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Rahali A, Aboulfath EM, Njoumi N, Rebbani M, El Brahmi Y, Elfahssi M, Elhjouji A, Zentar A, Ait Ali A. Sclerosing Encapsulating Peritonitis: Solving the Diagnosis Challenge of a Rare Entity. Case Rep Surg 2023; 2023:4022487. [PMID: 38179155 PMCID: PMC10764648 DOI: 10.1155/2023/4022487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 12/10/2023] [Accepted: 12/15/2023] [Indexed: 01/06/2024] Open
Abstract
Sclerosing encapsulating peritonitis (SEP) is an unusual fibroinflammatory disease of the peritoneum marked by the development of a fibrous membrane enveloping generally the small intestines. The knowledge around this subject is not completely understood. And the etiology can be either idiopathic or secondary to several diseases, treatments, and/or medications. We present a case of a 52-year-old man suffering from atypical clinical symptoms including recurrent abdominal ascites and intestinal obstruction. An abdominal computed tomography showed findings typical of SEP. Therefore, the patient benefited from exploratory laparotomy, which confirmed the diagnosis of idiopathic SEP. Postoperatively, he again had an episode of bowel obstruction, but this was controlled with steroids. Diagnosis of SEP is a real challenge to surgeons, gastroenterologists, and radiologists. And imagery is very helpful to make the diagnosis. Consequently, it is imperative that all hospital practitioners should distinguish between this lesion and other etiology of acute peritonitis.
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Affiliation(s)
- Anwar Rahali
- Department of Visceral Surgery, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Rabat, Morocco
| | - El Mehdi Aboulfath
- Department of Visceral Surgery, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Rabat, Morocco
| | - Noureddine Njoumi
- Department of Visceral Surgery, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Rabat, Morocco
| | - Mohammed Rebbani
- Department of Visceral Surgery, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Rabat, Morocco
| | - Yasser El Brahmi
- Department of Visceral Surgery, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Rabat, Morocco
| | - Mohammed Elfahssi
- Department of Visceral Surgery, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Rabat, Morocco
| | - Abderrahman Elhjouji
- Department of Visceral Surgery, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Rabat, Morocco
| | - Aziz Zentar
- Department of Visceral Surgery, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Rabat, Morocco
| | - Abdelmounaim Ait Ali
- Department of Visceral Surgery, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Rabat, Morocco
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Mohamed A, El Mouhafid F, Elfahssi M, Yakka M, Elhjouji A, Ehirchiou A, Zentar A, Ali AA. Occlusion intestinale révélant le primitif d’une tumeur carcinoïde métastatique. PAMJ-CM 2020. [DOI: 10.11604/pamj-cm.2020.4.52.23774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Mohamed A, El Brahmi Y, El Mouhafid F, Elfahssi M, Yakka M, Elhjouji A, Ehirchiou A, Zentar AE, Ali AA. Endométriose de la paroi abdominale antérieure, à propos d’un cas et revue de la littérature. PAMJ-CM 2020. [DOI: 10.11604/pamj-cm.2020.4.65.23614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Anajjar M, Essarghini M, El Mouhafid F, El Brahmi Y, El Yakka M, Elfahssi M, Elhjouji A, Ihirchiou A, Zentar A, Ali AA. Tuberculose pancréatique, une forme fortement simulatrice de malignité. PAMJ-CM 2020. [DOI: 10.11604/pamj-cm.2020.3.72.23090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Tarchouli M, Zentar A, Ratbi MB, Bensal A, Khmamouche MR, Ali AA, Bounaim A, Elfahssi M, Sair K. Perineal approach for surgical treatment in a patient with retro-rectal tumor: a case report and review of the literature. BMC Res Notes 2015; 8:470. [PMID: 26404544 PMCID: PMC4581409 DOI: 10.1186/s13104-015-1457-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 09/17/2015] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Retrorectal tumors in adults are very rare and little known condition. These tumors, often misdiagnosed or mistreated, should be completely excised because of the potential for malignancy or infection. A suitable operative approach is the key to the successful surgical management. CASE PRESENTATION We report the case of a 45-year-old Arab male who presented with chronic pelvic pain accompanied by straining to defecate and dysuria. The clinical examination showed a painless mass in the left perineal area. Pelvic magnetic resonance imaging and computed tomography scan demonstrated a huge and well-limited pelvic mass causing displacement and compression of the rectum and bladder. Although the large size of the mass (>7 cm in the greater diameter), it was successfully and completely excised through only perineal approach without undertaking coccygectomy or sacrectomy. The histopathological study revealed a low-grade leiomyosarcoma. The patient is currently in 4-years follow-up with no signs of recurrence or metastasis. CONCLUSION Even large retro-rectal tumors may be successfully excised by the perineal approach especially in carefully selected patients, but require extensive knowledge of pelvic anatomy and expertise in pelvic surgery.
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Affiliation(s)
- Mohamed Tarchouli
- Department of Digestive Surgery, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco.
| | - Aziz Zentar
- Department of Digestive Surgery, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco.
| | - Moulay Brahim Ratbi
- Department of Digestive Surgery, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco.
| | - Abdelhak Bensal
- Department of Digestive Surgery, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco.
| | - Mohamed Reda Khmamouche
- Department of Oncology, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco.
| | - Abdelmounaim Ait Ali
- Department of Digestive Surgery, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco.
| | - Ahmed Bounaim
- Department of Digestive Surgery, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco.
| | - Mohammed Elfahssi
- Department of Digestive Surgery, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco.
| | - Khalid Sair
- Department of Digestive Surgery, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco.
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Tarchouli M, Ali AA, Ratbi MB, Belhamidi MS, Essarghini M, Aboulfeth EM, Bouzroud M, Sbitti Y, Oukabli M, Elfahssi M, Sair K. Long-standing insulinoma: two case reports and review of the literature. BMC Res Notes 2015; 8:444. [PMID: 26374700 PMCID: PMC4572617 DOI: 10.1186/s13104-015-1424-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 09/07/2015] [Indexed: 02/07/2023] Open
Abstract
Background Insulinomas are rare pancreatic endocrine tumors. Most are benign and solitary. However, the nonspecific symptoms and small size of these tumors led to difficulties of diagnosis and localization. Case presentation We present two Arab patients with pancreatic long-standing insulinoma. Both patients presented episodic hypoglycemic symptoms respectively during 10 and 2 years. Biochemical and morphological workup detected localized pancreatic insulinoma. Open procedure surgery was done for the two patients and insulinomas were successfully removed by enucleation. Conclusion Insulinoma remains a diagnostic challenge to practitioners. Diagnosis of suspected cases is easily confirmed by standard endocrine tests, especially the supervised fasting test. Accurate preoperative localization is essential for more effective and safest surgery.
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Affiliation(s)
- Mohamed Tarchouli
- Department of Digestive Surgery, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco.
| | - Abdelmounaim Ait Ali
- Department of Digestive Surgery, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco.
| | - Moulay Brahim Ratbi
- Department of Digestive Surgery, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco.
| | - Mohamed said Belhamidi
- Department of Digestive Surgery, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco.
| | - Mohamed Essarghini
- Department of Digestive Surgery, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco.
| | - El Mehdi Aboulfeth
- Department of Digestive Surgery, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco.
| | - Mohamed Bouzroud
- Department of Digestive Surgery, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco.
| | - Yassir Sbitti
- Department of Oncology, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco.
| | - Mohamed Oukabli
- Department of Pathology, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco.
| | - Mohammed Elfahssi
- Department of Digestive Surgery, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco.
| | - Khalid Sair
- Department of Digestive Surgery, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco.
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Elm'hadi C, Tarchouli M, Khmamouche MR, Tanz R, Elfahssi M, Kettani F, Ali AA, Errihani H, Ichou M. Intestinal intussusception in a young women: unusual cause and specific management. World J Surg Oncol 2015; 13:252. [PMID: 26289057 PMCID: PMC4545985 DOI: 10.1186/s12957-015-0660-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Accepted: 07/27/2015] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Intussusception in adults is a rare cause of abdominal pain that is often associated with organic pathology. We describe a case of ileocolic intussusception revealing a cecal adenocarcinoma in a young woman successfully managed by laparoscopic-assisted surgery adhering to oncological principles. CASE PRESENTATION A 30-year-old woman with a family history of colon adenocarcinoma in a young brother presented to our emergency department with a 2-month history of intermittent colicky abdominal pain accompanied by nausea and vomiting. Physical examination showed a palpable mass in the right lower quadrant of the abdomen. Computed tomography showed a 3-layered structure giving the characteristic target-shaped appearance in the ascending colon, highly suggestive for an ileocolic intussusception associated with right colic parietal thickening and an adjacent lymphadenopathy. Patient was planned for laparoscopic exploration and eventually definitive surgery. Intra-operatively, we found an ileocolic intussusception with thickening of the colic wall and slight proximal intestinal dilation. Multiple lymphadenopathies along the ileocecal artery were observed. Laparoscopic right hemicolectomy was performed following strict oncologic principles with "en bloc resection" and lymphadenectomy given the risk of an underlying malignancy. Considering this risk, previous reduction of the invaginated segments was not attempted and primary extracorporeal anastomosis was performed using manual sutures. Macroscopic examination of the resected specimen revealed a tumor mass of the caecal wall .The histological analysis identified a moderately differentiated tubular adenocarcinoma invading the serosa (T3) without permeation of the lymphatic or venous capillaries. No lymphatic metastasis of 28 nodes removed was seen. Postoperative course was uneventful and patient was discharged 5 days after surgery. Postoperative chest, abdomen, and pelvis CT scan were normal. Therefore, tumor is classified as stage II A (T3N0 M0).There was loss of MLH2 and MSH6 protein expression on immunohistochemistry findings reflecting a microsatellite instability phenotype, and the patient was followed up without adjuvant chemotherapy. CONCLUSION Ileocolic intussusception rarely revealed a cancer in young adults. Laparoscopic surgery has a special interest in the diagnosis and treatment in this pathology. Oncogenetic consultation should be required in malignant lesion.
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Affiliation(s)
- Choukri Elm'hadi
- Medical Oncology Department, Mohammed V Military Teaching Hospital of Rabat, zip code 10100, Rabat, Morocco.
| | - Mohamed Tarchouli
- Department of Visceral Surgery, Mohammed V Military Teaching Hospital of Rabat, Rabat, Morocco.
| | - Mohamed Reda Khmamouche
- Medical Oncology Department, Mohammed V Military Teaching Hospital of Rabat, zip code 10100, Rabat, Morocco
| | - Rachid Tanz
- Medical Oncology Department, Mohammed V Military Teaching Hospital of Rabat, zip code 10100, Rabat, Morocco.
| | - Mohammed Elfahssi
- Department of Visceral Surgery, Mohammed V Military Teaching Hospital of Rabat, Rabat, Morocco.
| | | | - Abdelmounaim Ait Ali
- Department of Visceral Surgery, Mohammed V Military Teaching Hospital of Rabat, Rabat, Morocco.
| | - Hassan Errihani
- Medical Oncology Department, National Institute of Oncology Sidi Mohamed Ben Abdellah, Rabat, Morocco.
| | - Mohammed Ichou
- Medical Oncology Department, Mohammed V Military Teaching Hospital of Rabat, zip code 10100, Rabat, Morocco.
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Baba H, Allaoui M, Elfahssi M, Bounaim A, Ali AA, Oukabli M, Sair K, Zentar A. [Angiocholitis secondary to a tumor thrombus of a primitive neuroendocrine tumor of the liver]. Pan Afr Med J 2015; 22:308. [PMID: 26966504 PMCID: PMC4769041 DOI: 10.11604/pamj.2015.22.308.8185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 11/13/2015] [Indexed: 11/11/2022] Open
Abstract
Nous rapportons le cas exceptionnel d'une patiente de 54 ans prise en charge pour une angiocholite due à un thrombus tumoral, d'une tumeur neuroendocrine primitive (TNE Ive) du foie, dans la voie biliaire principale.
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Affiliation(s)
- Hicham Baba
- Service de Chirurgie Viscérale, Hôpital Militaire d'Instruction Mohammed V, Rabat, Maroc
| | - Mohamed Allaoui
- Service d'Anatomie Pathologique, Hôpital Militaire d'Instruction Mohammed V, Rabat, Maroc
| | - Mohammed Elfahssi
- Service de Chirurgie Viscérale, Hôpital Militaire d'Instruction Mohammed V, Rabat, Maroc
| | - Ahmed Bounaim
- Service de Chirurgie Viscérale, Hôpital Militaire d'Instruction Mohammed V, Rabat, Maroc
| | - Abdelmounaim Ait Ali
- Service de Chirurgie Viscérale, Hôpital Militaire d'Instruction Mohammed V, Rabat, Maroc
| | - Mohamed Oukabli
- Service d'Anatomie Pathologique, Hôpital Militaire d'Instruction Mohammed V, Rabat, Maroc
| | - Khalid Sair
- Service de Chirurgie Viscérale, Hôpital Militaire d'Instruction Mohammed V, Rabat, Maroc
| | - Aziz Zentar
- Service de Chirurgie Viscérale, Hôpital Militaire d'Instruction Mohammed V, Rabat, Maroc
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