[Intussusception due to Meckel´s diverticulum in adults: a case report]. / Invagination intestinale sur diverticule de Meckel chez l´adulte: à propos d´un cas.

Meckel´s diverticulum is the most common congenital anomaly affecting the gastrointestinal tract resulting from failure of involution of the omphalomesenteric duct. This anomaly is most often asymptomatic and may be revealed by a complication, such as intussusception. This study reports the diagnostic pathway and the management of an 18-year-old female patient admitted to the Emergency Department with ileoileal invagination due to Meckel´s diverticulum complicated by occlusion. This study is interesting because it provides an overview of this rare disease whose diagnosis, based on abdominal scanner, must be made early in order to prevent small bowel perforation or necrosis. Bowel resection without desinvagination is the gold standard treatment.

Giant cystic lymphangioma of the stomach: A case report.

INTRODUCTION: Cystic lymphangioma is a benign tumor originating from the lymph vessels. It commonly occurs in childhood, in the head or neck regions. However, abdominal Cystic lymphangioma is extremely rare in adult patients and often asymptomatic. Considering abdominal space, it may attain huge sizes whilst causing minimal symptoms. Due to this insidious presentation, these tumors become massive and can be diagnosed late at the complication stage. PRESENTATION OF CASE: This case report describes a rare and exceptional case of giant cystic lymphangioma of the stomach presented with a perforation in the abdominal cavity. The diagnosis was suspected following an abdominal CT scan, but could not confirm that the lesion was derived from the stomach. Therefore, an exploratory laparotomy found a multi-cystic mass occupying most of the abdominal space, adherent to the small gastric curvature and without delimitation line. This mass presents a small perforation responsible for an ascites of medium abundance. Then, the patient underwent a subtotal gastrectomy removing the entire cystic mass. Pathological analysis of the surgical specimen confirmed the diagnosis of cystic lymphangioma of the stomach.The postoperative recovery was uneventful, and the patient was discharged after 6 days. At the 3-month follow-up, the patient was in good health. DISCUSSION: The cystic lymphangioma of the stomach is rare and exceptionally described in the literature. However, if this tumor is benign, it has the potential to grow, invade vital structures, and develop life-threatening complications. CONCLUSION: We stress the importance of complete surgical excision to prevent cyst complications and to reduce the recurrence risk.

Solitary and complicated neurofibroma of small Bowel: A case report.

INTRODUCTION: Neurofibromatosis is a genetic disorder characterized by tumors and pigmentary changes on the skin, such as spots that color leans to 'White Coffee'. Neurofibromas of the gastrointestinal tract are commonly associated with neurofibromatosis type I (NF1). Although, digestive involvement can be the single manifestation of the disease and may consequently; represent the only diagnostic element. PRESENTATION OF CASE: We report here; a case of a patient admitted to the emergency department with a bowel obstruction, for which radiological investigations revealed the presence of intussusception due to an intestinal tumor. The patient underwent a bowel resection with anastomosis, and then, after being examined histologically, the result has identified an intestinal neurofibroma without evidence of malignancy. Then and on the fourth day following the surgery, the patient was discharged with good clinical improvement. DISCUSSION: The intestinal neurofibroma may be the first and the only manifestation of neurofibromatosis type I. Also, it's uncommon to present a neurofibroma isolated from the small bowel with an intussusception, which makes the pre-surgical diagnosis very difficult. And until now, only a few case reports of these conditions have been reported. CONCLUSION: We report this uncommon clinical case of an isolated neurofibroma from the small bowel to raise awareness among the medical team about this exceptional pathology. Nevertheless, its risk of developing serious complications and malignant transformation led us to opt for earlier surgical treatment. Furthermore, it requires a close clinical follow-up to eliminate the neurofibromatosis type I or the multiple endocrine neoplasia type II.

Sigmoid Colon Tuberculosis Revealed by a Perforation and Peritonitis.

Intestinal tuberculosis is a frequent disease in developing countries, causing considerable morbidity and mortality. However, tuberculosis of the colon is rarer, and it also appears to be more common in immunosuppressed patients. We report the case of a 71-year-old immunocompetent man who was admitted to the emergency department with an acute abdomen and features of perforation peritonitis. A sigmoid perforation on cancer was suspected on computed tomography (CT) scan and surgical exploration. A standard sigmoidectomy with end colostomy (Hartmann's procedure) and peritoneal toileting was done. The pathological assessment of the surgical specimen revealed the sigmoid colon tuberculosis, complicated by perforation and peritonitis. Thus, the unexpected diagnosis of sigmoid colon tuberculosis was only made after the histopathological examination. Then, he received anti-tuberculosis treatment for six months. Therefore, a complete colonoscopy was performed at the end of the treatment, which returned to be normal. Thereafter, the restoration of intestinal continuity was performed. Colon tuberculosis is a rare disease and even rarer in people without immunodeficiency or on immunosuppressive therapy. If diverticulitis is the most common cause of sigmoid perforation, sigmoid perforation because of tuberculosis is extremely rare. However, an isolated primary sigmoid perforation of tubercular origin is not reported. We report this exceptional case of sigmoid colon tuberculosis complicated by perforation and generalized peritonitis to sensitize the medical team to its rare occurrence, which will be of paramount importance due to the increasing incidence of tuberculosis worldwide.