Bifocal intracholecystic tubulopapillary neoplasm: A rare and distinct tumor of the gallbladder.

Intracholecystic papillary-tubular neoplasms are rare precancerous and polypoid lesions of the gallbladder, found in nearly 0.4% of cholecystectomy specimens. They follow the adenoma-carcinoma sequence. About half the cases are associated with invasive carcinoma. Their diagnosis relies on histopathological examination with extensive sampling of the surgical specimen.

[Digestive stomas: which professional impact?] / Les stomies digestives: quel impact professionnel?

INTRODUCTION: digestive stomas result from a certain number of surgical interventions. They may be temporary or definitive. The patient with stoma has potentially damaging physical and psychological problems. Therefore patient´s adaptation to the changes and acceptance of this temporary or permanent situation is essential. This study aims to assess the impact of intestinal stomas on patients´ quality of life and professional life. METHODS: we conducted a retrospective study from January 2010 to December 2014. During the study period, 115 patients had intestinal stomas. Among these patients, sixty were of working age, had a fixed employment and had resumed their work; they made up the study population. Data were collected using a specific questionnaire: the Short Form-36 (SF-36) health questionnaire conducted in the post-operative period. RESULTS: the average score for the overall quality of life for patients with stoma was 41. Forty patients had poor quality of life with a score SF-36 less than 50. Our study showed that patients with stoma experienced difficulties at work. Forty-eight patients reported discomfort directly linked to stoma during their professional activities. The causes mentioned were physical in 6 cases and psychological in 3 cases. Six patients were moved into more adapted working positions. CONCLUSION: the management of patients with digestive stomas should aim to an adequate social and professional reintegration. This can only be done by involving the occupational physician, the psychologist, the stoma therapist and the associations.

A disconcerting false gastric diverticulum mimicking malignancy.

Gastric diverticula are the most uncommon form of gastrointestinal diverticula. They can either be of true or false type with different pathogenesis. They may be very challenging to diagnose as symptoms are nonspecific and imaging can simulate a malignant lesion. We report an unusual case of pre-pyloric diverticulum in a 69-year-old man, leading to severe gastric obstruction with a poor general condition. As subsequent endoscopy and imaging were alarming and couldn't exclude malignancy, the patient underwent an antrectomy. The final diagnosis was made on pathological examination. We discuss, through this case, the clinical and pathological features of gastric diverticula with an emphasis on the pathogenesis of this rare entity and the risk of a malignant transformation.