ABSTRACT
BACKGROUND: Tuberculosis (TB) is a common endemic disease in Tunisia. Abdominal location is rare. Early diagnosis of abdominal TB remains difficult due to its non-specific clinical presentations. The aim of our study is to highlight the characteristics of the different presentations, to characterize tools contributing to a positive preoperative diagnosis, and finally to assess the role of surgery in the management of this entity. MATERIALS AND METHODS: A retrospective review from 2005 to 2015 identified 90 cases of confirmed abdominal TB managed in the Department of General Surgery of the Habib Thameur Hospital. The diagnosis was established by histopathology examination for all cases. This study was approved by the ethical committee. RESULTS: The mean age of the patient was 44.13 years with a sex ratio (M/F) of 0.34. We collected 56 cases of peritoneal TB, 12 cases of abdominal lymph node TB, 10 cases of intestinal TB, four cases of hepatic TB, and two cases of gallbladder's TB. For six patients, an association of many localizations was noted. The diagnosis was suspected on clinical, biological, and morphological arguments, but the confirmation was always made by surgical exploration and pathological examination of removed specimens. Surgical management was urgent in complicated cases (13.3%). Laparoscopy was performed in 71 cases (78.9%). Laparoscopic features of peritoneal TB were specific and always confirmed by histological examination. CONCLUSION: Despite the wide range of examination available for the preoperative exploration of abdominal TB, diagnosis is usually late and difficult. TB is a medical condition. However, surgical exploration is frequently needed in the management.
Subject(s)
Diagnostic Techniques, Surgical , Tuberculosis/diagnosis , Tuberculosis/surgery , Abdomen , Adolescent , Adult , Aged , Endemic Diseases , Female , Humans , Laparoscopy , Male , Middle Aged , Peritonitis, Tuberculous/diagnosis , Peritonitis, Tuberculous/epidemiology , Peritonitis, Tuberculous/surgery , Radiology , Retrospective Studies , Tuberculosis/epidemiology , Tuberculosis/pathology , Tuberculosis, Gastrointestinal/diagnosis , Tuberculosis, Gastrointestinal/epidemiology , Tuberculosis, Gastrointestinal/surgery , Tuberculosis, Hepatic/diagnosis , Tuberculosis, Hepatic/epidemiology , Tuberculosis, Hepatic/surgery , Tuberculosis, Lymph Node/diagnosis , Tuberculosis, Lymph Node/epidemiology , Tuberculosis, Lymph Node/surgery , Tunisia/epidemiology , Young AdultABSTRACT
Spigelian hernias represent 1-2% of all abdominal wall hernias. The pathogenesis often involves a dehiscence of the transverse and internal oblique muscle aponeurosis. The diagnosis is made by physical examination; but sometimes it is complicated by obesity. The risk of strangulation is important and can reach 30%. The abdominal CT scan is helpful in the description of hernia's topography and sometimes in diagnostic confirmation. The treatment is surgical. The rate of recurrence after direct closure is considerable. Synthetic mesh repair seems to be a more adequate alternative. The advent of laparoscopy has improved the management of these hernias.
Subject(s)
Hernia, Ventral/diagnosis , Hernia, Ventral/surgery , Laparoscopy/methods , Abdominal Muscles/pathology , Hernia, Ventral/etiology , Humans , Recurrence , Tomography, X-Ray Computed , Treatment OutcomeSubject(s)
Chondroma/diagnosis , Chondroma/pathology , Gastrointestinal Stromal Tumors/diagnosis , Gastrointestinal Stromal Tumors/pathology , Leiomyosarcoma/diagnosis , Leiomyosarcoma/pathology , Lung Neoplasms/diagnosis , Lung Neoplasms/pathology , Lymphatic Metastasis/pathology , Neoplasms, Multiple Primary/diagnosis , Paraganglioma, Extra-Adrenal/diagnosis , Paraganglioma, Extra-Adrenal/pathology , Stomach Neoplasms/diagnosis , Stomach Neoplasms/pathology , Adolescent , Cell Proliferation , Chondroma/surgery , Diagnosis, Differential , Female , Gastrectomy , Gastric Mucosa/pathology , Gastrointestinal Stromal Tumors/surgery , Humans , Leiomyosarcoma/surgery , Lung Neoplasms/surgery , Neoplasms, Multiple Primary/pathology , Neoplasms, Multiple Primary/surgery , Paraganglioma, Extra-Adrenal/surgery , Prognosis , Stomach Neoplasms/surgery , Tomography, X-Ray ComputedABSTRACT
The ectopic pancreas is defined by the presence of pancreatic tissue away from the pancreatic gland in the absence of any ductal or vascular connection. The authors report one exceptional case of aberrant pancreas located in the distal ileum with a double complication: Digestive hemorrhage and small bowel obstruction due to an entero-enteric Intussusception (AU)
No disponible
Subject(s)
Humans , Female , Adult , Choristoma/diagnosis , Pancreas , Ileum/pathology , Gastrointestinal Hemorrhage/etiology , Intussusception/etiology , Intestinal Obstruction/etiologySubject(s)
Diverticulitis, Colonic/complications , Intestinal Fistula/complications , Sigmoid Diseases/complications , Uterine Diseases/complications , Aged , Diverticulitis, Colonic/diagnostic imaging , Female , Humans , Intestinal Fistula/diagnostic imaging , Radiography , Sigmoid Diseases/diagnostic imaging , Uterine Diseases/diagnostic imagingSubject(s)
Appendectomy , Appendicitis/etiology , Cecal Diseases/surgery , Endometriosis/surgery , Laparoscopy , Adult , Cecal Diseases/diagnosis , Endometriosis/diagnosis , Female , HumansABSTRACT
Hydatid disease is endemic in Tunisia and has been considered as one of the most common surgical pathology. Several localizations have been described, but hydatidosis of the liver is the most frequent clinical entity. Primary hydatid cyst of the gallbladder is very rare. We report in this observation a new case of primary hydatid cyst of the gallbladder diagnosed by Magnetic Resonance Imaging (MRI).
