Khadija Krati

Coexistence de tumeur carcinoïde et maladie de Crohn iléale: une nouvelle observation !

RésuméL’association cancer grêlique avec maladie de Crohn est un fait connu. Il s’agit surtout d’adénocarcinome. Toutefois, la coexistence d’une tumeur maligne carcinoïde iléale et d’une maladie de Crohn était rapportée 11 fois dans la littérature. Nous rapportons une nouvelle observation de tumeur carcinoïde iléale associée à une maladie de Crohn.AbstractThe association of small bowel cancer and Crohn’s disease is a known fact. This association is especially described for adenocarcinoma. However, the coexistence of a malignant carcinoid tumor and ileal Crohn’s disease was reported eleven times in the literature. We report a new observation of ileal carcinoid tumor associated with Crohn’s disease.

Fatal hypoglycaemia from IGF II hyperproduction as a complication of a mesenteric gastrointestinal stromal tumour

a Gastroenterology Department, King Mohamed VI Hospital, FMPM, UCAM, King Mohamed VI University Hospital, Medical School of Marrakech, Cadi Ayyad University, Marrakech, Morocco b Surgery Department, King Mohamed VI Hospital, FMPM, UCAM, King Mohamed VI University Hospital, Medical School of Marrakech, Cadi Ayyad University, Marrakech, Morocco c Endocrinology Department, King Mohamed VI Hospital, FMPM, UCAM, King Mohamed VI University Hospital, Medical School of Marrakech, Cadi Ayyad University, Marrakech, Morocco d Anatomical Pathology Department, King Mohamed VI Hospital, FMPM, UCAM, King Mohamed VI University Hospital, Medical School of Marrakech, Cadi Ayyad University, Marrakech, Morocco

A giant abdominal well differentiated Liposarcoma: A rare etiology of abdominal mass

Liposarcoma is the most common retroperitoneal sarcoma and represents more than 15% of all sarcomas. Well differentiated liposarcoma is usually located in the extremities. We report the case of a patient with a giant retroperitoneal liposarcoma revealed by an abdominal mass.

Association maladie cÅliaque et tuberculose multifocale: à propos d'un cas avec revue de la littérature.

Coeliac disease is an autoimmune enteropathy related to gluten intolerance which occurs in subjects genetically disposed. The diagnosis is based on the combination of clinical biological and histological arguments. It is associated with many complications, including lymphoma. The risk of tuberculosis in patients with coeliac disease is increased. Several hypotheses explaining this association have been discussed. We report a case of coeliac disease associated with multifocal tuberculosis in a 17-year old patient.

Le carcinome hépatocellulaire : profil épidémiologique, clinique et thérapeutique au CHU de Marrakech (à propos de 76 cas)

Hepatocellular carcinoma is the most common primary liver malignancy, often developing on cirrhosis. We report a retrospective study of 76 cases of hepatocellular carcinoma collected at the hepato-gastroenterology unit of the Marrakech University Hospital Mohamed VI over a period of 12 years. The average age is 59 years, with a male predominance. The etiologies are dominated by cirrhosis in 72.3%. Clinical signs are dominated by abdominal pain in 75%. The diagnosis was based in 30.2% on the histology. In the remaining cases, it was based on characteristic morphological and biological data. 60.5% of the patients had a multinodular form and 6.6% had an infiltrating form. The size of the nodules varied between 1 cm and 14 cm. For the BCLC classification, 7.9% were classified as early stage A, and 50% were D-terminal. The curative treatment could only be proposed in 11.8%, including a case of transplantation. Palliative treatment was indicated in 26.3%. The evolution was different according to the treatment received, with good evolution in the transplanted patient and that treated by radiofrequency, while the mortality remains high in the patients treated with palliative or symptomatic treatment.

Pancréatite aiguë médicamenteuse secondaire à la 6-mercaptopurine : à propos d’un cas

Introduction: Patients with inflammatory bowel disease appear to be at high risk of acute or chronic pancreatitis. This complication can be integrated as part of extraintestinal manifestations of these diseases but in most of the described cases, it occurs due to immunosuppressive therapy (azathioprine/6mercaptopurine). Case report: 44-year old patient with ulcerative colitis revealed by a slight push by Truelove and Witts’ score, orally treated by mesalazine with good outcome, having presented one second severe pancolitis relapse. Remission was achieved with injectable corticosteroids for 5 days then oral treatment. To maintain remission, 6-mercaptopurine was started at a dose of 1.5mg/kg/day after a normal pre-immunosuppressive balance sheet. The evolution was marked by the appearance in the 3rd week of the treatment of acute pancreatitis, classified C stage on the abdominal CT scan, with no signs of biological gravity. Symptomatic measures were taken with immediate stopping of 6-mercaptopurine. The outcome was marked by good clinical improvement. Conclusion: The frequency of the acute pancreatitis in inflammatory bowel disease remains variable. The drug-induced origin including 6-mercaptopurine and azathioprine, is the main cause. The occurrence of this complication should be permanently discontinued from treatment and replaced by another therapeutic alternative. DOI : 10.4267/2042/61678

Giant Gastric Trichobezoar: Report of Two Cases

We report two cases of gastric trichobezoar, recorded in the last 3 years in our Hospital. Both cases presented abdominal pain and epigastric mass, as well as upper obstructive symptoms. The cases were surgically treated with satisfactory evolution. the clinician has to consider this diagnosis. Surgery is a successful treatment for these cases.

Métastases cutanées d'une linite gastrique : un cas exceptionnel

Gastric linitis is a gastric adenocarcinoma characterized by the presence of signet ring cells. Cutaneous metastasis of gastric linitis is extremely rare, and can be indicative of gastric neoplasia. Cutaneous metastases have a bad prognosis. We report an original case of cutaneous metastases associated to gastric linitis.

Carcinome épidermoïde primitif du duodénum : à propos d’un cas et revue de la littérature

La localisation duodénale d’un carcinome épidermoïde primitif est exceptionnelle. Seuls quelques rares cas ont été rapportés dans la littérature, notamment des localisations métastatiques. Nous rapportons une observation d’un carcinome épidermoïde primitif du duodénum chez une patiente de 60 ans révélé par des épigastralgies atypiques et un méléna. Le diagnostic a été confirmé par une endoscopie œsogastroduodénale qui a montré un processus tumoral bourgeonnant et infiltrant circonférentiel à la partie distale du deuxième duodénum. Les biopsies ont conclu à un carcinome épidermoïde. Un bilan clinique et paraclinique à la recherche d’une localisation primitive était négatif. Le bilan d’extension réalisé a montré la présence de multiples adénopathies latéro et sous-pancréatiques céphaliques et lomboaortiques. La prise en charge proposée était une chimiothérapie palliative étant donné le stade avancé.

La fistule gastrocolique: complication exceptionnelle de la maladie ulcère gastrique

RésuméLa fistule gastrocolique compliquant un ulcère gastrique est une entité rare (37 cas ont été rapportés dans la littérature). Elle se manifeste par une triade caractéristique: diarrhées, vomissements fécaloïdes, amaigrissement. Le diagnostic peut être confirmé par l’imagerie et l’endoscopie. La chirurgie reste le traitement classique. Nous rapportons une nouvelle observation avec revue de la littérature des différents aspects épidémiologique, clinique, paraclinique et thérapeutique de cette complication.AbstractA gastrocolic fistula is a rare complication of gastric ulcers (with only 37 reported cases present in the literature). It is characterised by three main symptoms: diarrhoea, vomiting of faeculant material and weight loss. Diagnosis is confirmed through imaging and an endoscopy. Surgery remains the traditional method of treatment. We are reporting on a new observation, with a review of the literature of different epidemiological, clinical, paraclinical and therapeutic aspects of this complication.