La colite aiguë grave: un vieux concept toujours en quête d’une définition consensuelle !

Although an important and continuous evolution of the severe acute colitis treatment, the definition of the severity of an acute colitis remained controversial. Indeed, during severe acute colitis, the criteria of severity are only well validated in the field of the inflammatory bowel diseases, especially in ulcerative colitis. In this article, we discuss the relevance of the clinical, biological, morphological and evolutive criteria in the definition of the severity of an acute colitis and then, in the therapeutic decision.     

Tumeur à cellules de la granulosa juvénile de l’ovaire: à propos de deux cas

Juvenile granulosa cell tumor of the ovary is a rare neoplasm that makes up less than 5% of ovarian tumors in childhood and adolescence. The majority of they tumors are diagnosed in stage I (FIGO) with a favorable prognosis. The aim of this work was to describe the pathological, clinical and therapeutic features of this rare tumor of ovary. The authors describe a juvenile cell tumor expressed by an abdominal and genital syndrome occurring in 30 and 35-year-old two young females. The tumor was strictly localized in the ovary in one case; the second patient presented a bilateral ovarian tumor and peritoneal metastasis at the diagnosis. Clinical follow-up of the latter patient showed a recurrence with liver metastasis in spite of a radical surgical treatment followed by chemotherapy. The first patient has a favorable evolution with a follow-up of two years. Various prognostic factors of the juvenile granulosa cell tumor of the ovary are currently being evaluated. Surgery is the treatment for local disease. Patients with locally advanced, recurrent or metastatic tumors require chemotherapy, although the optimal regimen remains to be determined.     

Adenocarcinoma at the site of ileo-anal anastomosis in Crohn's disease: report of a case

We reported a case of patient born in 1967 who has been operated on in 1987 on three years after the beginning of ulcerative colitis which became severe and resistant to the medical treatment. A total colectomy with an ileo-rectal anastomosis had been performed. The pathological diagnosis carried of the specimen was Ulcerative colitis Then a proctectomy, followed by ileo-anal anastomosis, was performed in 1993. After several episodes of pochitis and the appearance of intestinal lesions upstream the ileal pocket, the retained diagnosis was Crohn's colitis. Eight years after the ileo-anal anastomosis, the patient developed an adenocarcinoma in the ileal pocket. He has been operated on in 2002 and he had abdominoperineal resection, radiotherapy and chemotherapy. Re died in January 2003. The death was related to the recurrence of malignancy. Endoscopic controls with biopsies are mandatory doing to follow up dysplasia predictive of degeneration.     

Acute pancreatitis due to a metallic foreign body

We report a case of acute pancreatitis caused by a metallic foreign body located in the pancreatic head in a 38-Year-old woman. Only 15 cases of acute pancreatitis due to foreign bodies, metallic in five cases, have been published to date. In our case, diagnosis was established by the computed tomography scan. The patient declined surgery.     

Intra-abdominal desmoplastic small round cell tumor in childhood: case report and review of the literature

Desmoplastic small round cell tumor (DSRCT) correspond to a recent clinicopathological entity, individualized in 1989 into the group of tumors with small round cells. This pathology puts ethiopathogenic, diagnostic, therapeutic and prognosis problems. Indeed, the ethiopathogenic is still unknown, diagnosis is asserted only by immuno-histochimic and cytogenetic study because of the big number of differential diagnoses and the anatomopathologic polymorphism. Its treatment is not well codified and its outcome remains dark in spite of therapeutic progress. The objective of this work is to report a personal observation of a DSRCT and to proceed to a review of the literature to clarify the epidemiological, clinical, paraclinical and therapeutic aspects of this rare tumor.