Torticollis as a sign of spinal tuberculosis.

Bone localization of tuberculosis mainly affects the thoracolumbar spine. The cervical spine is rare. Its diagnosis is often late which exposes to great instability and potentially serious complications. We report the case of a 12-year old girl with no medical history, showing torticollis and high temperature without neurological complication. In the physical examination, he had torticollis and pain in the third, fourth and fifth cervical vertebra. When the biopsy was performed, we find an inter apophysis (between C7 and D1) collection. The histological examination confirmed the diagnosis of apophysis tuberculosis. The management based on tuberculosis chemotherapy and immobilization started as soon as possible.

Ciliated cyst of the gallbladder: A new case and literature review.

INTRODUCTION: The ciliated cyst is a rare anomaly that develops from the anterior primitive intestine. Its localization is essentially supra diaphragmatic. It's localization in the gallbladder is very uncommon. CASE REPORT: We report the first case in Tunisia of a ciliated cyst of the gallbladder in a 34 years old woman who was operated for a gallbladder stone and in whom the discovery of a cystic mass attached to the neck of the gallbladder was preoperatively. The pathologic study did conclude to a ciliated cyst. DISCUSSION: The ciliated cyst of the gallbladder is a benign congenital lesion that develops from the anterior primitive intestine. The most frequent clinical symptom is abdominal pain and the median age is 45 years old. The most frequent location is the neck. This pathology affects women more than men. Abdominal ultrasound is not very specific exam and describes the ciliated cyst as a cystic lesion often anechogenic and sometimes hyperechogenic. The CT-scan as well as the abdominal MRI are very helpful of the diagnosis. The positif diagnosis of ciliated cyst is histological. CONCLUSION: The recommended current treatment for this rare pathology is surgery and it consists of a celioscopic cholecystectomie. The place of conservatory treatment hasn't been established due to the rarity of described case and the possibility of degeneration.

Spontaneous rupture of the common hepatic duct associated with acute pancreatitis: a case report.

BACKGROUND: Rupture of the common bile duct is a life-threatening condition, usually observed after a trauma or in association with choledocholithiasis or an obstructive tumor of the bile duct. However, a spontaneous rupture of the common bile duct is a rare entity. CASE PRESENTATION: We report a new observation of a spontaneous rupture of the common bile duct, associated with biliary peritonitis and pancreatitis, in a 15-year-old North African girl. Etiological aspects, specificities of clinical presentation, means of diagnosis, as well as surgical and perioperative management are discussed. CONCLUSIONS: The diagnosis of spontaneous rupture of the common bile duct is a challenge for both radiologist and surgeon. Beyond the difficulty of diagnosis, which requires radiological exploration, management of the subsequent biliary peritonitis involves urgent surgery, life-supporting measures, and close monitoring.