Ascaridiose biliaire traitée par voie c?lioscopique

Background

Bilio-pancreatic ascariasis is the most frequent extra-intestinal localization of digestive ascariasis. Its diagnosis is generally made with ultrasonography and the therapeutic management is controlled by endoscopy.

Aim of study

We present a 24-year-old woman, with biliary ascariasis, operated by laparoscopy after failure of endoscopic treatment.

Observation

A 24-year-old woman was hospitalized for abdominal pain and fever. Abdominal ultrasound showed a common bile duct (VBP) dilated to 11 mm seat of a mobile serpiginous structure measuring 20 mm suggestive of an ascariasis. After failure of the extraction of the worm by endoscopic, treatment was laparoscopic surgery.

Conclusion

This case illustrates that the diagnosis of biliary ascariasis should be considered even in non-endemic countries. Endoscopic treatment was the reference. Surgery was indicated for failures of endoscopic treatment and association of ascariasis and common bile duct stones.     

Embolie paradoxale : mythe ou réalité ?

Paradoxical embolism should be suspected in front of a clinical phenomenon of thromboembolism associated with an anatomical right-to-left shunt. Others potential cardiac sources of thromboembolism must be ruled out. Strokes constitute the most frequent clinical manifestations of paradoxical embolism. Right-to-left left shunts are in connection with intracardiac defects (atrial septal defect and patent foramen ovale) or pulmonary arteriovenous malformations. The probability that a discovered PFO is stroke-related can be evaluated by a score. Therapeutic approaches for secondary prevention of recurrent stroke include antithrombotic and/or percutaneous treatments. The choice strategy begins to be clearer with the recent results of randomized controlled studies.     

Agénésie du tronc cœliaque : à propos d'un cas

Vascular anatomical variants in general, and of the celiac trunk (TC) in particular, are rarely reported in the literature because they are generally asymptomatic and detected incidentally by imaging examinations performed for other causes. We report a case of agenesis of the celiac trunk, with separate birth of its three branches directly from the abdominal aorta, discovered fortuitously during a CT scan performed as part of the extension assessment of colon adenocarcinoma in a woman. initially asymptomatic.     

Angiopathie amyloïde cérébrale ou atteinte des microvaisseaux cérébraux en rapport avec l’HTA : un challenge clinique

Cerebral amyloid angiopathy (CAA) is a entity characterized by degenerative Amyloïd deposits in the walls of the meningeal and cortical vessels. It is considered as the second cause of primitives cerebral hemorrhage in elderly. The differential diagnosis between AAC and hypertension-related cerebral small vessel diseases is difficult and represent a true challenge for the clinician. We report two cases of cerebral small vessel diseases revealed by malignant hypertension.