Huge desmoid tumor of the anterior abdominal wall mimicking an intraabdominal mass in a postpartum woman: a case report

Desmoid tumors are benign neoplasms that most often arise from muscle aponeurosis and have been associated with both trauma and pregnancy. The etiology of desmoids has not been determined. We report the case of anterior abdominal wall desmoid tumor in a female patient with previous history of cesarean section. Preoperative ultrasound and computed tomography demonstrated a large mass mimicking a large hematoma or an intraabdominal mass. The tumor was removed by wide excision with safe margins. The abdominal wall defect was reconstructed with polypropylene mesh. Subsequent histology revealed a desmoid tumor. Desmoid tumors in females are often associated with pregnancy or occur post-partum. The reasons behind this association are unclear. The most common sites are in the abdominal muscles.Pan African Medical Journal 2013; 14:5

A rare cause of proximal intestinal obstruction in adults - annular pancreas: a case report

Annular pancreas is a rare congenital anomaly characterized by the presence of ectopic pancreatic tissue surrounding the descending part of the duodenum. It is one of the few congenital anomalies of the gastrointestinal tract which can produce symptoms late in life. In adults, the factors initiating symptoms are recurrent pancreatitis, duodenal stenosis at the site of the annulus, or duodenal or gastric ulceration. We report a new case involving a 24-year-old woman hospitalised for epigastric pain, nausea and vomiting. Radiological examination was consisted with an annular pancreas. At operation a complete obstruction of the second part of the duodenum was found, caused by an annular pancreas, no other congenital anomaly of the intra-abdominal organs was noted. A gastroenterostomy was performed

Solid pseudopapillary neoplasm of the pancreas in an old man: age does not matter

Solid pseudopapillary tumor (SPN) of the pancreas is a rare tumor, but has favorable prognosis. It is typically observed in young women. Only few cases have been reported in young men. We report the observation of a 73-year-old man presented with a palpable mass in the left upper abdomen. CT scan showed 10 cm mass at the tail of the pancreas. This mass had mixed cystic and solid components. The patient underwent a distal pancreatectomy and splenectomy. SPN of the pancreas was diagnosed based on histopathological features. The patient recovered uneventfully and didn't receive adjuvant therapy. A CT scan performed 16 months postoperatively showed no evidence of disease recurrence. Although SPN of the pancreas is typically observed in young women, the diagnosis should not be discounted in old male patients. Male patients and those with old age, atypical histopathology and incomplete resection may have a higher risk of recurrence and death, deserving particular attention.Pan African Medical Journal 2012; 13:

Gastrointestinal bleeding due to an erosion of the superior mesenteric artery: an exceptional fatal complication of pancreatic pseudocyst

The erosion of a pancreatic pseudocyst into an adjacent artery is a rare and highly lethal complication of pancreatitis with reported death rates of 12% to 40%. The majority of patients had bleeding from the splenic artery, the gastroduodenal artery and the anterior pacreaticoduodenal artery. Exceptionally, some cases with bleeding from the superior mesenteric artery, or hepatic artery were reported. We report the case of a 50 year old patient having a cataclysmic upper gastrointestinal bleeding due to an erosion of the superior mesenteric artery by a pancreatic pseudocyst, and discuss contemporary methods in diagnosis and management of the condition.Pan African Medical Journal 2012; 12:6

Réaction à Moujahid et al.: Les kystes hydatiques du foie rompus dans les voies biliaires: à propos de 120 cas

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A wandering spleen presenting as a hypogastric mass: case report

Wandering spleen is a rare condition characterized by the absence or underdevelopment of one or all of the ligaments that hold the spleen in its normal position in the left upper quadrant of the abdomen. It is an uncommon clinical entity that mainly affects children. Among adults it most frequently affects women of reproductive age, in whom acquired laxity of the splenic ligaments is usually the cause. Patients with a wandering spleen may be asymptomatic, present with a movable mass in the abdomen, or have chronic or intermittent abdominal pain because of partial torsion and spontaneous detorsion of the spleen. A 26-year-old woman was admitted to our hospital with vomiting and abdominal pain. Abdominal examination revealed a large ovoid hypogastric mass. A CT scan showed a wandering spleen in the hypogastric region. Exploratory laparotomy revealed an ischemic spleen. A total splenectomy was performed

Intussusception caused by an inverted Meckel's diverticulum: a rare cause of small bowel obstruction in adults

Adult intussusception due to Meckel's diverticulum is an uncommon cause of intestinal obstruction. However, the surgeon should still be suspicious of this condition since the non specific symptoms and the rarity of it make a preoperative diagnosis uncertain. Considering the secondary nature of adult intussusception and the necessity of early surgical intervention to avoid morbidity and mortality, we report one case of intussusception due to Meckel's diverticulum in an adult. A 22-year-old patient was admitted to our hospital with vomiting and abdominal pain. The abdomen was hard with tenderness. We diagnosed an acute small bowel obstruction and performed emergency surgery. The intra operative findings were distention of the small bowel and intussusception of ileus due to an inverted Meckel's diverticulum located 70 cm from the ileocecal valve. 30 cm ischemic loop was identified. A segmental small bowel resection and hand-sewn anastomosis was performed. Histopathology distinguished Meckel's diverticulum measuring 5 cm x 3.5 cm x 1 cm and no signs of malignancy

Acute effects of low dose of caffeine ingestion combined with conditioning activity on psychological and physical performances of male and female Taekwondo athletes

This study investigated low-dose caffeine ingestion, conditioning activity (CA) effects on psycho-physical performances in young taekwondo athletes. In a randomized, double-blind, counterbalanced, crossover design, 20 athletes (10 males; 17.5 ± 0.7 yrs) performed taekwondo-specific agility test (TSAT), 10 s/multiple frequency speed of kick test (FSKT-10s/FSKT-mult) after ingesting 3 mg·kg-1 caffeine (CAF) or placebo (PL) 60 min before performing standard warm-up without (NoCA) or with CA (3 × 10 vertical jumps above 40 cm), resulting in four experimental (PL + NoCA, CAF + NoCA, PL + CA, and CAF + CA) and one control (warm-up session without CAF or CA) conditions. Mood/physical symptoms (MPSS), subjective vitality (SVS), and feeling (FS) scales were analyzed post-to-pre for all conditions. Ratings of perceived-exertion and perceived-recovery status were determined after tests. For TSAT, CAF + CA induced better performance compared with all conditions (p < 0.001). For FSKT-10s and FSKT-mult, CAF + CA induced better performance compared with all conditions (p < 0.001). For MPSS, FS, CAF + NoCA induced higher scores than PL + NoCA and PL + CA (p = 0.002, 0.009 for MPSS; p = 0.014, 0.03 for FS). For SVS, PL + CA elicited lower scores than PL + NoCA and CAF + NoCA (p = 0.01, 0.004). Sex comparisons resulted in better performances for males for TSAT (p = 0.008), FSKT-10s (p < 0.001), FSKT-mult (p < 0.01), MPSS (p = 0.02), SVS (p = 0.028), and FS (p = 0.020) scores. Caffeine and conditioning activity are two efficient performance-enhancing strategies, which could synergistically result in greater psycho-physical performances

Histopathologic characteristics and short-term outcomes of colorectal cancer in young Tunisian patients: one center’s experience

Introduction: Colorectal carcinoma (CRC) is generally a disease of persons older than 40 years. Concerning younger patients, controversies still exist regarding features and prognosis of CRC. We performed this study to characterise CRC in young patients (≤40 years) as well as to evaluate short-term outcome in comparison with older patients (>40 years) with CRC. Methods: Clinical and histopathological parameters of 40 patients aged 40 years or less were compared with 240 patients aged more than 40 years. Results: In young patients, the minority suffered from hereditary cancer syndromes (0.4%). Furthermore, up to 87% of young patients denied any cancers in their families. Compared with older patients, young patients had more mucinous adenocarcinomas (32.5% vs. 11.5%; p=0.02), more venous invasion (p=0.021), more perineural invasion (p=0.028). For grading (p=0.42), lymphatic invasion (p=0.17) and tumor sites (p=0.46), no significant differences between young and older patients were found. Young patients had less post operative morbidity (p=0.039), less post operative mortality (0.029). Young and older patients had the same overall 1-year survival rates (p=0.24), and the same cancer-related 1-year survival rates (p=0.1). Conclusion: Tunisian patients present with colorectal cancer at a more advanced stage of the disease at younger ages compared to developed countries. The early detection of CRC followed by a sufficient oncologic treatment is crucial regardless of age. It is mandatory for all patients with suspicious symptoms to undergo early adequate diagnoses. Pan African Medical Journal 2012; 12:1