Polysplenia syndrome mainly described in pediatrics; rarely and incidentally in adulthood. Most patients had their diagnosis done during childhood due to the frequent association to cardiac anomalies that speak for themselves earlier in life. Multiple spleens, cardiac defect and vascular malformation of the inferior vena cava with azygos or hemiazygos continuation are the most frequent observed malformations. Our patient was one this rarest adulthood incidental diagnosis, who presented in the emergency department for nephritic colic, and while imaging for this, multiples spleens and other visceral malformations were diagnosed. Hopefully, cardiac ultrasound hadn't showed any cardiac malformation and the patient was discharged aware of this condition. Through this publication we report the possible incidental diagnosis of polysplenia condition and highlight the fact that people with such important malformation can lead a normal life, and only awareness should be given for future surgeries, instrumental treatment or else.
Le cancer colorectal chez le sujet jeune est une affection rare et de mauvais pronostic. Plusieurs études ont objectivé l'augmentation de son incidence et l'agressivité de la tumeur. Le but de ce travail est d'étudier les caractéristi-ques épidémiologiques, anatomocliniques, thérapeutiques et évolutives afin d'évaluer les facteurs de mauvais pronostic chez cette jeune population. Dans une étude rétrospective, portant sur 144 cas de cancers colorectaux, 40 patients, porteurs de cancer colorectal, étaient âgés de moins de 40 ans. Des antécédents prédisposant au cancer colorectal étaient présents chez 20 % des patients. La symptomatologie clinique était dominée par les rectorragies, suivies du syndrome rectal. La tumeur était rectale chez 70 % des patients et colique dans 30 % des cas. Un adénocarcinome peu différen-cié était retrouvé dans 25 % des cas, un adénocarcinome mucineux dans 2,5 % des cas et un contingent colloïde muqueux dans 7,5 % des cas. Le stade B était retrouvé dans 45 % des cas, le stade C dans 25 % des cas et le stade D dans 30 % des cas. La survie globale de nos patients était de 12,5 % à cinq ans. L'amélioration pronostique et thérapeutique du cancer colorectal, chez le sujet jeune, passe par un dépistage familial, une étude génétique par biologie moléculaire et un diagnostic précoce en présence d'antécédents prédisposant.Abstract Colorectal carcinoma in patients younger than 40 years is a rare affection which has a bad prognosis. Several studies have shown the increase in its impact and the aggressiveness of the tumour. The object of this work is to study the epidemiologic, anatomoclinic, therapeutic and evolutionary characteristics and to evaluate the factors of bad prognosis in this young population. In a retrospective review of 144 patients with colorectal cancer, 40 patients were under the age of 40. The predisposing antecedents of colorectal carcinoma were noted among 20 % of the cases. The clinical symptomatology was dominated by rectal bleeding and rectal pain. The tumour was rectal in 70 % and colic in 30 %. The cancers were poorly differentiated in 25 % of the cases, 2.5 % had mucinous adenocarcinoma and 7.5 % had mucosal colloid carcinoma. Stage B was found in 45 %, Stage C in 25 % and Stage D in 30 % of the cases. The overall survival rate was 12.5 % at 5 years. The prognostic and therapeutic improvement requires a family screening, a genetic analysis and an early diagnosis, when predisposing antecedents exist.
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