Granular cell tumour of the common bile duct: A condition to be aware of

International audienc

Les métastases ovariennes d’origine biliaire: 2 cas avec revue de la littérature

Les ovaires constituent un site fréquent de métastases. L'origine gastrique prédomine. Les métastases ovariennes d'origine biliaire sont rarement rapportées dans la littérature. Les auteurs rapportent deux cas de   métastases ovariennes d'origine vésiculaire chez des patientes âgées respectivement de 63 et 40 ans. Le diagnostic de ces métastases ovariennes était concomitant avec le cancer d'origine dans le premier cas, et a survenu à distance de l'atteinte initiale dans le deuxième cas. Le diagnostic est suggéré sur les données radiologiques et confirmé histologiquement. Les métastases ovariennes d'origine biliaire sont rarement rapportées dans la littérature. L'atteinte ovarienne pose un problème de diagnostic différentiel avec une atteinte ovarienne primitive surtout si l'atteinte ovarienne précède les manifestations biliaires. L'imagerie joue un rôle important et oriente sur le caractère secondaire de l'atteinte ovarienne

Kyste hydatique du foie rompu dans la veine cave inférieure

La rupture du kyste hydatique dans la veine cave inférieure est une complication rare et grave des kystes hydatiques hépatique. La manifestation la plus fréquente est l’embolie pulmonaire. L’hémorragie aigue intra-kystique survienne surtout en per-opératoire et elle est d’évolution dramatique. Le diagnostic est basé sur le scanner. Le traitement est chirurgical. Nous rapportons un cas clinique rare chez un patient de 38 ans, opéré en urgence pour un sepsis sur un kyste hydatique du foie comprimant la veine cave inférieur (VCI) avec thrombose partielle de cette dernière. Après évacuation du kyste, une fistulisation spontané per opératoire s’est produite dans la VCI ayant causé le décès du patient. La rupture du kyste hydatique du foie dans la VCI doit toujours être redoutée devant un kyste hydatique des segments postérieurs du foie droit (VII et VIII), comprimant la VCI avec présence en son sein d’une thrombose ou des vésicules filles. Le traitement chirurgical doit être réalisé avec prudence et toujours sous contrôle vasculaire.Key words: Kyste hydatique hépatique, Rupture, Veine cave inférieure, Chirurgie, Contrôle vasculaire, Maro

Sheehan's Syndrome A Case Report and Literature Review

Post-partum pituitary necrosis (Sheehan's syndrome) is a rare complication of post-partum hemorrhage. The diagnosis can be erratic and often delayed. In this case report of Sheehan's syndrome in the post-partum period, the signs were characterized by agalactia, severe hypoglycemia, and low serum levels of thyroid hormones, cortico-adrenal hormones, and gonadotrophin (FSH, LH). The hypophyseal magnetic resonance imaging confirmed the diagnosis of hypopituitarism secondary to pituitary necrosis

Etiologie particuliere de l’encephalite limbique : la neurosyphilis (a propos de deux cas)

L’encéphalite limbique syphilitique est une affection rare et son incidence est inconnue nous rapportons l’observation deux patients hospitalisés pour troubles du comportement, troubles de mémoire et crises épileptiques, l’IRM cérébrale montrait un hypersignal sur les séquences pondérées en T2 et FLAIR des régions temporo-limbiques, la sérologie de la syphilis fut positive dans le sang et le LCR. Le diagnostic d’encéphalite limbique syphilitique fut retenu sur un ensemble d’arguments clinique, biologique etradiologique. Le traitement spécifique de la neurosyphilis a permis une amélioration de l’état neurologique des deux patients

Gastric duplication cyst in an adult with autoimmune hemolytic anemia: a case report and review of the literature

Abstract Background Gastric duplication cysts are uncommon congenital anomalies found primarily in children and rarely seen in the adult population. Accurate diagnosis of cysts before resection is difficult even using the most advanced imaging techniques. Case presentation In this report, we describe a 28-year-old Moroccan patient with a history of autoimmune hemolytic anemia who presented with an asymptomatic abdominal cystic mass detected during abdominal computed tomography performed before splenectomy. Magnetic resonance imaging performed for accurate characterization showed a high-signal-intensity cystic mass on T2-weighted images, located between the patient’s stomach and spleen. The patient underwent a complete cyst resection during exploratory laparotomy. The histological examination showed a cyst lined by three different epithelia with bundles of smooth muscle, which suggested a gastric duplication cyst. Conclusions We report a case of gastric cyst duplication in an adult with autoimmune hemolytic anemia, and we discuss this rare association, radiological findings, and the unique histological findings of this case

Splanchnic vein aneurysms: a report of 13 cases

articleInternational audiencePURPOSE: Splanchnic vein aneurysms are a rare and poorly known entity. From a review of 13 cases and reports from the literature, we have defined the imaging features and modalities for their diagnosis and management. PATIENTS AND METHODS: Retrospective study of 13 patients (7 females, 6 males, mean age of 53.5 years) who presented between 1993 and 2005 with splanchnic vein aneurysms. All patient charts were reviewed to collect and analyze epidemiological data, underlying etiologies, imaging work-up for diagnosis and management. Aneurysms were defined as fusiform or saccular enlargement of the portal venous vein or its branches, superior mesenteric vein and splenic vein. RESULTS: A total of 16 splanchnic vein aneurysms were identified. Four patients had portal venous hypertension. The imaging work-up was variable and included mainly non-invasive modalities (US: 8 patients; CTA: 8 patients and MRA: 9 patients) and conventional angiography in 2 patients. Eight aneurysms involved the portal vein (50%), 5 the splenic vein (31.3%), and 3 the superior mesenteric vein (18.7%). None of the patients underwent surgical or endovascular management. Imaging follow-up was performed in 12 patients, with no interval change over time with up to 10 years follow-up. CONCLUSION: In our series, the portal vein was most frequently involved. Diagnosis was exclusively based on imaging and management was limited to follow-up

Hereditary-hemorrhagic telangiectasia: one-step magnetic resonance examination in evaluation of liver involvement

articlePURPOSE: To describe the magnetic resonance imaging (MRI) features of hepatic involvement in hereditary-hemorrhagic telangiectasia (HHT) and to determine the interobserver agreement for all of them. PATIENTS AND METHODS: Twenty-three consecutive patients (including 17 women, mean age: 55 years) with HHT, according to the Curaçao criteria, underwent prospective MRI of the liver, including parenchymal, angiographic and biliary sequences, in one step. The scans were analyzed to determine the presence of vascular, biliary and parenchymal abnormalities (Mann-Whitney U test, kappa). The diameters of the hepatic vessels in the 23 patients were compared with those of 23 subjects with no signs of HHT or vascular or liver disease. RESULTS: MRI of the liver was abnormal in 21 patients with suspected HHT (91%). Vascular abnormalities were found in 21 patients (91%), consisting of marked dilatation of the hepatic artery (N=14), intrahepatic telangiectases (N=21), arteriosystemic venous shunting (N=19), arterioportal shunting (N=11) and aneurysms of the hepatic artery (N=3). Regenerative nodular hyperplasia was identified in 17 patients (74%) and ischemic cholangitis in nine (39%). No such lesions were found in the controls. The diameter of the hepatic artery proper was greater in patients with HHT than in the controls: 8.69+/-1.63 mm versus 5.17+/-0.44 mm, respectively (P<0.05). Good interobserver agreement was found with parenchymal and vascular abnormalities (0.62) and moderate interobserver agreement (0.42) with biliary abnormalities. CONCLUSION: One-step MRI of the liver appears to be an excellent tool for the evaluation of liver involvement in HHT, revealing vascular abnormalities, telangiectases, arteriovenous shunting, focal-liver lesions and ischemic cholangitis