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Introduction: In developed countries, authors have reported variations over time in the seat and histological type of gastric adenocarcinomas, which were explained by Helicobacter pylori infection (HPI) incidence changes. In North-African countries and the Arabic world, epidemiological changes in gastric adenocarcinomas are still unknown. Our study aims to explore and to describe those changes in central Tunisia. Materials and Methods: This is a retrospective observational and descriptive study including 876 cases based on the National Central Tunisian Register of Cancers over a period of 21 years. Two groups were formed and compared (group A: 337 patients from 1995 to 2005; group B: 539 patients from 2006 to 2015). Results: HPI decreased from 32.6% in group A to 11.2% in group B (p < 0.05). Signet ring cell carcinomas increased in 2 decades from 14% in group A to 36% in group B (p < 0.05). Proximal cancers were 16.61% in group A and increased to 19.66% in group B (p = 0.3). Total gastrectomy rate was 10.4% in group A versus 23.2% in group B (p < 0.05). Conclusion: This study has shown a significant increase of signet ring cell carcinomas with a simultaneous decrease in HPI in the last decade in central Tunisia.

Duodenal duplication is an extremely rare congenital abnormality that occurs mostly in children. It represents only 2% to 12% of all gastrointestinal tract duplication. Its clinical presentation is highly variable and non-specific making the positive diagnosis very difficult. Imaging modalities can help to detect the lesions making the diagnosis more accurate before surgery. Here, we report a case of duodenal duplication revealed by chronic abdominal pain and treated by surgical resection in a 26-year-old man. Even in adults, it is necessary to evoke the diagnosis of duodenal duplication in patients with unexplained abdominal pain. Surgical resection remains the treatment of choice and endoscopic treatment is reserved for selected patients in whom surgery is difficult.

Background: Gastric adenocarcinoma is a frequent disease characterized by recent changing trends in epidemiological features, mainly in developed countries. The aim of our study is to describe any changing trends, mainly, in distal and proximal gastric adenocarcinomas rates and signet ring cells adenocarcinomas rate. Methods: This is a retrospective monocentric study of 169 consecutive cases of primary invasive gastric adenocarcinoma, covering a period of 20 years. We have divided these cases into 2 equal-period groups. The rates of proximal cancers (cardia cancers), distal cancers (non-cardia cancers) and signet ring cells adenocarcinomas had been compared. Other parameters have been studied and compared such as gender, age and surgery types. Results: There is a statistically significant difference between the 2 groups regarding the rates of signet ring cells adenocarcinoma. The cardia cancer rates and non-cardia cancer rates are not statistically different between the 2 groups (p=0.074). However, there is an increasing trend in cardia cancers rate (7.6% to 16.7%) and a decreasing in non-cardia cancers rate (92.4% to 83.3%). There is no difference in regards to age, sex and type of surgery. Conclusions: The database of our retrospective study regarding age & sex incidence, clinicopathological features and therapeutic outcome was comparable to other studies in various literatures.