The authors report an observation of a 20-year-old patient, who was referred by the medical emergency department for abdominal distention. The disease would have started with the appearance of abdominal pain, a stop of materials without stopping gases appeared gradually and evolving for 4 months. The patient was chronically constipated. She administered daily enemas with homemade products to have a bowel movement. She never had rectal bleeding, there was no alteration diarrhea-constipation. Mother of 3 children alive and apparently healthy. On clinical examination the abdomen was enlarged in size, painless but of firm consistency. The hernial orifices were free. Hard and abundant stools were noted on digital rectal examination. The abdominal CT scan revealed a large endorectal fecal impaction going up into the left colon, an absence of abdominal mass. We retained the diagnosis of giant fecal impaction. The patient was hospitalized and we instituted paraffin oil therapy combined with an evacuator enema with glycerin. The evolution was marked by a resumption of transit in the form of stool and gas (3 to 4 stools per day). At Day 8 of hospitalization the abdomen had decreased in volume the transit was regular and the patient was discharged on Day 10. Reviewed 3 months later, she maintained a regular transit made of one bowel movement a day. After a setback of 3 years the transit is still preserved. The authors discuss the etiologies of fecal impaction and their respective treatments.
Hydatid cyst of the liver (KHF) is a parasitic condition caused by the development of the larval form of the dog tapenia Echinococcus granulosus. In sub-Saharan Africa, few writings are interested in this pathology, which remains common and constitutes a public health problem in highly endemic countries [1] [2]. We report the observation of a 61-year-old hypertensive patient owner of a dog admitted for abdominal pain without abdominal mass. In whom ultrasound and computed tomography have made it possible to make the diagnosis of hydatid cyst of the liver (KHF). The patient underwent surgery. We performed an associated conservative treatment post-operative albendazole. The post-operative follow-up was simple. In our patient the evolution was good after a setback of more than 2 months. Through this observation and a review of the literature, we insist on the contribution of imaging in diagnosis and treatment, which is essentially surgical.
Foreign bodies are a rare cause of appendicitis, because in most cases these ingested foreign bodies cross the digestive tract asymptomaticallyHowever, some penetrate the lumen of the appendix causing its inflammation. We report an unusual observation of acute appendicitis induced by a foreign body namely a bone fragment in the visceral surgery department of the Centre Hospitalier Intercommunal de Villeneuve Saint-Georges.
Wandering or ectopic spleen is a rare congenital or acquired abnormality due to a defect in the anatomical fixity of the spleen with the surrounding organs. Pedicle twisting is its most common complication. It is an anatomo-clinical entity most often described in children, but rare in adults. It is a serious condition, especially when it occurs on a pregnancy putting at stake maternal and fetal prognosis. Authors report a case of acute volvulus of wandering spleen in a 26-year-old patient admitted for abdominal pain on an active pregnancy of 15 weeks of amenorrhea. Abdominal ultrasound scan helped to set the diagnosis. At laparotomy, the enlarged spleen was in an ectopic position, in the iliac fossa with a pedicle abnormally twisted in several spiral turns. Splenectomy was performed. The post-operative period was simple and the pregnancy progressed well to term.
Introduction: Vaginal hydrocele is an amber-colored, sterile collection found between the parietal and visceral testis. It is said to be giant when it is larger than the patient's skull or when it contains more than two liters of liquid. Objective: To report our method and the result of the surgical treatment. Observation: The authors reported an observation of a 50-year-old patient who consulted for a painless large left bursa. Clinical and paraclinical investigations, in particular scrotal ultrasound, have made it possible to diagnose a giant hydrocele of the vagina. The patient had surgical treatment which consisted of resecting of the vagina with hemostatic suture of the resected vaginal slice. The post-operation effects were not complicated. After a six-month setup, we did not notice any recurrence. Conclusion: Resection of the vagina with hemostatic suture of the resected vaginal slice in case of giant hydrocele could certainly give good results.
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