Appendicite Aigue Gauche Sur Malrotation Intestinale: A Propos D’un Cas

L’appendicite aiguë est une urgence fréquente nécessitant une prise en charge chirurgicale en urgence. Dans sa forme typique, elle se manifeste par un syndrome d’irritation péritonéale en fosse iliaque droite. Toutefois, le tableau clinique est variable selon la localisation de l’appendice. Nous rapportons un cas d’appendicite gauche sur malrotation intestinale chez une patiente de 43ans, obèse, porteuse d’une uropathie malformative et multiopérée ; admise pour douleur en fosse iliaque gauche. Pas de fièvre, ni vomissement. L’examen clinique a retrouvé une irritation péritonéale en fosse iliaque gauche. Le bilan biologique a révélé un syndrome inflammatoire et une insuffisance rénale. Le scanner abdominal a permis de poser le diagnostic d’appendicite iliaque gauche sur mésentère commun complet. Elle a bénéficié d’une appendicectomie par laparotomie avec voie d’abord de Jalaguier gauche. Les suites opératoires ont été simples. L’appendicite sur mésentère commun complet est rare. Le diagnostic est basé sur le scanner abdominopelvien. Le traitement consiste en une appendicectomie idéalement par coelioscopie. Acute appendicitis is a common abdominal condition requiring emergency surgery. The typical manifestation is a peritoneal irritation in the lower-right quadrant of abdomen. However, this clinical presentation varies depending on the location of the appendix. Herein, we report a case of a left appendicitis on midgut malrotation in a 43-year-old obese patient with malformative and multi-operated uropathy; admitted with abdominal pain in the lower-left quadrant of the abdomen. No fever, no vomiting. The clinical examination revealed a peritoneal irritation in the left iliac fossa. The laboratory examination yieled an inflammatory syndrome and renal failure. An abdominal CT scan was performed and revealed a left iliac appendicitis on a complete common mesentery. An appendectomy was performed by laparotomy with left Jalaguier approach. The post-operative status wassimple. Appendicitis on complete common mesentery is rare. The diagnosis is based on the abdominal CT scan. The treatment is the appendectomy ideally through laparoscopy

Primary Carcinosarcoma of the Spleen: A Rare Case Report of Incidental Finding after Splenic Trauma

Primary carcinosarcoma of the spleen is a rare, aggressive splenic malignancy. To date, seven cases have been reported in the literature. We report a first case of primary carcinosarcoma of the spleen in France. A 75-year-old woman with a medical history of hysterectomy for uterine adenocarcinoma presented with left hypochondrium pain following blunt abdominal trauma. A splenic mass was noted on computed tomography (CT) scan. A splenectomy was performed by laparotomy. Histology revealed a malignant mixed Mullerian tumor. The PET scan allowed us to confirm that it was a primary lesion of the spleen. She is currently undergoing adjuvant chemotherapy despite the tumor progression. The interest of this case lies in the rarity of primary carcinosarcomas of the spleen and the circumstances of its diagnosis