A Rare Case of Ileocolic Obstruction Due to Lithophagia Associated with Cervical Oesophageal Perforation.

Lithophagia is a rare syndrome characterized by a repetitive ingestion of stones and pebbles. We herein report a case of a 61-year old mentally retarded man, with a past surgical history of multiple laparotomies for stone ingestion, presenting with cervical oesophagus perforation due to a large butterfly screw and massive impaction of 89 stones and other foreign bodies in the caecum, with consequent mechanical bowel obstruction.

[Meckel's diverticulum and obstruction of the small intestine in adult patients: report of two cases]. / Diverticule de Meckel et occlusion de l'intestin grêle chez l'adulte: propos de deux cas.

Meckel's Diverticulum (MD) is the most frequent congenital anomaly of the ileum. However, its clinical manifestations in adult patients are rare. In this paper, we report cases with two different mechanisms of small intestine obstruction due to MD and we discuss diagnosis and management of these symptomatic lesions in adult patients.

[Iron deficiency anaemia, pancreatitis and epigastric mass in a young female: a rare presentation of a large gastric trichobezoar]. / Anémie ferriprive, pancréatite et masse epigastrique chez une jeune patiente: une présentation clinique rare d'un volumineux trichobézoard gastrique.

We report the case of a 15-year old girl presenting with a gastric fullness sensation. The biological examination showed iron deficiency anaemia and elevation of the pancreatic enzymes. At endoscopy, a huge trichobezoar is found in the stomach. The endoscopic removal is impossible due to the compacity of the mass. Surgical resection is therefore performed. The postoperative course is uneventful and the biologic anomalies are rapidly corrected. A throughout anamnesis revealed a trichotillomania with trichophagia, this behavioural trouble found its origin in a familial conflict.

[Acute and latent right side diaphragmatic rupture after blunt trauma: cases studies and review of the literature]. / Ruptures diaphragmatiques droites aiguës et latentes après traumatismes fermés: observations cliniques et revue de la littérature.

A right diaphragmatic rupture (RDR) after blunt trauma is rare. Diagnosis of this entity remains difficult due to the absence of a precise anamnesis and pathognomonic signs. We report two cases of acute and latent RDR respectively. Immediate laparotomy was performed in the first case and thoracotomy was done nine weeks after blunt trauma for the second one. After the hepatothorax reduction, diaphragmatic lesions were sutured and reinforced by prosthesis. Acute RDR evolve inevitably to a latent and obstructive phases. Then, the mainstay treatment is surgical repair of the diaphragmatic defect. At present, thoracotomy is recommended for latent RDR. In the acute phases, thoracic and/or abdominal approaches depend on associated lesions, hemodynamical patient stability and surgical competence of the practitioner.

Stromal tumour of the rectum: laparoscopic approach of a rare localization of GIST.

The authors present the case of a 60 year-old man known for a rectal polyp which was diagnosed in 1994 and since then followed-up by means of a colonoscopy associated with periodic biopsies. Recently, the results of a biopsy revealed positive markers for the diagnosis of Gastro-Intestinal Stromal Tumor (GIST). Despite the absence of malignant criteria, an anterior resection of the rectum was performed by laparoscopy and the patient rapidly recovered. Epidemiology, diagnosis and management of this rare location of GIST's are discussed.

[Lymphoepithelial cyst of the pancreas]. / Kyste lymphoépithélial du pancréas.

A 66-year-old woman presented with abdominal pain and weight loss. Ultrasonography and computed tomography demonstrated a cystic lesion of the pancreas. After surgical resection, the patient's symptoms disappeared. Microscopic examination of the cyst lining showed mature, keratinizing squamous epithelium, surrounded by lymphoid tissue. Only three cases of this type of lesion, called "lymphoepithelial cyst", have been described previously. Histogenesis of this particular type of cyst is not well know, but can be histologically differentiated from other pancreatic cysts.

[Cystadenoma of the pancreas. Apropos of a case and review of the literature]. / Les cystadénomes du pancréas. A propos d'un cas et revue de la littérature.

With reference to a new case of pancreatic cystadenoma, the authors review the literature on the subject. These tumors are a relatively uncommon form of cystic lesion of the pancreas. They find the origin from pancreatic acinar cells or from ductal epithelium. Histologically, there are two different forms: benign, serous, microcystic adenoma and potentially malignant, mucinous, macrocystic adenoma. The type of the tumor is demonstrated by ultrasonography and computed tomography. but these examinations could not make a difference between benign and malignant form. Treatment of choice is complete tumor resection. Internal or external drainage of these cysts should not be done.

[Tuberculous peritonitis. Description of 2 cases associated with another infection and literature review]. / Péritonite tuberculeuse. Description de deux cas associés à une autre infection et revue de la littérature.

The authors report two cases of peritoneal tuberculosis observed in Belgium: a 28-year-old black man, immigrant from Ghana and a 24-year-old caucasian woman. In both patients, tuberculosis was associated with another infection. The first patient had a retroperitoneal amoebic cyst and in the second patient Chlamydia trachomatis was found with Koch bacillus in the ascitic fluid. Both patients were successfully treated with appropriate antibiotics. Following the review of recent literature, it appears that the incidence of extrapulmonary tuberculosis is increasing in the industrialized part of the world, peritoneal tuberculosis now representing 0.5% of all cases of tuberculosis. Mortality approaches 7%. The diagnosis is difficult and should be evoked more often in order to be confirmed by appropriate means, such as ascitic fluid adenosine desaminase, bacteriology and peritoneoscopy.

[Perforation of the small intestine caused by an enterolith originating from a Meckel's diverticulum]. / Perforation du grêle par entérolite provenant d'un diverticule de Meckel.

Meckel's diverticulum is a rare pathological condition with an incidence about 2%. We are presenting here a rare case report of a perforation of the terminal ileum caused by enterolithiasis of a Meckel's diverticulum. This patient has had repeated sub-occlusive states which was improved under conservative medical treatment. The operative decision was justified on bases of the evidence of an abdominal lesion discovered on barium follow-through and abdominal CT-scan.

[Volvulus of the gallbladder. Apropos of 2 new cases]. / Volvulus de la vésicule biliaire. A propos de deux nouveaux cas.

Acute torsion or volvulus of the gallbladder is a rare entity, which is seldom diagnosed before operation. Cholecystectomy, which must be performed without delay, is generally easy. Detorsion of the involved organ before cholecystectomy is recommended. The process occurs primarily in the aged. An increased incidence is noted in keeping with more enhanced longevity. Two new cases are reported. The literature is reviewed.