Large pancreatic hydatid cyst presenting with obstructive jaundice

Primary hydatid disease of the pancreas is very rare. We report about the case of a 38-year-old man who presented with jaundice, abdominal pain and epigastric mass. Abdominal ultrasound and computed tomography [CT] scan demonstrated a large, thick-walled pancreatic cystic mass compressing the common bile duct and causing obstructive jaundice. The treatment involved eccentration and the resection of the protruding mass by cystogastrostomy. The procedure was successful and no recurrence of complication occurred postoperatively. Hydatid disease should be considered in the differential diagnosis of all cystic masses in the pancreas, especially in the geographical regions where the disease is endemic

Factor VII polymorphisms associated with plasma factor VII coagulant activity levels in healthy Tunisians

Factor VII gene polymorphisms may contribute to elevations in factor VII coagulant [FVIIc] levels that have been associated with cardiovascular risk. We therefore studied the association of two polymorphisms--R353Q polymorphism at codon 353 involving the catalytic region and the 10 base pair [bp] insertion polymorphism involving the promoter region--with FVllc levels in 176 healthy Tunisians. The variant Q allele had a frequency of 0.213 [SD 0.021] whereas the frequency of the 10 bp insert allele was 0.250 [SD 0.023]. Subjects with R/R genotype had significantly higher FVllc levels than Q353 heterozygote and homozygote subjects [96.36 versus 59.52]. FVIIc levels with the 10 bp insertion polymorphism were not significantly different. The Q353 allele of the factor VII gene polymorphism is associated with decreased factor VII and could be protective against cardiovascular disease

Antiphospholipid syndrome and retinal vein occlusion in adults

Antiphospholipid antibodies may play and important role in the pathogenesis of retinal vascular occlusions; investigated the prevalence among 33 patients with retinal vein and artery occlusions and 80 controls. Prevalence was 33% and 5% respectively. Ophthalmic examination and fluorescein angiography showed that occlusions were due to ischaemic events. The 11 patients were diagnosed with antiphospholipid syndrome: 9 patients were treated successfully with laser photocoagulation and anticoagulant and anti-aggregant therapy. Two patients with antiphospholipid antibodies associated with resistance to activated protein C had unfavourable outcomes. Our results suggest a correlation between antiphospholipid syndrome and retinal vein occlusions; we recommend a systematic search for antiphospholipid antibodies in occlusions of unexplained origin and laser photocoagulation treatment and long-term oral anticoagulant and anti-aggregant therapy