We decided to report a case of gastrointestinal stromal tumor of the small intestine in a patient with neurofibromatosis type 1 because of the increase of its incidence as shown in the literature, also, by its revelation; its occurrence in a picture of acute peritonitis due to the rupture of the tumor. These tumors, commonly called by their English acronym GIST (Gastro-Intestinal Stromal Tumors), found in people with neurofibromatosis type 1 generally occur in the small intestine and are often multiple.

This case report describes a 52-year-old man who had undiagnosed and poorly managed celiac disease, and presented with acute peritonitis. Further examination revealed a rare complication of celiac disease, which was a T-cell lymphoma of the gastrointestinal tract. Imaging is important in confirming the diagnosis and chemotherapy is the main treatment option.

Case Report Taking into account the frequency, morbidity and mortality of peritoneal adhesion, they constitute a real public health problem in both developed and emerging countries. Small bowel obstruction (SBO) due to postoperative adhesions is their main presentation. We report a case of patient admitted to the emergency department after a 5 hours-onset small bowel obstruction with a history of appendectomy 5 years ago. According to the onset of symptoms, hemodynamic stability and normal blood tests, we choose a non-surgical management. With the hemodynamic deterioration non resolution of the obstruction the patient was operated. Postoperative adhesions are currently the main cause of acute small bowel obstruction. The most effective prevention way is the respect of the general principles of abdominal surgery.

BACKGROUND:The liver is the most commonly damaged organ in abdominal trauma. The management of liver trauma has experienced many changes over the last two decades. Currently there is a trend toward a non-operative treatment warranted by the successful pediatric experience and better results recorded in many trauma centers worldwide. This study aimed to evaluate outcomes of operative and non-operative management of liver trauma in our institution over the last five years. METHODS:The patients with a diagnosis of blunt or penetrating liver injuries, admitted and managed in our hospital from January 2012 to December 2016 were retrospectively studied. The patients were divided into 2 groups, operated and non-operated groups, according to the initial management considered appropriate at the time of patient admission. Clinical features and outcomes were analyzed. RESULTS:The study involved 83 patients, with a mean age of 33 years and a marked male predominance (85.5%). The most common type of lesions was blunt trauma and the main cause was road traffic accidents. Sixty-eight liver injuries (81.9%) were of low severity (grades I, II, III), while 15 (18.1%) were of high severity (grade IV or greater). Fifty-six patients (67.5%) had multiple injuries. Surgical treatment was performed in 26 (31.3%) patients. Non-operative management was undertaken in 57 cases (68.7%). The morbidity and mortality rates were clearly lower in non-operative patients compared to those in the operated group. CONCLUSIONS:Careful non-operative management is an adequate therapeutic strategy for the patients suffering from liver trauma with stable hemodynamics. Patients with complex hepatic trauma and especially those with other organ injuries continue to have significantly higher mortality.

Background Neurofibroma is a rare benign tumor. The isolated presence of such lesions in the preperitoneal space with no evidence of systemic disease has never been reported in the literature. Case presentation A 29-year-old white man presented with a 12 months history of progressive abdominal distension. Clinical examination revealed a bulky hypogastric mass. Abdominal computed tomography and pelvic magnetic resonance imaging showed a large, well defined preperitoneal tumor measuring 18 x 17cm extending in the pelvis. A computed tomography guided biopsy was performed which revealed a neurofibroma. Exploratory laparotomy showed a well encapsulated elastic soft tumor in the preperitoneal space which measured 17 x 18cm and weighted 2 Kg. The tumor was completely excised. No recurrence occurred after one year of follow-up. Conclusion Solitary preperitoneal neurofibroma is an extremely rare benign tumor. Its clinical and radiological signs are nonspecific. Preoperative histology can be useful to guide the surgical approach which is the only curative treatment.

Undifferentiated pancreatic carcinoma with osteoclast-like giant cells (UPC-OGCs) is a rare neoplasm with frequency of 0.2 % of reported pancreatic carcinomas [1]. Tumors with osteoclast-like giant cells have rarely been reported in a variety of extra-skeletal sites. On the alimentary tract, the pancreas is the most concerned [2, 3]. A number of terms have been used to describe variants of undifferentiated pancreatic carcinoma, especially pleomorphic carcinoma, pleomorphic giant cell carcinoma, sarcomatoid carcinoma, spindle cell carcinoma, anaplastic carcinoma, undifferentiated carcinoma, and osteoclastic or pleomorphic giant cell tumors [4]. Histologically, the tumor combines two main cell populations, a malignant mononuclear cells population and the scattered nonneoplastic osteoclast-like giant cells [3, 5]. Since the first description by Rosai in 1968 [6], there have been only a few cases reported in the world literature. Our aim is to describe a new case of undifferentiated carcinoma of the pancreas with osteoclast-like giant cells which was early diagnosed, with a review of literature.

Peritonitis encapsulante or sclerosing encapsulating peritonitis is diffuse peritoneal fibrosis may develop into a true sclerosis, or a hull sheathing peritoneal intestinal loops commonly found in a cocoon during laparoscopy or laparotomy. His diagnosis but especially pre-operative enables the surgeon to treat the patient optimally. The main etiologies are peritoneal dialysis,intraperitoneal chemotherapy, infections. We report a case of peritonitis encapsulating complicated of occlusion to a patient monitoring for tuberculosis peritoneale and discuss its main clinicaland etiopathogenic.

La péritonite encapsulante ou sclérosante est une fibrose péritonéale diffuse pouvant évoluer vers une véritable sclérose voire une coque péritonéale engainant les anses intestinales dans un cocon découvert fréquemment lors des laparoscopies ou laparotomie. Son diagnostic surtout prémais aussi opératoire permet au chirurgien de traiter le patient de façon optimale. Les principales étiologies sont la dialyse péritonéale, la chimiothérapie intra péritonéale, les infections. Nous rapportons une observation d’une péritonite encapsulante et nous discutons ses principaux aspects cliniques et étiopathogéniques

Nous rapportons l’observation d’une tumeur papillaire solide de la tête du pancréas découverte à l’occasion des douleurs abdominales chez une femme de 27 ans. Les caractéristiques échographiques et scannographiques de la lésion ne permettaient pas d’assurer un diagnostic étiologique de certitude. Le pronostic est bien meilleur que celui des autres tumeurs pancréatiques. Le traitement est exclusivement chirurgical.

Introduction: Sigmoid volvulus during pregnancy is an extremely rare complication with fewer than 76 cases reported in the literature.Observation: We report a case of sigmoid volvulus complicating pregnancy. A 23-year-old primigravida presented during week 37 with an intestinal obstruction and abdominal pain. An exploratory laparotomy revealed a volvulated, gangrenous, massively distended sigmoid colon. The sigmoid colon was resected and Hartmann's colostomy was performed. The patient made a successful recovery.Discussion: Sigmoid volvulus complicating pregnancy is an uncommon and potentially devastating development that should be suspected in cases of worsening abdominal pain and evidence of bowel obstruction. Prompt intervention is necessary to minimize maternal and fetal morbidity and mortality.

Le volvulus du sigmoïde au cours de la grossesse est très rare, environ 76 cas ont été décrits dans la littérature mondiale.

INTRODUCTION:Leiomyosarcomas account for approximately 75% of all gastrointestinal sarcomas but only 8-10% of duodenal malignancies. Pain and bleeding are the principal symptoms. Prognosis of these tumors is difficult to assess. If excision is successful, however, prognosis is usually good. We report the case of a patient with leiomyosarcoma of the duodenum first identified because of gastrointestinal hemorrhage.CASE:We report the case of a 57-year-old women who underwent duodenopancreatectomy for duodenal leiomyosarcoma. Histological and immunohistochemical findings confirmed the diagnosis of low-grade leiomyosarcoma and ruled out a gastrointestinal stromal tumor.DISCUSSION:Duodenal leiomyosarcomas are very rare. Preoperative diagnosis is difficult. The combination of a mass and a hemorrhage must suggest the presence of leiomyosarcoma. Radiological and endoscopic findings may not be conclusive: only histologic examination provided the definitive diagnosis here. Many criteria have been used to assess prognosis; complete resection appears to be the principal prognostic factor and is associated with improved survival.

Introduction > Leiomyosarcomas account for approximately 75% of all gastrointestinal sarcomas but only 8-10% of duodenal malignancies. Pain and bleeding ore the principal symptoms. Prognosis of these tumors is difficult to assess. If excision is successful however prognosis is usually good. We report the case of a patient with leiomyosarcoma of the duodenum first identified because of gastrointestinal hemorrhage.Case > We report the case of a 57-yeor-old women who underwent duodenopancreatectomy for duodenal leiomyosarcoma. Histological and immunohistochemical findings confirmed the diagnosis of low-grade leiomyosarcoma and ruled out a gastrointestinal stromal tumor.Discussion > Duodenal leiomyosarcomas ore very rare. Preoperative diagnosis is difficult. The combination of a moss and a hemorrhage must suggest the presence of leiomyosarcoma. Radiological and endoscopic findings may not be conclusive: only histologic examination provided the definitive diagnosis here. many criteria hove been used to assess prognosis; complete resection appears to be the principal prognostic factor and is associated with improved survival.

A 70-year-old woman with cardiac arhythmia, presented a 2-day history of persistent vomiting bilious fluids. The physical examination revealed a distended abdomen. Full blood examination was unremarkable. Small bowel contrast study revealed a pneumobilia and cholecysto-duodenal fistula (Fig. 1). CT scan showed the presence of a large calculus in the distal jejunum (Fig. 2). At laparotomy, the gallstone was extracted by means of a longitudinal enterotomy (Fig. 3), which was then closed transversely. The cholecysto-duodenal fistula was left intact. The follow-up was simple.

Although intussusception is relatively common in children, it is clinically rare in adults A 54-year-old woman who presented with cramping abdominal pain and rectal bleeding was found to have sigmoid rectal intussusception secondary to adenomatous polyps of the sigmoid colon. Following confirmation of intussusception by CT scan, surgical resection was performed after manual reduction.