[Gastric stomal tumor revelated by post traumatic rupture]

The rupture of stromal gastric tumour is an exceptional cause of hemoperitoneum. We report a case of ruptured stromal gastric tumor in the peritoneal cavity after a contusion of the left hypochondrial region in a 58 years old male patient operated in emergency for an acute anemia thought to be caused by a pathological rupture of the spleen. The emergency laparotomy revealed an exo-gastric tumor located in a fundus intimately linked with the spleen. Therefore, we realized a partial gastrectomy and the patient was treated by chemotherapy with Glivec [R] [imatinib]. The evolution was favorable for two years without recurrence. The traumatic rupture of a stromal gastric tumour is an exceptional event. The diagnosis is rarely evocated before intervention. It constitutes an predicative sign of malignancy. The circumstances of finding a stromal gastric tumour are not specific. However, their rupture indicates an urgent laparotomy in order to perform a hemostatic gastrectomy

Cancer colon and pregnancy

We are reporting a case of colonic adenocarcinoma in a 18 weeks pregnant woman aged 42 years. We realised a left segmental colectomy completed by an adjuvant chemotherapy after a normal delivery. For months later, bilateral ovarian metastases were diagnosed. Therfore, hysterectomy and a bilateral ablation of annexes with an omentectomy was done. The ovulation was good without recurrence for four months later. Discussion: The advised therapeutical attitde is to stop pregnancy before intervention during the first trimester, in the scond trimester surgical treatment is indicated regardless pregnancy, in the third trimester, it is necessary to wait until full pulmonary maturity of the foetus is reached, then intervene by a caesarian section and a curative surgical treatment at the same time. The diagnosis of cancer colon associated with pregnancy is difficult and needs a strong multidisciplinary collaboration. The prognosis of cancer colon is aggravated in pregnant women. It can not be improved except with an early diagnosis