Hydatid cyst rupture in peritoneal cavity is a rare complication. Imaging assessment has an important role in diagnosis but clinical signs are mandatory. A quick diagnosis and emergency surgery can decrease postoperative death. Surgery and postoperative care constitute the basis of treatment.

HighlightsGastroblastoma is a rare gastric biphasic tumor with both epithelial and mesenchymal components.To the best of our knowledge only eight cases have been reported in the English literature till date.Surgical excision remains the mainstay of treatment.

HighlightsAdenosquamous carcinoma is a rare colorectal tumor with both glandular and squamous histologic component.To the best of our knowledge only few cases have been reported in the literature till date.Adenosquamous carcinoma is a rare colorectal neoplasm with non-specific complaints.Its clinicopathologic behavior is not understood.Preoperative diagnosis is often difficult. Surgical resection remains the mainstay of treatment.

HighlightsIntrauterine devices (IUD) are effective, safe, and widely used contraceptive devices. Their use is about 14.7% in the developing countries and 8.9% in developed ones.The perforation of the uterus by the IUD is a relatively rare complication whose incidence is estimated between 1.3 and 1.6 per 1000 insertions, but the consequences can be very serious.Ectopic migration of IUD with involvement of adjacent organs can cause catastrophic complications such as gastrointestinal perforation.Ideal treatment of IUD migration remains controversial.

Context:Autoimmune pancreatitis is a particular type of pancreatitis of presumed autoimmune etiology, it is an entity distinct from all others forms of chronic pancreatitis, characterized by clinical, histopathological, radiographic, serologic and therapeutic features. This benign disease resembles pancreatic carcinoma both clinically and radiographically.Case Report:A 27-year-old man presented with obstructive jaundice and evocative image of pancreatic tumor. A pancreaticoduodenectomy (Whipple operation) was performed and pathological examination of the specimen diagnosed AIP. Patient responded well to a course of corticosteroids with resolution of clinical and biological disorders.Conclusion:Accurate and timely diagnosis of autoimmune pancreatitis is particularly important because steroid therapy is effective and pancreatic resection is not necessary.

Liver hydatid cyst with cystobiliary communication and superadded acute cholangitis is a serious clinical problem requiring the early diagnosis and surgery in the absence of endoscopic therapy.

A 22-year-old female, with no particular past medical history except for consumption of raw milk, was hospitalized with symptoms of severe epigastric pain, penetrating to the back and associated vomiting; symptoms were progressive over a one-month period. She had no other change in her general health. Examination revealed no signs of clinical tuberculosis (sweats, weight loss, hemoptysis). Laboratory findings and tumor markers were normal.Abdominal CT revealed a heterogeneous tumoral mass in the pancreatic isthmus and body, measuring 6 × 4.5 cm (Fig. 1); the mass appeared partially necrotic and there was extensive celiac mesenteric lymphadenopathy, infiltration of the peri-pancreatic fat, and moderate ascites. The peritoneum and omentum had a scalloped irregular border, particularly in the peri-colic gutters, and a nodule in the right iliac fossa was suggestive of peritoneal carcinomatosis.Diagnostic laparoscopy showed hypertrophy of the pancreas, mainly in the area of the isthmus and body, associated with numerous nodules studding the pancreatic capsule and peritoneum; this had the appearance of disseminated peritoneal carcinomatosis (Fig. 2). Biopsies of these nodules showed epithelioid granulomas with giant cells, diagnostic of pancreatic and peritoneal tuberculosis. The remainder of the diagnostic testing, including chest X-ray, and acid-fast staining of sputum and urine was negative. The patient was treated with quadruple antituberculous antibiotic therapy with isoniazid, rifampin, ethambutol, and pyrazinamide for 2 months, followed by another 6 months of two-drug therapy with isoniazid and rifampin. Follow-up abdominal CT at 3 months after initial therapy confirmed the disappearance of the pancreatic lesion; the pancreas was of normal size with homogeneous enhancement and conserved lobularity (Fig. 3). DiscussionOur case is a good illustration of the difficulties inherent in characterizing a deep mass by imaging. The images of this lesion were strongly evocative of a tumoral mass, despite the young age of our patient. Pancreatic tuberculosis is a rare entity and is usually associated * Corresponding author. Tel.: +216 98 63 93 53.

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