Synchronous occurrence of pheochromocytoma and pancreatic tumors is rare and considered as part of Von Hippel Lindau Syndrome. We herein report a such case that was managed by a two staged resection of the pancreatic tumor along with excision of bilateral pheochromocytomas and also discuss in detail our review of literature about this condition.

Gastro intestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastro intestinal tract [1] and account for 80 % of all GI tumors. Approximately 30% of GISTs are malignant [2]. Occurring throughout the entirety of the GI tract, GISTs most commonly present in the stomach or small intestine [3], Most GISTs present asymptomatically. They are best identified by computed tomography (CT) scan and most stain positive for CD117 (C- Kit). For localized, resectable tumors, surgical resection remains the cornerstone of treatment. For patients with locally advanced disease, preoperative imatinib can be used to help reduce tumor burden before resection [4]. We report the case of a 48 years old patient who presented a gastric stromal tumor invading the spleen, the pancreas and a portion of the left liver. After 6 months of néo adjuvant Imatinib therapy, the patient has undergone a longitudinal gastrectomy associated with splenectomy caudal pancreatectomy and left hepatectomy in which the evolution was favorable.

Leiomyoma is a benign soft tissue tumor of mesenchymal origin that derives from smooth muscle fibers [1, 2]. In the digestive tract, the anorectal location is uncommon and is usually diagnosed late due to intraluminal growth in over 50% of the cases [2]. We present the case of a 55-year-old woman who presented with a peri anal mass found more than 3 years ago. The 5cmx4cmx3cm mass was located in the left side of the anus, MRI revealed a clear demarcation between the mass and the external anal sphincter. Surgery was performed with a para-anal incision. The external anal sphincter was largely intact. A complete extracapsular dissection was performed.

Annular pancreas is a rare congenital condition in which a ring of ectopic pancreatic tissue partially or completely surrounds the second part of the duodenum [1]. This Congenital anomaly is usually presented in infants and newborn, rarely in adult life. It can present in a wide range of clinical severities making it difficult to diagnose. CT scan can illustrate the pancreatic tissue encircling the duodenum. Surgery still remains necessary to confirm diagnosis and bypassing the obstructed segment. We report the case of a 22 years old female patient who presented with history of vomiting and weight loss causing a stature weight growth delay, the diagnosis was made by the CT scan. Then the patient was scheduled for a gastroenteroanastomosis. The evolution was favorable.

Anticoagulant drugs are widely used for various purposes as a prophylactic agent or for treatment and its most common side effect is bleeding. Intramural hematoma of the small intestine due to use of high-dose anticoagulation is the most common form. Computed tomography (CT) is the most commonly used imaging method in diagnosis. Conditions requiring surgery are serious intraluminal bleeding, bowel perforation or the presence of ischemia.