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Doppler sonographic parameters of superior mesenteric artery are significantly correlated with disease activity in non-operated and non-complicated Crohn's disease.

Hydatid cyst of the adrenal gland (HCAG) is an exceptional occurrence. We report our experience of six cases of HCAG and discuss the diagnosis and treatment of this hydatid localization. We retrospectively reviewed and analyzed the clinical files of six patients admitted to our institution from January 1990 to December 2000 for HCAG. Patients varied in age from 24—59 years. They were five males and one female. One patient had a history of pulmonary hydatidosis treated surgically 10 years previously. Five patients presented with lumbar pain and one patient had bouts of hypertension, headache, and palpitation. Physical examination was normal except in one patient who was hypertensive. Preoperative diagnosis was highly suggested by ultrasonography. CT scan performed in all cases clearly showed the relationship of the cyst with adjacent organs. Serology tests were positive in two cases. One patient had elevated urine VMA and was operated on with the diagnosis of cystic phaeochromocytoma. All six patients were operated on and had either an adrenalectomy (two cases) or partial pericystectomy (four cases). In one case, partial pericystectomy was conducted through a retroperitoneal laparoscopic approach. The hydatid nature of the cyst was confirmed pathologically. All patients had a smooth postoperative course with no cystic recurrence on follow-up. The diagnosis of HCAG is based mainly on ultrasonography and CT scan. Surgery with either partial or total excision of the cyst, with or without preservation of the adrenal gland, is the treatment of choice.

Background. Intramural pregnancy is a rare form of ectopic pregnancy, difficult to diagnose and generally complicated by uterine rupture. Case. A 38-year-old woman, gravida 5 para 1, was diagnosed with intramural pregnancy by ultrasound and confirmed with MRI. A uterine rupture occurred, which lead to laparotomy and a conservative treatment. Conclusion. Early diagnosis is necessary for conservative treatment.

Cesarean scar pregnancy is a rare type of ectopic pregnancy associated with severe complications such as uterine rupture, uncontrollable bleeding which may lead to hysterectomy, and definitive infertility. Many therapeutic options are available such as Dilatation & Curetage, excision of trophoblastic tissues using either laparotomy or laparoscopy, systemically administered Methotrexate, and more recently uterine artery embolization. The use of Methotrexate sometimes required laparotomy later because of severe hemorrhage. Through this paper, we demonstrated that viable cesarean scar pregnancy can be managed safely by systemically delivered Methotrexate at the cost of a prolonged followup.

A case of intraprostatic cyst is reported. The patient presented with a completely evacuated hydatid cyst of the prostate. The intraprostatic cystic cavity that was communicating with the urethra developed urinary stones. The patient had transurethral resection of the prostate, the stones in the cyst were pushed into the bladder and fragmented using a ballistic lithotripter. Pathological examination concluded to a prostatic hydatid cyst that had evacuated through the urethra and was complicated by stone formation within the residual cavity. Postoperative course was uneventful and follow-up did not show evidence of recurrence. This is the first case of hydatid cyst of the prostate to present as an intraprostatic stone pouch.

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Pseudoaneurysms of the splanchnic arteries are rare causes of gastrointestinal bleeding. We report a case of a spontaneous gastroduodenal artery false aneurysm ruptured into the duodenum in a patient with hemophilia. The diagnosis was confirmed by spiral computed tomography and magnetic resonance angiography. The patient died from massive gastrointestinal bleeding.