Les paragangliomes rétropéritonéaux non fonctionnels sont des tumeurs rares. Ils sont définis comme des tumeurs chromaffines extra- surrénaliennes et représentent environ 1/5ème des tumeurs chromaffines. Ils sont souvent asymptomatiques et peuvent atteindre des dimensions importantes. Nous rapportons l'observation d'une patiente âgée de 34 ans opérée pour une tumeur rétropéritonéale géante et dont l'examen anapath a conclu à un paragangliome. Les formes malignes, plus fréquentes que les formes bénignes, présentent un envahissement locorégional et métastasent tardivement. La prise en charge des paragangliomes doit être multidisciplinaire mais seul le traitement chirurgical est curatif. Il n'existe par contre pas de consensus sur l'utilité des thérapeutiques complémentaires qui peuvent néanmoins constituer un appoint à titre symptomatique. Les paragangliomes présentent un caractère génétique dans 25% des cas. Une enquête génétique doit être systématiquement proposée.
Introduction: Richter's hernia is an abdominal hernia in which part of the circumference of the intestine is incarcerated in the hernia sac. Case report: We report a case of Richter's hernia incarcerated through an indirect inguinal hernia. The patient presented with an occlusive syndrome with an imaging appearance of a right inguinal hernial strangulation bowel obstruction. Surgical exploration revealed the presence of an indirect inguinal Richter's hernia with a viable bowel. Discussion: Richter's hernia is a rare hernia of the abdominal wall, it is known by the unusual clinical presentation and the often erroneous late diagnosis that leads to high morbidity and mortality rates. Therefore, with high clinical suspicion, an abdominal CT scan is recommended to establish a prompt diagnosis, as timely surgical intervention is important to reduce mortality. Conclusion: Surgery is the basis of its treatment, but prompt surgical intervention remains. Assessment of bowel viability is an essential part of the repair.
Acute pancreatitis is an inflammation of the pancreas that can be caused in rare situations by ansa pancreatica, it is a rare anatomic variation of the pancreatic ducts. It is a communication between the main pancreatic duct (Wirsung) and the accessory pancreatic duct (Santorini). We report a case of the patient, in a 44-year-old, non-alcoholic, hospitalized for acute pancreatitis stage C of Baltazar. A magnetic resonance Cholangiopancreatography (MRCP) was performed which showed a gallstone and ansa pancreatica, than an endoscopic retrograde cholangiopancreatography (ERCP) revealed an ansa pancreatica with a common bile duct clear, a sphincterotomy of the major papilla was performed. It is still not clear whether the presence of these two pathologies is a coincidence or if the ansa pancreatica is the cause of acute pancreatitis. New studies are necessary to clarify these points.
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