A gastric bezoar is a foreign materiel occur in the stomach & can be extended through duodenum, jejunum and colon. Trichobezoar, is an underdiagnosed entity, has to be considered in children and adolescents (especially females suffering from trichotillomania and trichophagia). The disease is usually underdiagnosed so showed by threatening complications: occlusion, bleeding of perforation. The present report concerns a 19-year-old girl presenting with abdominal pain. On the abdominal exam an acute peritonitis which rapidly evolved to septic shock and an emegercy laparomy was performed, by supraumbilical laparaotomy and anterior gastrotomy objictived peritonitis jejunal perforation caused by large gastrojejunal trichobezoar. Acute peritonitis following hollow viscus perforation caused by tichobezoars is an therapeutic emergency in order to avoid visceral spillage, peritonitis & mortality.

Intestinal cystic pneumatosis (ICP) is a rare disease, defined by the presence of gaseous cysts in the digestive wall with intestinal predilection. The first case was described in autopsy specimen in 1730 by Duo Vernoi. rare condition characterized by multiple gas-filled cysts in the intestinal wall and can be caused by many conditions. As patients with PCI are mostly asymptomatic, they are not likely to seek medical care. It affected any portion of gastrointestinal tract with the cysts being either confined to the mucosa, submucosa, or subserosa or involving all three layers. It is primary in 15% of cases and complicates an underlying pathology in 85% of cases. We report the case of a 47-year-old chronic smoker who had a history of epigastralgia, admitted to the emergency room for an acute abdominal pain with septic shock. A laparotomy was performed showing necrosis ileum with ICP associated to ulcerative pyloric stenosis & ulcer perforation peritonitis. Therapeutic management consisted of specific treatment of the pathology associated with grelic resection of the necrosis ileum affected by ICP. The patient died during his stay in intensive care on 3th day due to multi-visceral failure despite all intense resuscitation efforts.

The ileosigmoid node is a rare cause of intestinal obstruction. Its ethiopathology remains poorly understood. The diagnostic approach is similar to that of occlusions in general but remains difficult, due to its rarity and clinical-radiological atypia. In the majority of cases the diagnosis is made intraoperatively. Hartmann colectomy should be preferred to ideal colectomy because of its high morbidity and mortality. The prognosis essentially depends on the time of admission, the general condition of the patient, the presence or absence of loop necrosis and the circumstances of the surgical intervention. We report the case of an occlusion with ileosigmoid node according to the experience of the hospital ibn tofail Marrakech.