Introduction and importance: A bezoar is an agglutination of ingested materials forming an indigestible and insoluble mass inside the gastrointestinal tract. Trichobezoars formed by ingested hair are rare. The stomach tends to be the typical location. In some cases there is an extension to the duodenum, jejunum or even to the colon and it is called Rapunzel syndrome. Case presentation: We present a case of an occlusion due to double trichobezoars in 17 years old woman who underwent an extraction by enterotomy and gastrotomy. Clinical discussion: Trichobezoar is a compact conglomeration of swallowed hair and makes up less than 6% of all bezoars. It appears in young women under 20 years of age who carry psychiatric or chronic metabolic diseases that can alter the behavioral balance. Physical examination is often poor in uncomplicated forms: forms without peritonitis or occlusion or hemorrhage or appendicitis or pancreatitis but it may reveal a well-limited, smooth, firm, and mobile epigastric mass. For uncomplicated forms or forms complicated by hemorrhage, the reference examination requested in the first line remains the esophagogastroduodenoscopy (EGD) which allows a dual role both diagnostic and therapeutic. Computed Tomography (CT) remains the preferred imaging modality requested urgently in case of an occlusion or peritonitis presentation. Endoscopic extraction represents the therapeutic approach for uncomplicated forms but surgical treatment remains the main therapeutic means of trichobezoar. Conclusion: Trichobezoars are rare and present both diagnostic and therapeutic challenge. Laparotomy remains the most successful surgical treatment although laparoscopy currently appears to have promising results in expert hands. A post-operative pscychologic management is essential to correct psychobehavioral disorders of patients to prevent recurrence.

INTRODUCTION:Intramural duodenal hematoma is a rare entity, often secondary to traumatic origin, but more rarely spontaneous due to blood flow disorders, especially in the context of anticoagulant therapy.CASE PRESENTATION:We report the case of a 66-year-old woman under anticoagulant treatment for atrial fibrillation, who was diagnosed with acute pancreatitis secondary to a spontaneous duodenal hematoma. The evolution was favorable under medical treatment.DISCUSSION:Intramural duodenal hematoma is frequently associated with abdominal pain and hematemesis, more rarely, it can be responsible for an acute pancreatitis, which is considerate as an unusual complication. We report here a case of duodenal hematoma revealed by acute pancreatitis along with a review of the literature since 2011.CONCLUSION:Monitoring of patients on oral anticoagulants helps prevent the occurrence of IDH and avoid its complications, which can be fatal.

Inertial Measurement Units (IMU) are in highlight for joint and motion monitoring applications. Several IMU sensor fusion algorithms have been proposed in literature. Kalman Filter and its variants are the most used for more precision. However, they are computationally expensive. However, for faster computations, researchers and industry use complementary filter. More recently, a new variant of Kalman Filter was introduced as a Double Stage Kalman Filter in order to reduce the Kalman Filters computation cost. Our research investigates the performance of the Complementary and Double Stage Kalman filters in monitoring of joints in serial manipulators using Microelectromechanical-system MEMS based IMU. This study carried dynamic experiments using a serial robot to estimate the orientation of IMU, thus the joint angle of the associated segment. The study showed that both filters yield accurate estimations. The study showed also that Double Stage Kalman Filter has lower RMSE and achieves more precise estimates than Complementary filter mainly when the movement is around IMU x- and y- axis. Our findings indicate that the Double Stage Kalman Filter can achieve higher precision than the complementary filter using lower computation time than the former variants of the Kalman Filters in serial manipulator joint monitoring applications.

INTRODUCTION:Gastrointestinal stromal tumors (GISTs) usually develop in the stomach and small intestine and only rarely occur in the ampulla of Vater (AV).CASE PRESENTATION:We report a case of a GIST of the AV. A 21-year-old, previously healthy woman presented with a three-month history of epigastric pain, jaundice and weight loss. The diagnosis of a tumor in the second part of the duodenum was made by the computed tomography. The patient underwent pancreatoduodenectomy, the operative specimen revealed an intermediate risk group of GIST and thus, the patient didn't take adjuvant therapy.DISCUSSION:GIST rarely develops in the duodenal ampulla region and it has no specific symptomatology. Radiological investigations play an important role in the diagnosis of Stromal Tumor of the Ampulla of Vater (STAV) mainly computed tomography because STAV has a large size in the majority of cases contrary to adenocarcinoma.CONCLUSION:The aim of this study is to report a new case of STAV combined with a systematic review of reported cases published in peer-reviewed journals.

Enterobiusvermicularis is the most common parasitic infection. In some cases, it can cause appendicitis. Pinworms have been seen escaping into the peritoneal through the appendix. we report rare case illustrating Pinworms in the peritoneal cavity during laparoscopic appendicectomy

Cutaneous metastases of visceral tumours are uncommon and might have umbilical and/or extra umbilical locations. The umbilical location, also named "Nodule of Sister Marie-Joseph" among 7 to 9% are secondary to a pancreatic tumour. In this article, we reported a case of a 50-years-old man presenting pancreatic cancer discovered by umbilical nodules and weight loss noticed 3 months earlier treated by palliative chemotherapy. We report this case of rare presentation of cutaneous metastases of pancreatic disease to insist on its bad prognosis level. Keywords: Cutaneous metastasis; pancreatic cancer; chemotherapy; nodule of Sister Mary Joseph

This paper describes our results of the AMNS modular multiplication algorithm for efficient implementations of ECC over 𝔽_p on the Hardware/Software (HW/SW) implementation in FPGA. We provide both arithmetic operators and computation architectures optimized for high speed. We also compare our results with the implementation of the CIOS method for modular multiplication.

Introduction: Corrosive esophagitis following caustic agent ingestion remains a significant medical and social concern in Tunisia. Secondary stricture is the most challenging complication. The aim of this study is to determine the incidence of caustic esophageal injuries and to highlight the characteristics of the management. Methods: Over a 20 years period, we conducted a retrospective and descriptive study about 164 consecutive patients presented to our department following ingestion of caustic agents. Results: The mean age was 26 years (16-87) with a gender ratio of 0.2. The ingestion was accidental in 58% of cases and as a suicidal attempt in 42%. Bleach largely dominates ingested solutions in 78.3 % of cases. The delay of the consultation was less than 12 hours in 98.4% of cases. We noticed gravity signs in eight patients. Lesions in Esophagoscopy were recorded in 62 patients (37.8%). The esophageal injury assessed as grade I in 36 patients, grade IIa limited lesions in 10 patients, grade IIa extensive in 8 patients, grade IIb in 5 patients and grade III in 3 patients. During the follow-up, 26 patients (41.9%) had a second assessment during the secondary stage, only 4 patients (2.4%) presented esophageal strictures. Three patients underwent coloplasty for esophageal replacement. Conclusion: During a 20-year period, 164 cases of caustic ingestion were reported. Constituted esophagitis injuries were noted in 37.8% and strictures in 6.45% of all cases.

The Textiloma is secondary to the omission and retaining of textile foreign bodies following surgical procedures. It is still one of the most frequent medical errors. Different clinical presentations and complications have been reported worldwide. hereby we report a case of intra-abdominal Textiloma diagnosed nine year after open cholecystectomy presenting as huge abdominal cyst.

BACKGROUND: A Spigelian hernia is rare. Diagnosis and treatment remain controversial, mainly because of its unusual presentation. The aim of this study was to report the outcomes of open treatment of eight rare cases and to evaluate our experiences in managing this condition. PATIENTS AND METHODS: We performed a retrospective and descriptive study about operated patients for Spigelian hernia in our department of surgery between 2002 and 2016. RESULTS: Eight patients were enrolled. The mean age was 52.25 years. There was a female predominance. All cases presented hernia risk factors. A painful abdominal mass presented the reason for consultation in four cases. Two of our patients had an associated inguinal hernia and one other had an umbilical hernia. In three cases, the hernia was strangulated. The diagnosis was confirmed by clinical examination in two cases and using radiological examinations in six cases. The content was a small bowel in four cases, epiploic in three cases, and colic in one case. A sublay mesh repair was performed in five cases and a primary suture in three cases. No recurrences were detected after 2 years of follow-up. CONCLUSION: Spigelian hernia is underestimated. Open sublay mesh repair is feasible and safe. It ensure a great short and long term results. The open approach is feasible and safe to treat this condition.

Peptic ulcer complication has decreased over le last years. Spontaneous bilio-digestive fistulas, in the absence of primary biliary disease, remain a very unusual complication of the upper digestive tract. The choledochoduodenal fistula is an extremely rare entity which can be caused by a duodenal peptic ulcer. It appears with the symptoms of peptic ulcer disease. They are diagnosed incidentally on radiological exams. It was suspected after finding pneumobilia on abdominal ultrasound and confirmed by X-barium meals study. The purpose of this observation is to report the case of a patient presenting a choledochoduodenal fistula diagnosed by X-barium meal to underline the importance of this radiological exam to diagnose this disease and to insist on the conservative treatment for choledochoduodenal fistula caused by a duodenal peptic ulcer. The prognosis of patients treated medically is good, although the fistula can remain asymptomatic. Angiocholitis and biliary sequelae remain rare and do not warrant prophylactic surgical treatment.

Right diaphragmatic post-traumatic rupture with liver herniation is an extremely rare condition. The diagnosis is mainly radiological and the rupture may go unnoticed in the acute setting.Depending on the size of the right diaphragmatic defect, the initial herniation can be partial and the total hepatothorax is established progressively.The diagnosis may be delayed and made with the onset of the first symptoms. Hepatothorax leads usually to severe right lung atelectasis with respiratory and cardiac impairment.Definitive treatment consists in surgical repair of the diaphragm. We present hereby the case of an hepatothorax diagnosed 4 years after a penetrating thoracoabdominal trauma.Key words: Trauma, diaphragmatic rupture, hepatothorax.

It is commonly admitted that laparoscopic surgery has the advantage of abdominal wall preservation. Therefore, having port-site incisional hernia caused by trocars of laparoscopy must be avoided. The aim of this work is to specify predictive factors, therapeutic modalities and to insist on prevention of this avoidable complication. It is a retrospective and descriptive study over a period of 10 years, between January 2006 and December 2015. This series includes 19 consecutive patients who present port-site incisional hernia. Age, initial intervention, site and size of the trocars incisional hernia, diagnostic method, delay and type of the second procedure with the final results were examined and recorded. Our study contains 19 female. The average age was 55 years (29-78). Risk factors were resent in 12 patients. All our patients were operated initially by laparoscopic approach. The average onset time was 6.6 months (3-12). Fourteen patients presented swelling at the trocar site and 5 patients had an emergent surgery due to the strangulation of the port-site incisional hernia. For these five patients a primary suture was made. Hernia content was the great omentum in 11 cases and small bowel in 8 cases. It was umbilical in 16 patients and in the left flank in 3 patients. They occur all where it was placed a 10 mm trocar. The evolution was suitable in all cases. There were two recurrences, one after primary suture and the other after a mesh repair. Port-site incisional hernia is rare. The most incriminated risk factors are essentially trocar size, obesity and open coelioscopy. Vital prognosis can be engaged if port-site incisional hernia is incarcerated or strangulated then prevention is necessary.

Background: Hydatid disease is a worldwide zoonosis and is localized in the liver in most cases. Biliary rupture and infection are the most common complications of hydatid liver. Simultaneous biliary and colonic fistula is uncommon. Clinical diagnoses is difficult, however, ultrasound echography and abdominal computed tomography (CT) scan can detect these complications. Case Presentation: Our case was diagnosed by a peri-operative trans-cystic cholangiography showing simultaneous opacification of liver hydatid cyst and the right colonic angle. The decision was to disconnect the kysto-colonic fistula and create colonic stoma on the colic defect followed by drainage of the residual cavity. The course was marked by the death of the patient after four days caused by respiratory and renal failure. Conclusion: This abnormal communication is always secondary to hydatid-cyst infection caused by hydatid cyst-biliary fistula. Surgical treatment is sometimes difficult and prognosis depends on the gastrointestinal organ affected.