ABSTRACT
Colonic volvulus usually occurs as a single event that can affect various parts of the colon. The usual sites affected being the sigmoid colon (75%) and the caecum (22%). The phenomenon of multiple sites simultaneously undergoing volvulus is an extremely rare occurrence. We report a rare case of simultaneous sigmoid and transverse colon volvulus in a 52-year-old female. The clinical presentation and the radiological findings were that of large bowel obstruction. A subtotal colectomy and colocolic anastomosis were performed and the postoperative period was uneventful. Though rare the development of transverse and sigmoid volvulus in the same patient must always be considered in the differential diagnosis, when dealing with recurrent intermittent abdominal pain or acute intestinal obstruction.
Subject(s)
Colon, Sigmoid/pathology , Colon, Transverse/pathology , Intestinal Obstruction/etiology , Intestinal Volvulus/complications , Abdominal Pain/etiology , Anastomosis, Surgical/methods , Colectomy , Colon, Sigmoid/surgery , Colon, Transverse/surgery , Female , Humans , Intestinal Obstruction/diagnosis , Intestinal Obstruction/surgery , Intestinal Volvulus/surgery , Middle AgedABSTRACT
The ileosigmoid knot (ISK) or double ileosigmoid volvulus is a wrapping of the small intestine around the base of the sigmoid colon. We report an unusual case in the digestive surgery department of the Ibn Tofail Hospital of CHU Mohammed VI Marrakech of a 28-year-old man with Down's syndrome who presented with symptoms and signs of intestinal obstruction. Abdominal CT scan revealed a whirl sing and significant distension of the sigmoid loop. Exploratory laparotomy revealed ISK resulting in gangrene of ileum and sigmoid colon. The surgical procedure was a necrotic digestive segments resection, with a double-barrelled ileostomy and a Hartmann procedure. One month afterwards, the patient was operated on to reestablish of the continuity. Through this observation and a review of the literature we define the diagnostic, therapeutic and prognosis aspects of this rare clinical entity.
Subject(s)
Down Syndrome , Intestinal Obstruction/surgery , Intestinal Volvulus/surgery , Adult , Gangrene/diagnosis , Gangrene/surgery , Humans , Ileal Diseases/diagnostic imaging , Ileal Diseases/surgery , Ileostomy , Intestinal Obstruction/diagnostic imaging , Intestinal Volvulus/diagnostic imaging , Laparotomy , Male , Sigmoid Diseases/diagnostic imaging , Sigmoid Diseases/surgery , Tomography, X-Ray ComputedSubject(s)
Abdominal Injuries/therapy , Contusions/therapy , Abdominal Injuries/diagnosis , Abdominal Injuries/epidemiology , Accidental Falls/statistics & numerical data , Accidents, Traffic/statistics & numerical data , Adolescent , Adult , Aged , Blood Transfusion/statistics & numerical data , Child , Contusions/diagnosis , Contusions/epidemiology , Developing Countries , Disease Management , Female , Humans , Laparotomy/statistics & numerical data , Length of Stay/statistics & numerical data , Male , Middle Aged , Morocco/epidemiology , Occupational Injuries/epidemiology , Physical Examination , Survival Analysis , Viscera/injuriesABSTRACT
A 48-year-old male patient was admitted to suffering from hydatid disease located in the gall bladder. Although Morocco remains an endemic area for echinococcosis, this presentation of the disease was rare. The pericyst was tightly attached to the liver. Complete pericystectomy with cholecystectomy was done. Histopathology confirmed the presence of a calcified hydatid cyst of the gall bladder. Perioperative adjuvant medical therapy with albendazole was administered. After a 2-year follow-up, no recurrence occurred.
Subject(s)
Calcinosis/complications , Echinococcosis, Hepatic/complications , Gallbladder Diseases/etiology , Liver/pathology , Albendazole/therapeutic use , Anthelmintics/therapeutic use , Calcinosis/diagnosis , Calcinosis/therapy , Cholecystectomy/methods , Constriction, Pathologic/diagnosis , Constriction, Pathologic/etiology , Constriction, Pathologic/surgery , Diagnosis, Differential , Echinococcosis, Hepatic/diagnosis , Echinococcosis, Hepatic/therapy , Follow-Up Studies , Gallbladder Diseases/diagnosis , Gallbladder Diseases/surgery , Humans , Laparotomy , Liver/surgery , Male , Middle AgedSubject(s)
Blood Glucose/metabolism , Gastrointestinal Stromal Tumors/complications , Hypoglycemia/etiology , Insulin-Like Growth Factor II/metabolism , Paraneoplastic Endocrine Syndromes , Biopsy , Diagnosis, Differential , Fatal Outcome , Female , Gastrointestinal Stromal Tumors/diagnosis , Gastrointestinal Stromal Tumors/metabolism , Humans , Hypoglycemia/diagnosis , Hypoglycemia/metabolism , Middle Aged , Tomography, X-Ray ComputedABSTRACT
Gastrointestinal tuberculosis is quite rare, representing only 3% of all extrapulmonary cases. Involvement of the appendix is rare, only occurring in about 1% of cases. It is usually secondary to tuberculosis elsewhere in the abdomen. A prompt diagnosis depends on a high index of suspicion as clinical signs may be nonspecific and microbiological confirmation is difficult. Histopathologic examination is often the only way to reach a diagnosis and to establish specific antibiotic therapy. In these cases, due to the absence of specific symptoms and signs, the diagnosis is delayed until after surgery.
Subject(s)
Appendicitis/microbiology , Appendicitis/therapy , Tuberculosis, Gastrointestinal/therapy , Adult , Antitubercular Agents/administration & dosage , Appendectomy/methods , Appendicitis/pathology , Biopsy, Needle , Combined Modality Therapy , Female , Follow-Up Studies , Humans , Immunohistochemistry , Male , Morocco , Severity of Illness Index , Treatment Outcome , Tuberculosis, Gastrointestinal/pathologyABSTRACT
Primary mucinous adenocarcinoma is a rare malignancy of the anus (3% of anal cancers), the pathogenesis of which is better understood by immunohistochemistry. We reviewed cases of primary mucinous adenocarcinoma of the anus from 2000 to 2009 in the Hepatogastroenterology Department of the University Hospital Centre of Marrakech. Three cases were identified who were males with the mean age of 68years, and presented with a chronic anal fistula. Two cases had anal pain. Clinical examination revealed multiple fistulae in two cases with a secretion simulating 'cooked grains of tapioca'. Diagnosis was confirmed by histopathology and immunohistochemical profile (CK7 positive/CK20 negative). Imaging revealed a retro-rectal collection with thickening of the anal wall without metastasis (two cases). One patient underwent abdominoperinal resection without recurrence.
