Mesenteric appendicitis strangulating small bowel: an exceptional internal herniation

Primitive internal hernias are a rare cause of intestinal obstruction. They are often paraduodenal even transmesocolic, but only rarely transomental. We present a rare case of an internal abdominal hernia in a young man. The small bowel was strangulated by an intra mesenteric appendicitis. This hernia was revealed by abdominal pain, nausea and vomiting. Plain X-ray of the abdomen showed dilated jejunal and ileal loops with multiple air-fluid levels. The diagnosis of appendicitis was suggested by ultrasound but the internal hernia was found only upon surgical exploration. An appendicectomy and adhesiolysis were performed. The patient recovered fully after 3 days, and had an uneventful postoperative course. The authors discuss the possible cause of this rare intestinal obstruction.     

La fistule gastrocolique: complication exceptionnelle de la maladie ulcère gastrique

A gastrocolic fistula is a rare complication of gastric ulcers (with only 37 reported cases present in the literature). It is characterised by three main symptoms: diarrhoea, vomiting of faeculant material and weight loss. Diagnosis is confirmed through imaging and an endoscopy. Surgery remains the traditional method of treatment. We are reporting on a new observation, with a review of the literature of different epidemiological, clinical, paraclinical and therapeutic aspects of this complication.     

Dilatation kystique du cholédoque et maladie de von Recklinghausen

A choledochal cyst is rare, occurring mostly in childhood. Clinical symptoms are non-specific. CholangioMRI had proved her great values in the classification of the disease. The treatment is surgical. We report the rare case of a 45 year old woman with a choledochal cyst, associated with von Recklinghausen syndrome.     

Tuberculous Appendicitis

Gastrointestinal tuberculosis is quite rare, representing only 3% of all extrapulmonary cases. Involvement of the appendix is rare, only occurring in about 1% of cases. It is usually secondary to tuberculosis elsewhere in the abdomen. A prompt diagnosis depends on a high index of suspicion as clinical signs may be nonspecific and microbiological confirmation is difficult. Histopathologic examination is often the only way to reach a diagnosis and to establish specific antibiotic therapy. In these cases, due to the absence of specific symptoms and signs, the diagnosis is delayed until after surgery.     

La prise en charge des lésions anopérinéales de la maladie de Crohn: revue de la littérature

The anoperineal Crohn??s disease lesions pose a several problems in diagnostic and therapeutic steps. The frequency of these lesions was around 21 to 23% in the literature [1]. The data in the literature are still insufficient in the absence of studies devoted to this location particularly debilitating. The purpose of this literature review is to highlight the current diagnostic and therapeutic modalities and new recommendations.