Background Lymphoma and dysplasia are rare complications of long-standing Crohn’s disease. We report an exceptional case of a synchronous intestinal marginal zone B-cell lymphoma (MALT lymphoma) and colonic adenoma in a Crohn’s disease patient. Case presentation A 50-year-old male patient presented with right lower quadrant for the last 9 months. He also had associated weight loss and diarrhea alternating with constipation. Ileo-colonoscopy revealed a pseudopolypoid appearance of the colonic and ileal mucosa with many discontinuous ulcerations with a 3 cm sessile polypoid mass at 17 cm from the anal verge. Histological examination of the polypoid lesion revealed an adenoma with high grade dysplasia, while the biopsies of colonic mucosa showed histologic features of Crohn’s disease. Abdominal computed tomography scan (CT scan) and magnetic resonance imaging (MRI) showed circumferential wall thickening of the colon and ileum, enlarged mesenteric lymph nodes and a sessile polypoid mass of the rectosigmoid junction. The patient was scheduled for an ileocoletectomy with resection of the upper rectum and ileorectostomy. The histological examination of the resected segment showed histologic features of Crohn’s disease, a recto-sigmoid polyp with high grade. dysplasia and extensive small lymphocytic infiltrate in both colonic and ileal wall which is strongly stained by CD20 and BCL2. The diagnosis of MALT lymphoma with adenoma on a background of Crohn’s disease was made. The patient successfully completed 8 cycles of Rituximab+ chlorambucil chemotherapy. Nowadays the patient is asymptomatic without evidence of lymphoproliferative recurrence 10 months after surgery. Conclusion We report the first case in the literature of Malt lymphoma with colonic adenoma associated with Crohn’s disease, and discuss his unique macroscopic and histological features in a patient. Without immunosuppressive therapy.

Liver is most commonly involved organ in hydatid cyst. Primary splenic hydatid cysts are rare; we report a case of an isolated giant hydatid cyst of spleen in a 17-year-old man. The diagnosis was confirmed by imaging findings and serology. Partial cystectomy was performed with success. In cystic lesions of spleen, hydatid cyst should be kept in patrician’s mind in the differential diagnosis. Although splenectomy is the gold standard for treating hydatid disease of the spleen, in young patient spleen-preserving surgery seems give good results.

OBJECTIVE: Non-alcoholic fatty liver disease (NAFLD) is recognized as a common cause of chronic liver disease worldwide. Its association with type 2 diabetes mellitus (T2DM) is known to increase the risk of degenerative complications of diabetes and the likelihood of developing severe hepatic injuries. The objective of this study was to assess the prevalence of NAFLD and to describe the characteristics of its association with T2DM. METHODS: This was a descriptive analytical study, involving patients with T2DM with no history of alcohol consumption, viral hepatitis, hepatotoxic medications, or other chronic liver diseases. The patients underwent an investigation of NAFLD including abdominal ultrasound, non-invasive biomarkers of liver fibrosis, elastography and ultrasound-guided liver biopsy. RESULTS: We collected data from 180 patients with a mean age of 59.3 ± 10.9 years with strong female predominance. The mean duration of diabetes progression was 9.2 ± 7.3 years. Hepatic sonography showed signs of NAFLD in 45.6% of cases. Non-invasive hepatic biomarkers indicated significant fibrosis in 18.3% of cases. Overall, 21% of patients underwent an elastography evaluation, revealing severe fibrosis or cirrhosis in 15.4% of patients. The diagnosis of NASH (Non-alcoholic steatohepatitis) was confirmed histologically in 3 patients. The overall prevalence of NAFLD was 45.6%. Patients with NAFLD had a statistically significant incidence of obesity, metabolic syndrome, hypertension, dyslipidemia, macrovascular complications, and hypertriglyceridemia (p < 0.05). CONCLUSIONS: The combination of NAFLD and T2DM is often found in patients with obesity or metabolic syndrome. The presence of NAFLD can be responsible for increased morbidity and important cardiovascular risks in patients with T2DM.

We report the case of an immunocompetent patient with an isolated tuberculoma of the liver, which was diagnosed by percutaneous US-guided liver biopsy. The patient received an antitubercular therapy, and there has been no relapse to date.

Gastric cancer constitutes one of the leading causes of cancer incidence and mortality in the worldwide despite its decline over the past century. In this article we will first review descriptive epidemiology of gastric cancer. Next we will discuss its precursors and risk factors; the principal risk factors of stomach cancer are HP Infection, smoking, high salt intake and genetic factors. Finally we will discuss screening strategies and prevention of gastric cancer.

Aim: The study aims were to evaluate and compare the effectiveness and safety of non-bismuth quadruple therapy with sequential therapy and dual therapy with high dose esomeprazole and amoxicillin as an empirical first-line approach to eradicate Helicobacter pylori infection. Patients and methods: Prospective randomized trial included 393 patients infected with H. pylori naïve to eradication therapy, randomized to receive a 10-day non-bismuth quadruple or concomitant (CT) therapy, 10-day sequential therapy (SQ), or 14-day high-dose esomeprazole and amoxicillin (BT). Treatment outcome was assessed by C13-urea breath test at least six weeks after therapy. Adverse events and compliance were assessed with questionnaires and residual medication count. Results: The baseline demographic clinical and endoscopic characteristics were similar among the three groups. The intention to treat (ITT) analysis was performed in 130, 132, and 131 patients in the BT, SQ, and CT groups, respectively. The eradication rates in ITT were 64.6%, 83.1%, and 92.3%, respectively, in the BT, SQ and CT groups (p = 0.0001). The eradication rates per protocol were 67.7%, 88.5%, and 95.3% (p = 0.0001), respectively, in the BT, SQ, and CT groups. The CT and SQ groups were higher than the BT group (p = 0,0001) but no significant results were seen in the eradication rate between CT and SQ, both in PP analysis and in ITT analysis (p = 0.09). The prevalence of the side effects following the non-bismuth quadruple therapy was 38.2%, significantly higher (p = 0.001) than the BT group (13.80%) and SQ group (22%). There were no significant differences in compliance among the three therapies (p = 0.16). Conclusion: This study found that non-bismuth quadruple therapy yielded a higher H. pylori eradication rate over sequential regimen as a first-line treatment in Morocco, with no statistical difference between the two protocols studied, while the eradication rate of dual high-dose of esomeprazole and amoxicillin did not exceed 60%. All three therapy schemes showed excellent compliance. However, the prevalence of side events was more important and significantly higher with non-bismuth quadruple therapy.

Background. Basilar thrombosis is a potentially fatal event, whose traumatic etiology has been repeatedly stated. Methods. We performed the autopsy and the microscopic examination of the brain stem structures from an individual, whose sudden death raised logical suspicions regarding the causative factor. Results. The brain was swollen and clearly hyperemic; a massive basilar thrombus with complete occlusion of the median segment of the basilar artery was macroscopically seen. The brainstem showed an infarcted zone in the pons, with secondary hemorrhagic changes, mainly in the form of multiple petechial hemorrhages. Pontine arteries showed extensive alterations, mainly in the form of severed endothelium, which suggested a thrombotic-traumatic mechanism as the main etiological factor. Conclusions. Minor injuries, such as slight whiplashes, abrupt neck movements, neck trauma related to the slowing down of the vehicles, and critical neck positioning, can all of them explain a thrombotic event in the basilar artery, leading to a fatal occurrence. Other risk factors may obviously concur, but their importance seems unclear.

Viral hepatitis is a serious public health problem. Its epidemiology is not precisely known in Morocco. Our objective was to assess the prevalence of HBV and HCV in a particular population of “blood donors” at the Regional Blood Transfusion Centre in Oujda. A retrospective study was conducted from May 1, 2013 to May 31, 2015. Thirty-one thousand nine hundred and fifty-two blood donors were tested. Antigen detection was made according to ELISA technique (MonolisaTMHBs Ag ULTRA). HCV research was performed by ELISA using the kit « Monolisa HCV Ag-Ab ULTRA ». 177 blood donors included, they are divided into 155 male (87.6%) and 22 female (12.4%) subjects with a ratio of 7. The average age was 37.64 ± 12 years. Six cases were positive for HCV with an overall prevalence of 0.02%. The population study by sex shows a prevalence of 0.004% for 23177 male sera and 0.057% for 8775 female sera. Six donors were HCV positive, of which 05 were female (83.33%) and one was male (16.66%). The average age was 43 ± 14 years. Co-infection with HCV HBV-HCV and HCV-Syphilis and HCV-HIV are absent. Co-infection with HBV and HIV was found in one case. HBV-syphilis co-infection was found in 04 cases. Chronic viral hepatitis is a real global health problem. Its prevalence is currently estimated at 0.55% for HBV and 0.02% for HCV, reclassifying Morocco as a low endemic area. The prevention remains the most effective method to successfully control HBV and HCV infection.