Duodenal adenocarcinoma is very rare. It represents 0.3 to 1% of all gastrointestinal malignancies. The symptoms are non-specific and vague, and the diagnosis is often delayed at an advanced stage. We report a case of duodenal adenocarcinoma in a 54-year-old female who was admitted to our hospital with chronic epigastric pain. Upper gastrointestinal endoscopy revealed a thickening narrowing the lumen in the second duodenal portion, which was diagnosed, using endoscopic biopsy. The computed abdominal tomography scan showed no lymph node or distant metastases, and cephalic pancreaticoduodenectomy was performed.
Background: Mauriac syndrome (MS) is a rare complication of type 1 diabetes (T1D). It is related to low insulin concentrations and is less common since longer-acting insulins became available. It is characterized by hepatomegaly, growth and puberty delay, and the presence of elevated transaminases and serum lipids. Case reports of patients with Mauriac syndrome are found infrequently in the literature given historic improvements in diabetes management due to readily available insulin therapy. Case: We report a case of Mauriac syndrome diagnosed in a 15-year-old male. The patient maintained poor glycemic control since childhood, presenting glycated hemoglobin persistently higher than 10% and recurrent episodes of ketoacidosis. He was referred for hepatomegaly evolving for 6 months. The clinical examination objectified a distended abdomen with hepatomegaly at 16 cm. Biological examinations showed hyperglycemia, major cytolysis and cholestasis anicteric. Support based on therapeutic education of the child and his family, as well as adequate insulin therapy have been established. The etiological investigation of hepatic disturbances was negative. The clinical and biological evolution was favorable. The diagnosis of hepatic glycogen storage disease was retained on a bundle of anamnestic and clinical arguments, in the absence of other anomalies responsible for the disturbances liverworts. The diagnostic certainty is histological, and the treatment is based on the equilibration of the diabetes. Conclusion: Although MS is an ancient entity described in T1D, it still exists, particularly in adolescent patients. Being aware of MS is of extreme importance since most of the clinical features are reversible with better glycemic control.
Since its declaration in December 2019, SARS-CoV-2 has been rapidly responsible for a major global pandemic. The disease is mainly characterized by respiratory symptoms; nevertheless digestive manifestations have been frequently reported. The objective of our study is to describe the epidemiological, clinical, evolutionary profile of diagnosed cases of COVID-19 with digestive manifestations. This is a retrospective bicentric descriptive study carried out in patients with COVID-19 at the Hassan II Hospital in Agadir and at the Mohammed VI University Hospital in Marrakech, from April 2020 to May 2021. Digestive manifestations are frequent and varied in patients infected with SARS-CoV-2. They may present as the main complaint or the only manifestation of the disease, leading to delayed diagnosis and increased risk of transmission. It has been noted that SARS-CoV-2 RNA can be detected in fecal matter for an extended period of time, even after respiratory samples have tested negative and patients are asymptomatic. Treatment of these symptoms is mandatory to prevent transmission of the disease and progression to complications that can worsen the prognosis.
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