HCV and HBV infections and diabetes are the main determinants of HCC development in North Africa. An active surveillance and secondary prevention programs for patients with chronic hepatitis and nutrition-associated metabolic liver diseases are the most important steps to reduce the risk of HCC in the region.
Introduction: The rupture of a hydatid liver cyst in the portal system is an exceptional complication. It has been reported only few observations in the world literature. We report a case a patient that we operated on for a complicated hydatid liver cyst.
Observation: This is a 46-year-old patient, a professional driver with a hunting dog hospitalized in the surgical department for obstructive jaundice. Abdominal ultrasonography, computed tomography and magnetic resonance imaging diagnosed 3 hydatid cysts in stage III of Gharbi accompanied by partial thrombosis of the portal vein with an absence of visualization of its right branch. The exploration operation revealed the existence of 3 hydatid cysts that communicate with each other and destroy half of the right liver. At the end of the total cystectomy, a communication of the cyst with the right branch of the portal vein was highlighted and the evacuation of the daughter vesicles followed by a major hemorrhage. The daughter vesicle was evacuated and the right branch of the portal vein was ligated and the bile ducts drained by a transcystic drain. The postoperative complications were complicated by a biliary fistula which dried up on the 19th postoperative day. The patient was discharged from the service on the 30th postoperative day. Currently, he is on Albendazole tablet 400mg / day with well health. Conclusion: The rupture of a hydatid cyst in the portal system remains rare and its diagnosis is well established by modern examinations such as ultrasound, computed tomography and magnetic resonance imaging. The treatment involves surgery and Albendazole but remains quite difficult.
Introduction: Described for the first time by Frantz in 1959 [1], pseudopapillary solid tumors of the pancreas (PPSTP) and have been defined since 1996 by the WHO as solids and papillaries [2]. They are particular by their clear predominance occurring in young women (30 years on average) and their good long-term prognosis [3]. Their positive diagnosis is often based on modern morphological examinations such as computed tomography and MRI. Surgery occupies a prominent place in their therapeutic management and all importance must be given to their diagnosis or at least their strong presumption in order to make curative surgical resection. We report seven cases all involve women, with an average age of 26.4 years (15-59 years). Radical surgery was performed in all cases with simple consequences in 5 patients and complicated in 2 others, including a pancreatic fistula and a pulmonary embolism. The histological study confirmed the diagnosis in all cases and the latter was supplemented by immunohistochemistry. In the long term, the seven patients are alive without recurrence at 100, 88, 78, 78, 74, 48 and 24 months. Conclusion: this form of pancreatic tumors has a good prognostic if well treated. The surgery is the best treatment. Clinician, radiologist, histologist and surgeon must know this disease.
Introduction: Endometrial sarcoma is a rare condition, affecting women in their 60s. If total hysterectomy associated with bilateral adnexectomy is the standard treatment and can control the disease when it is localized in the uterus, at the peritoneal localization stage its prognosis becomes more negative with reduced possibilities of resection and overall survival at 5 years, therefore, the same with rates close to 30%. We report two cases of endometrial sarcoma with peritoneal localizations managed with a multidisciplinary approach and in several steps or multimodal approach associating a cytoreduction preceded or associated with systemic chemotherapy and intraperitoneal chemotherapy. These two advanced tumours were cured with this approach and at the final step, no deposit tumor were present. The global survival is respectively of 28 months and 63 months.
Conclusion: this approach seems to be efficient in front of the advanced stage of endometrial sarcoma and we think that it must be adopted for a great number of patients to improve the survival and quality of life.
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