology was dominated by traffic accidents 7 cases [50%]. Trauma was closed in 13 cases [92%]. -Associated lesions were present among 13 patients [92%]. The traumatism appeared by an urgent surgical abdomen among 9 patients, secondarily in 3 cases, tardily in 2 cases: a case of deep suppuration 3 months after a traumata treated into ambulatory and a case of persistent ascites after a past unperceived traumata. Abdominal ultrasonography was made among 4 patients. It allowed diagnosing only a case. Scanner was made among 4 patients. It allowed diagnosing all the cases. Only a patient was treated medically, it was a post-traumatic acute pancreatitis. Surgical treatment was made in 13 cases: conservative in 7 cases and radical in 6 cases. Follow-up was complicated in 11 cases [78%] and non-complicated in 3 cases. Mortality rate was 7.1%

tumeurs mucosecretantes de l'appendice. A propos de 22 cas

The retrospective study presented in this article was realized on a series of 22 cases of mucus secreting tumor of the appendix compiled among 8373 appendicectomies. The clinical picture was dominated by an appendiceal syndrome [73%]. The diagnosis was made pre or preoperatively in 10 cases and it was only with to the systematic anatomopathologic exam that 12 other cases were discovered. The histological study of the appendectomy piece showed a retention mucocele [12 cases], a mucosal hyperplasia [8 cases] and a cystadenoma [2 caases]. For 5 patients, the diagnosis of peritoneal pseudomyxoma [4 cases] or extraperitoneal [1 case] was retained. All the patients underwent an appendicectomy, associated to an evacuation of the peritoneal gelatinous ascites for 5 patients among whom two underwent in more an omentectomie. Two cases of recurrence were recorded 5 months later

Tumeurs carcinoides de l'appendice. A propos de 46 cas

Carcinoid tumors of the appendix are rare. The appendix constitutes the most frequent localization of these tumors. We studied of a retrospective way all cases that had an appendectomy in the service of general surgery of sfax on a period of 7 years going from 1995 to 2001. during this period 9584 patients had an appendectomy in our service. Among which, 46 cases [0.48%] of carcinoid tumor of the appendix have been diagnosed. In more than 95% of cases, patients were admitted due to acute appendicitis; but none of them had the signs of the carcinoid syndrome. The treatment was a simple appendectomy in 44 cases [95%]. The right hemicolectomy was necessary in two cases, because of an invasion of the appendicular base in a case and a tumor greater than 2 cm in the other case. There is no reported case of lymph node or systemic metastasis. The authors discuss data in the literature and analyse the features of the clinical picture, diagnosis, and try to define a convenient attitude of treatment of these tumors