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Biliary cystadenocarcinomas are very rare malignant epithelial tumours of the liver. The preoperative diagnosis of this cystic tumor is difficult because its clinical and radiological presentation is non-specific. Complete surgical removal is the recommended treatment for hepatic cystadenocarcinoma. Incomplete resection is a source of tumor recurrence and metastatic dissemination, which is the case when it is wrongly diagnosed as another benign cystic lesion of the liver. We report a new case of biliary cystadenocarcinoma that has been diagnosed as a hepatic hydatic cyst, resulting in inadequate management.

Unexpected diagnosis of primary synchronous cancer in a patient with esophageal squamous carcinoma cell makes therapeutic management difficult. the careful evaluation of synchronous tumors is a primority aspect of management. we present the unusual case of an individual with esophageal squamous carcinomas cell synchronously associated with another primary laryngeal tumor. Initial clinical assessment was performed and consisting in a pan endoscopy and FDG-Pet scan / CT revealed the presence of synchronous head and neck and esophageal carcinoma (SHNEC). As recommended in the literature, surgical resection was not indicated. In this case radio chemotherapy often remains the only therapeutic alternative which guarantees a better result and improves the prognosis. The patient progressed well under concomitant radio chemotherapy even if complications inherent to this treatment required the cessation of treatment for a short period.

Hepatic hydatid cyst is one of the common public health problems in Maghreb, remains a benign pathology, but its seriousness concerns its complications, which are largely dominated by cystic rupture in the bile ducts.The aim of this study is to highlight the difficulty of surgical treatment of hydatic cyst, localized in central part of liver and ruptured in biliary ducts with the place of endoscopywe report the cases of three patients with central hepatic hydatid cyst opening in biliary ducts which are treated differently by surgery and endoscopy. Results:The surgery with the radical and conservative treatment in compared to endoscopy procedure was technically more difficult and efficient, but at the expense of morbidities and a longer hospitalization period. Conclusion:Cysto-biliary fistula is the most frequent and the most frightening complication of liver hydatid cyst, the surgery is the gold standard treatment with the conservative and radical methods. however, some locations such as central part of liver make surgery very difficult and dangerous which open the topic of the usefulness of the endoscopy in this problem. &nbsp

Endometriosis of the abdominal wall is a rare pathology occurring after gynecological or obstetrical surgery. We report the case of a patient presenting with menstrual pain localised at the point of a caesarean scar. The clinical examination found a nodule located at the level of the right iliac fossa. The rest of the examination was normal. Computer tomography (CT) scan showed a nodular focus that has a long axis of 2.38 cm which is hypo dense, hence the decision to excise the lesion. After excision, the anatomo-pathological studies confirmed the diagnosis of endometriosis. An 18 months post-operative follow-up was done and there was no complication found, no recurrence of the mass or pain at the site of excision.

Rectal malignant melanomas (RMM) are remarkably uncommon, the rectal location represents less than one percent of all rectal cancer. Because of its low global survival rate, the surgical strategy is a subject of controversy for attaining a r0 resection. the palliative treatment is also debateable, but recently; radiotherapy and immunotherapy became the preferred treatment and offer the best outcome. to ensure r0 resection, abdominoperineal resection (apr) is considered the main surgical option, but because of its morbidity and functional limitations, local excision techniques such as endoscopic mucosal resection (emr) combined with chemoradiotherapy are being increasingly performed to preserve the quality of life and reduce local recurrence rate. In this report, we evaluate the place that apr still keeps as surgical procedure in comparison to partial excision. we report a case of a 72 years old patient, who presented rectal syndrome with rectorrhagia for 2 months, the diagnosis of localized rectal melanoma was confirmed by endoscopy, magnetic resonance imaging, histological analysis tissue with immunohistochemistry. the procedure strategy was a surgical treatment with apr. After a long recurrence-free survival period, the patient develops local recurrence and immunotherapy-resistant metastasis.

Foramen of Winslow hernia is a rare occurrence, accounting for only 8% of all internal hernias and 0.08% of all hernias. It presents a diagnostic challenge with subtle clinical and radio - logical features. The rate of preoperative diagnosis has been reported to be

Digestive manifestations accompanying or preceding respiratory symptoms of coronavirus disease (COVID-19) caused by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) are frequent and appears to be associated with its most severe forms. In contrast, isolated digestive involvement in covid-19 is rare and misdiagnosed. It was found that nausea/vomiting, diarrhea, abdominal pain and loss of appetite are the main recognized digestive disorders in patients infected by SARS-COV-2. Acute abdomen with occlusive syndrome has never been reported in the literature to our knowledge. We report the case of a 60-year-old woman who was presented with an occlusive syndrome related to retro and intraperitoneal lesions caused by Covid-19 infection without any respiratory manifestations. She underwent an emergency surgery. The paucity of data about this unusual clinical presentation posed a serious diagnostic and therapeutic challenge.

Intestinal Behcet?s disease may cause serious complications. Massive hemorrhage, fistulisation and intestinal perforation are encountered complications in approximately 50% of patients suffering from intestinal Behcet?s disease. The main sites of involvement are the terminal cecum and ileum. In patients with Beh?et syndrome, CT is advocated for early detection of complications as well as for exclusion of other abdominal pathologic conditions but there is no specific exam. The report of histology in conjunction with the clinical history and the presence of oral ulcers, uveitis and suspected cutaneous lesions suggests the diagnosis. The optimal medical treatment of Beh?et syndrome has not yet been well established. In rare cases surgery must be required to control the disease. We describe a case of ileal perforation with abscess in a 26-year-old female with Behcet\'s disease.

Background: The liver is the most commonly damaged organ in abdominal trauma. The management of liver trauma has experienced many changes over the last two decades. Currently there is a trend toward a non-operative treatment warranted by the successful pediatric experience and better results recorded in many trauma centers worldwide. This study aimed to evaluate outcomes of operative and non-operative management of liver trauma in our institution over the last five years. Methods: The patients with a diagnosis of blunt or penetrating liver injuries, admitted and managed in our hospital from January 2012 to December 2016 were retrospectively studied. The patients were divided into 2 groups, operated and non-operated groups, according to the initial management considered appropriate at the time of patient admission. Clinical features and outcomes were analyzed. Results: The study involved 83 patients, with a mean age of 33 years and a marked male predominance (85.5%). The most common type of lesions was blunt trauma and the main cause was road traffic accidents. Sixty-eight liver injuries (81.9%) were of low severity (grades I, II, III), while 15 (18.1%) were of high severity (grade IV or greater). Fifty-six patients (67.5%) had multiple injuries. Surgical treatment was performed in 26 (31.3%) patients. Non-operative management was undertaken in 57 cases (68.7%). The morbidity and mortality rates were clearly lower in non-operative patients compared to those in the operated group. Conclusions: Careful non-operative management is an adequate therapeutic strategy for the patients suffering from liver trauma with stable hemodynamics. Patients with complex hepatic trauma and especially those with other organ injuries continue to have significantly higher mortality.

L’hémangiome surrénalien est une entité histologique très rare appartenant au groupe des incidentalomes. Il est souvent asymptomatique, de découverte fortuite lors d’un examen d’imagerie sollicité par une autre affection abdominale. Nous rapportons dans ce travail un seul cas permettant d’étoffer la série internationale qui reste jusqu’à nos jours très limitée.Mots clés: Hémangiome, glande surrénale, hémangiome caverneux, laparoscopieEnglish Title: Adrenal gland hemangioma: about a caseEnglish AbstractAdrenal gland hemangioma is a very rare histologic entity belonging to the group of incidentalomas. It is often asymptomatic, unexpectedly detected during imaging examination and resulting from another abdominal affection. We here report a single case to further enrich international case series which are still very limited.Keywords: Hemangioma, adrenal gland, cavernous hemangioma, laparoscopy

Les tumeurs pseudopapillaires et solides du pancréas sont des tumeurs rares, d’étiopathogénie encore incertaine, et surviennent surtout chez la jeune femme. Leur pronostic reste bon surtout après exérèse complète. Nous rapportons une nouvelle observation d'une jeune femme, révélée par des douleurs abdominales. Le diagnostic est porté sur l’étude histologique associée à l'immuno-histochimie de la pièce de spléno-pancréatectomie caudale.

L’hémangiome surrénalien est une entité histologique très rare appartenant au groupe des incidentalomes. Il est souvent asymptomatique, de découverte fortuite lors d’un examen d’imagerie sollicité par une autre affection abdominale. Nous rapportons dans ce travail un seul cas permettant d’étoffer la série internationale qui reste jusqu’à nos jours très limitée.

In this work, we discuss the preliminary results of the effectiveness of the hemorrhoidal artery ligation under control Doppler as a new technique for the treatment of hemorrhoids. We report the results of patients with hemorrhoids we have followed over a period of one year who were treated with HAL Doppler. The intra-and postoperative complications were monitored. Patient follow-up was established on the immediate postoperative period, after one month, six months and one year of evolution. Monitoring parameters were both objective (prolapse) and subjective (pain, discomfort, bleeding, satisfaction). 120 patients, all stages combined, were treated with HAL Doppler. The pain is easily controlled with painkillers. Residual rectal bleeding was noted in 3% of the cases. In addition, there was one case of recurrent prolapse which underwent reoperation. After one month, 86,5 % patients were satisfied. The hemorrhoidal artery ligation under control Doppler is an easy technique, well accepted by patients who are increasingly demanding it. It is less invasive, less painful and gives fewer complications. It is not only effective for stage III and IV hemorrhoids for which the effect is spectacular but also for stages I and II symptoms, which can expand its indications.Key words: Symptomatic hemorrhoids, Hemorrhoidal Artery Ligation, Doppler, mucopexy.

Undifferentiated pancreatic carcinoma with osteoclast-like giant cells (UPC-OGCs) is a rare neoplasm with frequency of 0.2 % of reported pancreatic carcinomas [1]. Tumors with osteoclast-like giant cells have rarely been reported in a variety of extra-skeletal sites. On the alimentary tract, the pancreas is the most concerned [2, 3]. A number of terms have been used to describe variants of undifferentiated pancreatic carcinoma, especially pleomorphic carcinoma, pleomorphic giant cell carcinoma, sarcomatoid carcinoma, spindle cell carcinoma, anaplastic carcinoma, undifferentiated carcinoma, and osteoclastic or pleomorphic giant cell tumors [4]. Histologically, the tumor combines two main cell populations, a malignant mononuclear cells population and the scattered nonneoplastic osteoclast-like giant cells [3, 5]. Since the first description by Rosai in 1968 [6], there have been only a few cases reported in the world literature. Our aim is to describe a new case of undifferentiated carcinoma of the pancreas with osteoclast-like giant cells which was early diagnosed, with a review of literature.