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Bouassida M.,Mohamed Tahar Maamouri Hospital
The Pan African medical journal | Year: 2012

Solid pseudopapillary tumor (SPN) of the pancreas is a rare tumor, but has favorable prognosis. It is typically observed in young women. Only few cases have been reported in young men. We report the observation of a 73-year-old man presented with a palpable mass in the left upper abdomen. CT scan showed 10 cm mass at the tail of the pancreas. This mass had mixed cystic and solid components. The patient underwent a distal pancreatectomy and splenectomy. SPN of the pancreas was diagnosed based on histopathological features. The patient recovered uneventfully and didn't receive adjuvant therapy. A CT scan performed 16 months postoperatively showed no evidence of disease recurrence. Although SPN of the pancreas is typically observed in young women, the diagnosis should not be discounted in old male patients. Male patients and those with old age, atypical histopathology and incomplete resection may have a higher risk of recurrence and death, deserving particular attention.

Mahdi B.,Mohamed Tahar Maamouri Hospital
The Pan African medical journal | Year: 2011

Annular pancreas is a rare congenital anomaly characterized by the presence of ectopic pancreatic tissue surrounding the descending part of the duodenum. It is one of the few congenital anomalies of the gastrointestinal tract which can produce symptoms late in life. In adults, the factors initiating symptoms are recurrent pancreatitis, duodenal stenosis at the site of the annulus, or duodenal or gastric ulceration. We report a new case involving a 24-year-old woman hospitalised for epigastric pain, nausea and vomiting. Radiological examination was consisted with an annular pancreas. At operation a complete obstruction of the second part of the duodenum was found, caused by an annular pancreas, no other congenital anomaly of the intra-abdominal organs was noted. A gastroenterostomy was performed.

Hamzaoui L.,Mohamed Tahar Maamouri Hospital | El Bouchtili S.,Mohamed Tahar Maamouri Hospital | Siai K.,Mohamed Tahar Maamouri Hospital | Mahmoudi M.,Mohamed Tahar Maamouri Hospital | Azzouz M.M.,Mohamed Tahar Maamouri Hospital
Clinics and Research in Hepatology and Gastroenterology | Year: 2013

Hepatitis B virus and hepatitis C virus are the two most common causes of chronic liver disease in the world. Dual infection with hepatitis B virus and hepatitis C virus, whose prevalence is underestimated, is characterized by a more severe liver injury, a higher probability of liver cirrhosis and a higher incidence of hepatocellular carcinoma. Treatment of these patients represents a therapeutic challenge. We report the case of an hepatitis B virus-hepatitis C virus co-infected patient, which particularly illustrates the interactions between these two viruses and therapeutic problems caused by the dual infection. HCV was initially dominant, which indicated a combination therapy by pegylated interferon and ribavirin. This treatment was associated with an early virological response of the HCV but an increase of HBV DNA occurred, requiring the use of a nucleoside analogue. A good response was obtained for the HBV but a relapse of HCV was noted, posing a problem for therapeutic decision. © 2012 Elsevier Masson SAS.

Hamzaoui L.,Mohamed Tahar Maamouri Hospital | Bouassida M.,Mohamed Tahar Maamouri Hospital | Kilani H.,Mohamed Tahar Maamouri Hospital | Medhioub M.,Mohamed Tahar Maamouri Hospital | Chelbi E.,Mohamed Tahar Maamouri Hospital
Journal of Clinical and Diagnostic Research | Year: 2015

Primary squamous cell carcinoma of the stomach is very rare. Its pathogenesis is unclear and the treatment strategy is controversial. We report an agressive primary squamous cell carcinoma of the stomach with liver and lung metastases in a 55-year-old man. The patient presented with a 1-month history of abdominal pain, vomiting and weight loss. Abdominal ultrasound revealed multiple liver metastases. Endoscopic examination showed two tumour masses on the fundus of the stomach. Biopsy of the lesions revealed squamous cell carcinoma of the stomach. Chest x-ray showed multiple large pulmonary nodules highly suggestive of pulmonary metastases. The patient died ten days after he was admitted because of progression of the tumour and before any therapeutic decision. © 2015, Journal of Clinical and Diagnostic Research. All rights reserved.

Bouassida M.,Mohamed Tahar Maamouri Hospital | Bouassida M.,Tunis el Manar University | Mighri M.M.,Mohamed Tahar Maamouri Hospital | Mighri M.M.,Tunis el Manar University | And 8 more authors.
International Journal of Surgery | Year: 2013

Objective and background: Despite its importance in pancreatic head carcinoma, the retroportal lamina is still under studied, with only two anatomical cadaveric dissections in the English literature, with recent controversies about the concept of a mesopancreas. Methods: Resection of the mesopancreas was performed in 33 fresh cadavers. The pancreas and mesopancreas were separated from each other and the mesopancreas was immunohistochemically investigated. Results: The retroportal lamina is roughly rectangular in shape. Its dimensions are: height 6.2cm (5-8), 2.5cm wide (1.5-4). It contains a right hepatic artery arising from the superior mesenteric artery in 13.3% of cases. Microscopic examination revealed areolar tissue, adipose tissue, peripheral nerve, nerve plexus, lymphatics and capillaries. However, fibrous sheath and fascia were not found around these structures. Conclusion: A right hepatic artery arising from the superior mesenteric artery is a frequent anatomic variation. Surgeons must be aware of this to ensure the integrity of the hepatic artery blood supply in patients treated by pancreaticoduodenectomy. Despite controversy about the reality of the mesopancreas (postulated in analogy to the mesorectum), because of the absence of fibrous sheath or fascia, its complete removal in pancreatic head carcinoma is feasible by a subadventitial dissection of the superior mesenteric artery which can be considered as the real limit of the mesopancreas. © 2013 Surgical Associates Ltd.

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