Tumeur stromale rectale : à propos d’une observation

Gastro-intestinal stromal tumors are uncommon mesenchymal tumors. There are localized preferentially in the stomach. The rectal localization is exceedingly rare. Through a new case of rectal stromal tumour as well as a review of the literature, we propose to focus on clinical, radiological and therapeutic particularities of this rare entity.     

Laser utility in the treatment of hemorrhoidal pathology: a review of literature

Lasers in Medical Science - Hemorrhoidal disease is a common reason for consultation in proctology. It can be treated in several ways (medical, endoscopic, and surgical). Laser treatment has been...     

Clinical aspects and etiology of lower respiratory tract infections in hospitalized children]

The authors report a prospective study conducted in one of the general pediatrics unit. One hundred one children, aged 20 days to 12 years, admitted with acute lower respiratory tract infections have been studied on clinical paraclinicals and etiology grounds. All children had a chest Ray roentgenogram, a total blood cell count and C-reactive protein. The detection of a viral agent in nasopharyngeal aspirate by immunofluorescent technic were performed. 85% of patients have bronchiolitis, the chest--Rays showed an abnormal pictures in 84.2% of cases, an anaemia was present in 54.7%. Viral agent as identified in 58 patients, the RSV indicated in 56 cases. Bacterial infection as present in 57 of the 101 children. A mixed viral-bacterial infection as documented in 28 cases. Among bacterial causes the predominant agent as Haemophilus influenzae 24, Branhamella Catarrhalis 17, streptococcus pneumoniae in 16 cases. Early empiric antibiotic as performed. All patients recovered uneventfully.     

Factor V Leiden, prothrombin 20210G>A, MTHFR 677C>T and 1298A>C, and homocysteinemia in Tunisian blood donors

Specific genetic conditions are known to be associated with high risk of venous thromboembolism. This genetic basis varies widely between ethnic groups. We investigated the distribution of four inherited polymorphisms in 113 unselected Tunisian blood donors by using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. The allele frequencies of Factor V Leiden (FVL), prothrombin 20210G>A, methylenetetrahydrofolate reductase (MTHFR) 677C>T, and MTHFR 1298A>C mutations were 3, 0.9, 30, and 31%, respectively. The MTHFR 677C>T polymorphism was influenced by age. Twenty-nine of the 113 blood donors demonstrated more than one genetic markers. Hyperhomocysteinemia was found in 12 subjects, and it was statistically associated to the MTHFR 677TT genotype. Principal component analysis allowed disclosing the resemblance between Mediterranean populations. Our findings may be helpful for population genetics study, and provide epidemiologic database for further studies in thrombosis field among Tunisians.     

Isolated colonic metastasis from breast cancer 11 years after primary diagnosis

Colon is a very rare site of metastasis from breast cancer. Its diagnosis is challenging. We report a new case of 56-year-old woman who was previously treated for lobular breast carcinoma 11 years ago. Radiologic features on barium enema and computed tomography (CT) were concordant with primary cancer of the transverse colon. The true diagnosis was made by immunohistochemical study of hemicolectomy specimen, which showed positivity for CA 15-3, cytokeratin 7, estrogen receptor, and progesterone receptor and negativity for cytokeratin 20 and carcinoembryonic antigen (CEA). The patient received chemotherapy and hormonal therapy. After a follow-up of 17 months, she is still alive with no evidence of recurrence. Literature review revealed that diagnosis should be suspected in the presence of bowel disorders in women with history of breast cancer even several years later. Surgery is beneficial in only isolated colonic metastasis. Otherwise, the treatment is based on systemic therapy. The prognosis is usually poor.     

Post-traumatic Jejunojejunal Intussusception

Intussusception is a well-known cause of acute abdomen in the pediatric population. Traumatic intussusception is exceedingly rare, with only 22 cases reported in the English language literature. We report a case of jejunojejunal intussusception that happened after blunt trauma to the abdomen in a 10-year-old boy. The patient presented with clinical presentation of small-bowel obstruction. Through this case and brief review of the literature, we try to focus on the etiology of this rare condition, the clinical particularities, and treatment modalities.     

Sphenoid sinus mucocoele: a possible late complication of radiotherapy to the head and neck.

A case of sphenoid sinus mucocoele following radiotherapy in a patient with nasopharyngeal carcinoma is reported. Diagnosis was made by radiological investigation and confirmed at surgery performed via a sublabial transeptal approach. Its content was completely removed and continuous drainage of the sinus was maintained by an indwelling tube. It is felt that the sphenoid mucocoele developed as a result of occlusion of the sinus ostium by scarred mucosa following radiotherapy.     

Primary leiomyosarcoma of the inferior vena cava: Is vascular reconstruction always necessary?

Both MRI and CT scan can determine tumor size and its extension. PLV have a poor prognosis if surgical resection cannot be achieved. We recommend no reconstruction for type II PLV if venous contact is less than 180° or where the implantation base does not exceed one third of the vena cava.     

MASSIVE EPlSTAXlS FROM TRAUMATIC ANEURYSM OF THE INTERNAL CAROTID ARTERY

Intracavernous carotid artery aneurysm following head injury is a rare occurrence. Two such cases presenting with delayed but massive and repeated epistaxis are reported and the literature reviewed. The first case required a trapping procedure while the second case had only cervical carotid ligation to control the bleeding. Both resulted in no neurological sequelae.