Publications by authors named "Atri Souhaib"

3 Publications

  • Page 1 of 1

Primary duodenal tuberculosis complicated with perforation: A review of literature and case report.

Ann Med Surg (Lond) 2021 Jun 12;66:102392. Epub 2021 May 12.

Department of Digestive Surgery 'A', La Rabta Hospital University, Faculty of Medicine of Tunis, Tunisia.

Tuberculous (TB) disease remains an endemic pathology in Tunisia. the ileocecal region is the predominant site of involvement while gastroduodenal tuberculosis is very rare, this form is often presenting as one of the complications, mainly upper gastrointestinal stenosis or exceptionally as a perforation. We describe a case of female patient aged 33 years-old presented with a 2-day history of acute abdominal pain, with a tenderness of the right hypochondrium and the epigastrium, ultrasound of the abdomen revealed gallbladder distension with a wall thickening. The diagnosis of acute cholecystitis was suspected and the patient had an exploratory laparoscopy that revealed the presence of a perforated duodenal ulcer which was blocked by the gallbladder and several peri-duodenal lymph nodes. Cholecystectomy was performed and the edges of the ulcer were resected and the ulcer was sutured. Histological examination revealed duodenal tuberculosis and the patient was referred to the TB eradication program.
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June 2021

The management of hidradenitis suppurativa degenerating into squamous cell carcinoma: About three case reports.

Ann Med Surg (Lond) 2021 Apr 24;64:102239. Epub 2021 Mar 24.

Department of Surgery A, Rabta Hosptial, Tunis, Tunisia.

Introduction And Importance: Hidradenitis suppurativa (HS) is a chronic inflammatory and suppurative disease of the apocrine sweat glands. Its transformation into squamous cell carcinoma (SCC) is very rare.

Case Presentation: We describe 3 cases of males aged 57, 58 and 55-years-old. The diagnoses were confirmed by pathology examination in all cases. Two of our patients underwent extended and complete surgery. The first two patients died during the year after the diagnosis was established, the third one is still alive with no recurrence after one year of surgery.

Clinical Discussion: Hidradenitis suppurativa mostly concerns perianal location and it targets mainly male patients with a multifactorial development. Surgical treatment consists of large excision. The SCC is associated with a high mortality rate.

Conclusion: Hidradenitis suppurativa needs early diagnosis and effective surgery. The transformation into squamous cell carcinoma is rare and and its management is challenging. Extended and complete excision is required with rigorous postoperative follow-up.
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April 2021

Acute pancreatitis as an uncommon complication of hydatid cyst of the liver: A case report and systematic literature review.

Ann Med Surg (Lond) 2021 Feb 26;62:341-346. Epub 2021 Jan 26.

Department of Surgery "A", La Rabta Hospital, Tunis, Tunisia.

Hydatid disease is a major health problem worldwide. The liver is the most frequent location of hydatid disease. Acute pancreatitis secondary to liver hydatid cyst ruptured in the biliary tract is scarce and fewly described in literature. The management of this pancreatic complication of liver hydatid disease is challenging and includes a combination of surgical and endoscopic approaches. We report herein a rare case of hydatid cyst of the liver with cysto-biliary communication revealed by acute pancreatitis. A systematic literature review of similar cases reported was provided to compare surgical and endoscopic techniques. A thirty-year-old woman was referred to our emergency unit for acute pancreatitis. The CT-scan findings revealed a liver hydatid cyst ruptured in the biliary tract and daughter vesicles within were found, responsible for C-grade acute pancreatitis. We decided then to perform an emergency surgery through a bisoucostal incision. We performed a cholecystectomy and a peroperative cholangiogram that showed the communication between the cyst and left biliary tracts and the presence of daughter vesicle within the common bile duct. We conducted an exploration of the common bile duct with extraction of vesicle daughters. We left behind a T-tube in the common bile duct and we sutured the cysto-biliary fistula. Drainage was left in the remnant cavity after unroofing the cyst. Postoperative course was uneventful. Six months follow-up showed no recurrence. Cysto-biliary communication of liver hydatid disease revealed by acute pancreatitis is uncommon. We chose to perform emergency open surgery. However, through a systematic literature review, we noticed that endoscopic treatment is an efficient therapeutic and diagnostic tool to delay a morbid surgery of the liver and the common bile duct.
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February 2021