A. Daghfous
Tunis El Manar University
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Featured researches published by A. Daghfous.
Gastroenterologie Clinique Et Biologique | 2008
H. Bedioui; A. Daghfous; M. Ayadi; R. Noomen; Faouzi Chebbi; W. Rebai; A. Makni; F. Fteriche; Rachid Ksantini; A. Ammous; Mohamed Jouini; M. Kacem; Zoubeir Bensafta
UNLABELLED Phytobezoars are a rare cause of acute bowel obstruction. The purpose of this work was to identify the predisposing factors and diagnostic difficulties of this rare entity. MATERIAL AND METHODS This was a retrospective study including all cases of small-bowel obstruction secondary to phytobezoars observed between April 2001 and August 2007. The diagnosis of bezoars was established by surgical exploration or by computed tomography (CT). RESULTS During the study period, 375 patients were hospitalized at our institution with a diagnosis of bowel obstruction that, in 15 (4%) cases, was secondary to phytobezoars. The average patient age was 55 years, with a gender ratio of 1.7, favoring men. The predisposing factors were gastroduodenal surgery for peptic ulcer in nine patients, and excessive consumption of prickly pears (cactus figs) in 12. The diagnosis was established by CT scans in three patients, who were successfully treated with gastric aspiration, thereby avoiding surgery. Laparotomy was performed in 12 patients to allow digital fragmentation of the bezoar, which was then washed into the colon. There were no postoperative deaths and morbidity was about 13%. CONCLUSION An abdominal CT scan should be obtained for patients with small-bowel obstruction. This examination offers a precise diagnosis of bezoars, reducing the number of unnecessary surgical procedures, and helping to guide the approach if surgery is needed.
Journal of Emergency Medicine | 2010
H. Bedioui; S. Ayadi; A. Daghfous; Mohamed Jouini; Malek Bakhtri; Hatem Rajhi; Faouzi Chebbi; F. Fteriche; Rachid Ksantini; Montassar Kacem; Zoubeir Ben Safta
Gastrointestinal bleeding from a pancreatic pseudocyst is a rare condition that is diagnostically and therapeutically challenging. A 78-year-old woman with a history of acute pancreatitis due to gallstones was hospitalized for abdominal pain and gastrointestinal bleeding. Gastroscopy revealed blood extruding from the papilla of Vater. A computed tomography scan revealed hemorrhage into a pancreatic pseudocyst. The patient was successfully treated by coil embolization.
Arab Journal of Gastroenterology | 2011
A. Daghfous; O. Baraket; S. Ayadi; Heykel Bedioui; Azzouz Heifa; Mohamed Jouini; A. Makni; Wael Rebai; Faouzi Chebbi; Rachid Ksantini; F. Fteriche; M. Kacem; Zoubeir Ben Safta
A 41-year-old female patient, presented with recurrent epigastric pain of 2 years duration. Physical examination revealed a 15-cm epigastric mass that was mobile and tender on palpation. Abdominal ultrasound revealed a 20-cm hypoechoic mass, containing multiple hyperechoic structures. The exact origin of the mass could not be clearly defined. CT scan of the abdomen revealed a well-circumscribed voluminous cystic mass measuring approximately 25 cm in size, with heterogeneous content. After the administration of contrast material, no enhancement of the mass
Acta Chirurgica Belgica | 2009
M. El Ajmi; Rachid Ksantini; Faouzi Chebbi; A. Makni; Wael Rebai; A. Daghfous; H. Bedioui; F. Fteriche; Mohamed Jouini; M. Kacem; Z. Ben Safta
Abstract Background: Parosteal osteosarcoma is a rare, well-differentiated, predominantly fibro-osseous variant of osteosarcoma. It is regarded as a distinct form of osteosarcoma with better prognosis than conventional osteosarcoma. Aim: We report an unusual case of abdominal mass recurrence of parosteal osteosarcoma of the left distal femur treated eight years previously with wide resection, hip disarticulation and chemotherapy, which presented as an acute abdomen: we discuss the clinical outcomes of this rare entity. Case presentation: We present a 54-year-old patient with low-grade parosteal osteosarcoma of the left distal femur. Left total hip disarticulation was indicated after several local relapses of the tumour following extensive resection and chemotherapy. Eight years later, he presented with an acute large bowel obstruction secondary to a compression of the large bowel by an abdominal mass. Abdominal computed tomography showed a large abdominal calcified mass with dilated large bowel loops. During laparotomy, the mass was unresectable. So, the patient underwent emergent colostomy of diversion. Biopsy of the lesion yielded grade III parosteal osteosarcoma material. The patient received adjuvant chemotherapy, but the response was poor: six months later, the patient presented with a peristomal mass and two pulmonary metastases. Conclusion: Abdominal recurrence of parosteal osteosarcoma of the distal femur eight years after definitive surgery is rare. This case emphasises the importance of the long-term follow-up of patients with parosteal osteosarcoma.
Presse Medicale | 2018
A. Labidi; Sarra Hamdi; Aymen Ben Othman; Beya Chelly; A. Daghfous; M. Fekih
La Presse Medicale - In Press.Proof corrected by the author Available online since mercredi 24 octobre 2018
journal of Clinical Case Reports | 2017
Anis Haddad; Amine Sebai; Souhaib Atri; A. Daghfous; Zoubeir Ben Safta
The situs inversus is a rare anatomical condition which is characterized by the transposition of organs towards the opposite side. The left position of the gall-bladder makes the diagnosis of acute cholecystitis difficult because of an unusual symptomatology. It is also associated with a difficulty of laparoscopic dissection of the stone-block triangle especially for the right-handed surgeons. We report the cases of 2 patients whose different explorations confirmed the diagnosis of acute cholecystitis and total situs inversus and benefited from a laparoscopic cholecystectomy. Laparoscopic cholecystectomy, in these two cases, is an original intervention because of the mirrored vision of the intraperitoneal organs and can even be difficult leading to iatrogenic complications. However, the laparoscopic approach remains the gold standard even in the presence of this mirrored anatomy.
Anatomy & Physiology: Current Research | 2017
Tarek Kellil; Mohamed Amine Makni; Maghrebi Houcine; Rami Rhaiem; Anis Hadded; Mohamed Sabri B’chir; Wael Rebai; A. Daghfous; Rachid Ksantini; Faouzi Chebbi; Mohamed Juini; Montassar Kacem; Zoubeir Ben Safta
Pancreas divisum (PD) is a common congenital anomaly of the pancreas, which results from an abnormal fusion between the ventral and dorsal pancreatic ducts during fetal development. Association with Intraductal papillary mucinous neoplasm (IPMN) is extremely rare. The treatment of this entity will depend both on the malignant potential of IPMN and on the symptoms related to pancreas divisum. We report a rare case of Intraductal papillary mucinous carcinoma of the pancreas associated with pancreas divisum, one of the most difficult situations which the surgeon can be confronted to in his practice.
Gastroenterologie Clinique Et Biologique | 2010
W. Rebai; Rachid Ksantini; M. Bouassida; A. Makni; Faouzi Chebbi; S. Ayadi; A. Daghfous; F. Fterriche; H. Bedioui; Mohamed Jouini; A. Ammous; M. Kacem; Z. Ben Safta
Homme âgé de 22 ans, issu d’un mariage consanguin de premier degré, a été hospitalisé pour douleurs abdominales et vomissements. Le patient présentait depuis cinq mois des douleurs de l’hypochondre droit associées à des vomissements alimentaires et bilieux. L’interrogatoire a noté la notion de syndromes subocclusifs spontanément résolutifs, d’infections urinaires récidivantes et d’un amaigrissement par autorestriction alimentaire. À l’examen physique, le patient était maigre et présentait une dysmorphie faciale avec un hypertélorisme, une obliquité antimongoloïde, des fentes palpébrales et une micro-ophtalmie droite. L’examen ophtalmologique a mis en évidence au niveau de l’œil droit une microcornée, un nystagmus et l’absence de perception lumineuse. L’œil gauche était normal. La fibroscopie digestive haute a mis en évidence un aspect d’endobrachyœsophage s’étendant de façon circonférentielle à partir du cardia sur une hauteur de 10 cm environ. Le bulbe était normal et le duodénum était dilaté contenant du liquide de stase empêchant toute exploration. Les biopsies œsophagiennes ont confirmé le diagnostic d’endobrachyœsophage avec présence de métaplasie intestinale étendue. Le transit œsogastroduodénal a montré la présence d’une importante dilatation duodénale sans obstacle organique d’aval. Le diagnostic retenu en préopératoire était celui d’un diverticule géant du duodénum. Le patient a été opéré après aspiration gastrique. L’exploration peropératoire a mis en évidence une dilatation s e m t i
Gastroenterologie Clinique Et Biologique | 2010
W. Rebai; Rachid Ksantini; M. Bouassida; A. Makni; Faouzi Chebbi; S. Ayadi; A. Daghfous; F. Fterriche; H. Bedioui; Mohamed Jouini; A. Ammous; M. Kacem; Z. Ben Safta
Homme âgé de 22 ans, issu d’un mariage consanguin de premier degré, a été hospitalisé pour douleurs abdominales et vomissements. Le patient présentait depuis cinq mois des douleurs de l’hypochondre droit associées à des vomissements alimentaires et bilieux. L’interrogatoire a noté la notion de syndromes subocclusifs spontanément résolutifs, d’infections urinaires récidivantes et d’un amaigrissement par autorestriction alimentaire. À l’examen physique, le patient était maigre et présentait une dysmorphie faciale avec un hypertélorisme, une obliquité antimongoloïde, des fentes palpébrales et une micro-ophtalmie droite. L’examen ophtalmologique a mis en évidence au niveau de l’œil droit une microcornée, un nystagmus et l’absence de perception lumineuse. L’œil gauche était normal. La fibroscopie digestive haute a mis en évidence un aspect d’endobrachyœsophage s’étendant de façon circonférentielle à partir du cardia sur une hauteur de 10 cm environ. Le bulbe était normal et le duodénum était dilaté contenant du liquide de stase empêchant toute exploration. Les biopsies œsophagiennes ont confirmé le diagnostic d’endobrachyœsophage avec présence de métaplasie intestinale étendue. Le transit œsogastroduodénal a montré la présence d’une importante dilatation duodénale sans obstacle organique d’aval. Le diagnostic retenu en préopératoire était celui d’un diverticule géant du duodénum. Le patient a été opéré après aspiration gastrique. L’exploration peropératoire a mis en évidence une dilatation s e m t i
Journal De Chirurgie | 2007
H. Bedioui; Mohamed Jouini; Rachid Ksantini; F. Fteriche; Faouzi Chebbi; A. Daghfous; S. Ayadi; M. Kacem; Jalel Boubaker; Azza Filali; Z. Ben Safta
Resume Nous rapportons l’observation d’une femme âgee de 23 ans suivie depuis 11 ans pour une maladie de Crohn ileo-colique et qui avait ete operee pour des stenoses etagees multiples jejuno-ileales symptomatiques. Neuf stricturoplasties de type Heineke-Mikulicz et une de type Finney avaient ete realisees. Les suites operatoires avaient ete simples. La patiente est restee asymptomatique sous Imurel ® pendant 15 mois. Elle a ete rehospitalisee pour une peritonite par perforation au niveau de la stricturoplastie de type Finney. Une exteriorisation de la perforation a ete realisee. Ce premier et unique cas rapporte de perforation sur stricturoplastie est une complication grave. Il ne doit cependant pas remettre en question l’interet de ce procede chirurgical conservateur des stenoses multiples compliquant une maladie de Crohn.