Intestinal obstruction and cystic fibrosis: a case report

Distal intestinal obstruction syndrome is one of the frequent digestive complications of cystic fibrosis; due to a more or less complete small bowel obstruction. Proximal intestinal obstruction syndrome is a rarer variant, but has been more often described since the improvement of the management of CF that has led to enhance CF patient survival. We described a 19-year-old male followed in the pediatrics department of the HMIMV for cystic fibrosis complicated by exocrine pancreatic insufficiency and type 1 diabetes, who presented an intestinal obstruction syndrome for two days, consisting on abdominal pain, bloating, bilious vomiting and cessation of stool and gas. Imaging has suspected a mechanical obstruction of the small bowel however no transitional zone could be identified. A conservative treatment was start and because of the inefficiency of this first approach, the decision was made to proceed with a laparotomy. Intra-operatively, a mid-jejunum point with inssipationed stool was noticed to be the transitional aera of the obstruction and conducted us to proceed for an entrotomy and digitaly empty the proximal bowell. PIOS is a more rare intestinal complication but should be considered when the ileo cecal clinical location is absent in an obstruction syndrome. Its treatment is based on laxatives however surgery should wisely be considered in front of failure of the conservative approach or critical condition

Giant splenic cysts discovered incidentally after early abortion

Splenic cysts are rare tumors, grouped into parasitic and non-parasitic cysts, no-parasitic cysts are further classified into primary and secondary cysts depending on the mucous membrane of the cyst, radiological imaging allows the diagnosis to be made but confirmation of the diagnosis is based on an atom-o-pathological examination of the part. surgical treatment is the cornerstone of symptomatic and complicated splenic cysts. The conservative treatment is a reference for splenic cysts. We report the case of a young woman who was presented with a simple cyst of the spleen

Mixed neuroendocrine-non-neuroendocrine neoplasms of the right colon: a case report

Mixed neuroendocrine-non neuroendocrine neoplasm (MiNENs) is a rare gastrointestinal neoplasm that has been redefined by the World Health Organization (WHO) in 2017 as the association of two types of components, neuroendocrine and non-neuroendocrine, each of them present in at least 30% of the tumour mass. Small case reports and case series have demonstrated the occurrence of this neoplasm in the colon. We here report the case of a 47-year-old man undergoing colonscopy for anemia. This showed impassable polypoidal tumor budding in the right colic flexure. Computerized tomography (CT) scan and magnetic resonance imaging (MRI) showed the presence of liver metastases. As the tumor was hemorrhagic, right hemicolectomy with lymph node dissection was performed. The histological examination showed MiNEN of the ascending colon. The patient received adjuvant chemotherapy

Place du bloc pénien comme seule technique anesthésique lors d'une campagne de circoncision

L’Anesthésie locorégionale connaît depuis plus d’une vingtaine d’années, une large utilisation en pratique pédiatrique en raison de la qualité de l’analgésie qu’elle procure pendant l’intervention et en phase postopératoire. Nous rapportons ici l'expérience d'une campagne de circoncision qui a eu lieu à l hôpital Moulay Ismail de Meknès dans laquelle 60 enfants tous ASA1 ont été circoncis ; Ces circoncisions ont été réalisé sous bloc pénien, chez des enfants sous sédation préalable; selon la technique de Dallens. L'objectif de ce travail étant d'évaluer l'efficacité du bloc pénien comme technique anesthésique dans le cadre d'une campagne de circoncision. Cette dernière s'est déroulée dans de bonnes conditions ; sans aucun incident rapporté ; Nous discuterons, à travers ces résultats et les dernières publications, de son utilité dans ce cadre de chirurgie ambulatoire, de ses avantages par rapport à l'anesthésie générale mais également de ses alternatives