A large gastrointestinal stromal tumor of the duodenum treated by partial duodenectomy with Roux-en-Y duodenojejunostomy: a case report

INTRODUCTION: Duodenal gastrointestinal stromal tumors are uncommon and a relatively small subset of gastrointestinal stromal tumors whose optimal surgical procedure has not been well defined. Because submucosal spread and local lymph node involvement are infrequent in gastrointestinal stromal tumors, wide margins with routine lymph node dissection may not be required. Various surgical procedures for duodenal gastrointestinal stromal tumor, pancreatoduodenectomy, pancreas-sparing duodenectomy, segmental duodenectomy, or local resection, have been described depending on the size and exact site of the lesion. CASE PRESENTATION: We present the case of a 65-year-old African woman with a giant gastrointestinal stromal tumor involving the second and third portion of the duodenum successfully treated by partial duodenectomy with duodenojejunostomy. This surgical technique is ideal when a gastrointestinal stromal tumor does not involve the ampulla because it avoids a pancreatoduodenectomy, and has not been previously described for the management of this malignancy. Duodenal gastrointestinal stromal tumor should be suspected in any patient with a duodenal wall mass. CONCLUSIONS: Gastrointestinal stromal tumors of the duodenum should be suspected in any patient with a duodenal wall mass. Extramural growth and central ulceration with or without bleeding should alert the endoscopist to the possibility of a duodenal gastrointestinal stromal tumor diagnosis

Une maladie immunoproliférative de l’intestin grêle révélée par une invagination intestinale aigue: à propos d’un cas

La maladie immunoproliférative de l'intestin grêle IPSID est un lymphome rare qui se développé à partir du système lymphoïde associé aux muqueuses au niveau de l'intestin grêle. Sa révélation par une  invagination intestinale aigue est exceptionnelle et n'a jamais été rapporté dans la littérature auparavant. Nous rapportons le cas d'un patient de 65ans, admis aux urgences dans un tableau d'invagination  intestinale aigue. Le scanner abdominal a mis en évidence masse grêlique à paroi concentrique avec incarcération du segment  mésentérique au sein de la lésion fortement évocatrice d'une invagination intestinale. Le patient a été opéré et a bénéficié d'une résection iléale emportant le boudin d'invagination. L'examen histologique de la masse a été en faveur d'une maladie des chaines alpha transformée en un lymphome B diffus à grandes cellules. Les auteurs rapportent un cas rare d'une IPSID révélée par une invagination intestinale aigue et à travers cette observation, mettent en relief les principaux aspects cliniques, histologiques, thérapeutiques de cette entité avec une revue de la littérature.Key words: Maladie immunoproliférative, intestin grêle, invagination intestinale

Fistule bilio-pleurale post traumatique: à propos d’un cas

Les fistules bilio thoraciques post traumatiques sont extrêmement rares, leur traitement peut être conservateur mettant en œuvre des techniques de radiologie et d’endoscopie interventionnelle ou chirurgical si échec du premier. Nous rapportons une observation de fistule bilio pleurale post traumatique où l’indication du traitement chirurgical de première intention a été indiscutable vu le sepsis et l’instabilité hémodynamique

Pathological complete response in advanced gastric stromal tumor after imatinib mesylate therapy: a case report

<p>Abstract</p> <p>Introduction</p> <p>Gastrointestinal stromal tumors are a rare neoplasm exhibiting, in most cases, mutations of <it>c-kit</it>. Imatinib mesylate is the standard treatment for patients who have advanced gastrointestinal stromal tumors. Although the response rate in patients treated with imatinib mesylate in prospective clinical studies is above 50%, a complete response is very rare. We report the case of a patient with a gastric gastrointestinal stromal tumor who had a pathological complete response after neoadjuvant treatment with imatinib mesylate.</p> <p>Case presentation</p> <p>We report the case of a 54-year-old Arab woman with a gastrointestinal stromal tumor who had a pathological complete response after neoadjuvant treatment with imatinib mesylate.</p> <p>Conclusion</p> <p>The pathological examination of our patient documented a complete pathological response after imatinib therapy. Recently, it has been confirmed that the kinase genotype of <it>KIT </it>and <it>platelet-derived growth factor receptor α </it>can accurately predict a good response to imatinib mesylate therapy. We propose that this patient had a mutation conferring high sensitivity to imatinib mesylate.</p

Simultaneous acute appendicitis and ectopic pregnancy

The acute abdomen in pregnancy is a surgical emergency. Ectopic pregnancy and appendicitis are two causes of acute abdomen in pregnancy. Difficulties in correctly identifying the cause of the pain can be hazardous to the patient and care needs to be taken in obtaining a prompt and accurate diagnosis enabling the most appropriate management. The case presented here underlies the pathogenesis of the simultaneous existence of these two conditions in a patient

Adult intussusceptions caused by a lipoma in the jejunum: report of a case and review of the literature

<p>Abstract</p> <p>Intussusceptions in adults is rare. Gastrointestinal lipomas are rare benign tumors and intussusceptions due to a gastrointestinal lipoma constitutes an infrequent clinical entity. Lipoma may develop as a benign tumor in all organs and rarely in large or small intestine. The present report describes a case of jejunojejunal intussusceptions in an adult with a history of colicky upper abdominal pain. Ileo-ileal invagination was diagnosed by computed tomography scan. Exploratory laparotomy revealed jejunojejunal intussusceptions secondary to a lipoma which was successfully treated with segmental intestinal resection. A review of the literature is also performed regarding this rare association revealing the diagnostic and therapeutic debates that exist.</p> <p>Abstract (french)</p> <p>L’invagination chez les adultes est rare. Les lipomes gastro-intestinaux sont de rares tumeurs bénignes et l’invagination intestinale due à un lipome gastro-intestinal constitue une entité clinique trés rare. Le lipome peut se développer comme une tumeur bénigne dans tous les organes et rarement dans l’intestin grêle ou le colon. Le présent rapport décrit un cas d’invagination jéjunojéjunale chez un adulte avec une histoire de douleurs abdominales. Iléo-iléale invagination a été diagnostiquée par tomodensitométrie. Une laparotomie exploratrice a révélé l’existence d’une invagination jéjunojéjunale secondaire à un lipome qui a été traitée avec succès par une résection intestinale segmentaire. Une revue de la littérature est également effectuée au sujet de cette association rare révélant les débats diagnostiques et thérapeutiques qui existent.</p

Small Bowel Adenocarcinoma Complicating Coeliac Disease: A Report of Three Cases and the Literature Review

Coeliac disease is associated with an increased risk of malignancy, not only of intestinal lymphoma but also of small intestinal adenocarcinoma which is 82 times more common in patients with celiac disease than in the normal population. We report three additional cases of a small bowel adenocarcinoma in the setting of coeliac disease in order to underline the epidemiological features, clinicopathological findings, and therapeutic approaches of this entity based on a review of the literature. The three patients underwent a surgical treatment followed by adjuvant chemotherapy based on capecitabine/oxaliplatin regimen, and they have well recovered