Ahmed Bouhafa

Primary hydatid cyst of the gallbladder: an unusual localization diagnosed by magnetic resonance imaging (MRI).

Hydatid disease is endemic in Tunisia and has been considered as one of the most common surgical pathology. Several localizations have been described, but hydatidosis of the liver is the most frequent clinical entity. Primary hydatid cyst of the gallbladder is very rare. We report in this observation a new case of primary hydatid cyst of the gallbladder diagnosed by Magnetic Resonance Imaging (MRI).

Ascending Cholangitis secondary to migrated embolization coil of gastroduodenal artery pseudo-aneurysm a case report

BackgroundGastroduodenalartery (GDA) pseudo-aneurysms are very rare. Their clinical importance lies in the eventuality of rupture, causing bleeding and ultimately exsanguination.Case presentationWe report the case of a man, with prior history of biliary surgery, presenting with haemobilia secondary to a rupture of GDA pseudo-aneurysm eroding the main bile duct. The patient was treated with coil embolization. This technique is considered to be safe. However, on the long term, some complications may occur. In our case, the patient presented with cholangitis subsequent to coil migration in the lower bile duct. This situation was managed using endoscopic retrograde cholangiopancreatography (ERCP) allowing coil extraction with favorable evolution.ConclusionsGDA pseudo-aneurysms are very rare. Bleeding, secondary to the rupture of these lesions, is a serious complication that could lead to death. Diagnosis and treatment of ruptured GDA pseudo-aneurysms rely on angiography. This method is considered to be safe. Cholangitis secondary to coil migration in the main bile duct is exceedingly rare,but remains an eventuality that physicians should be cognizant of.

Idiopathic Sclerosing Encapsulating Peritonitis Revealed by Intestinal Obstruction.

Sclerosing encapsulating peritonitis (SEP) is a very rare entity characterized by encasement of small intestine by a fibrocollagenous membrane. It is divided into primary (idiopathic) which is named as abdominal cocoon and secondary forms. The preoperative diagnosis is difficult and most cases are diagnosed intraoperatively. A conservative treatment approach is the most suitable management strategy in asymptomatic idiopathic SEP. In this paper, we aimed to present a case of idiopathic SEP revealed by intestinal obstruction.

Surgical Treatment of Choledocal Cyst with Choledocolithiasis

Choledochocele is also known as Todani type III cyst or intraduodenal diverticulum and represents only 4% of all choledochal cysts. It is defined as a cystic dilatation of the distal intramural portion of the common bile duct protruding into the duodenal lumen. It remains an uncommon anomaly of the biliary tract with small malignant potential. Definitive treatment of the choledochocele can be carried out operatively or by endoscopic sphincterotomy. We report a case of a 39 year old female patient on whom we successfully performed surgery with a Roux-en-Y hepatico-jejunostomy.