Publications by authors named "Mouaqit Ouadii"

25 Publications

  • Page 1 of 1

WSES/GAIS/WSIS/SIS-E/AAST global clinical pathways for patients with skin and soft tissue infections.

World J Emerg Surg 2022 01 15;17(1). Epub 2022 Jan 15.

Department of Surgery, Texas Health Resources, Ft Worth, TX, USA.

Skin and soft-tissue infections (SSTIs) encompass a variety of pathological conditions that involve the skin and underlying subcutaneous tissue, fascia, or muscle, ranging from simple superficial infections to severe necrotizing infections.Together, the World Society of Emergency Surgery, the Global Alliance for Infections in Surgery, the Surgical Infection Society-Europe, The World Surgical Infection Society, and the American Association for the Surgery of Trauma have jointly completed an international multi-society document to promote global standards of care in SSTIs guiding clinicians by describing reasonable approaches to the management of SSTIs.An extensive non-systematic review was conducted using the PubMed and MEDLINE databases, limited to the English language. The resulting evidence was shared by an international task force with different clinical backgrounds.
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http://dx.doi.org/10.1186/s13017-022-00406-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8761341PMC
January 2022

WSES/GAIS/SIS-E/WSIS/AAST global clinical pathways for patients with intra-abdominal infections.

World J Emerg Surg 2021 09 25;16(1):49. Epub 2021 Sep 25.

Department of general, Digestive and Metabolic Minimally Invasive Surgery, Centre Hospitalier Intercommunal De Poissy/St Germain en Laye, Poissy, France.

Intra-abdominal infections (IAIs) are common surgical emergencies and have been reported as major contributors to non-trauma deaths in hospitals worldwide. The cornerstones of effective treatment of IAIs include early recognition, adequate source control, appropriate antimicrobial therapy, and prompt physiologic stabilization using a critical care environment, combined with an optimal surgical approach. Together, the World Society of Emergency Surgery (WSES), the Global Alliance for Infections in Surgery (GAIS), the Surgical Infection Society-Europe (SIS-E), the World Surgical Infection Society (WSIS), and the American Association for the Surgery of Trauma (AAST) have jointly completed an international multi-society document in order to facilitate clinical management of patients with IAIs worldwide building evidence-based clinical pathways for the most common IAIs. An extensive non-systematic review was conducted using the PubMed and MEDLINE databases, limited to the English language. The resulting information was shared by an international task force from 46 countries with different clinical backgrounds. The aim of the document is to promote global standards of care in IAIs providing guidance to clinicians by describing reasonable approaches to the management of IAIs.
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http://dx.doi.org/10.1186/s13017-021-00387-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8467193PMC
September 2021

[Epiploic appendagitis: a rare cause of acute abdomen].

Pan Afr Med J 2020 3;36:149. Epub 2020 Jul 3.

Service de Chirurgie Viscérale, CHU Hassan II, Faculté de Médecine, Fès Maroc.

Epiploic appendagitis is a rare cause of acute abdomen. It can mimic other inflammatory processes such as diverticulitis or appendicitis. Diagnosis is based on CT scan. Medical management is the approach of choice in the absence of complications.
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http://dx.doi.org/10.11604/pamj.2020.36.149.21033DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7436646PMC
December 2020

Analysis of Molecular Pretreated Tumor Profiles as Predictive Biomarkers of Therapeutic Response and Survival Outcomes after Neoadjuvant Therapy for Rectal Cancer in Moroccan Population.

Dis Markers 2020 11;2020:8459303. Epub 2020 Jan 11.

Laboratory of Biomedical and Translational Research, University of Medicine and Pharmacy of Fez, Morocco.

Pathologic features depending on tumor response to preoperative chemoradiotherapy are important to determine the outcomes in patients with rectal cancer. Evaluating the potential predictive roles of biomarker expression and their prognostic impact is a promising challenge. We reported here the immunohistochemical staining of a panel marker of mismatch repair protein (MMR), Ki67, HER-2, and p53. Additionally, identification of somatic mutations of KRAS, NRAS, and BRAF genes were performed by direct sequencing and pyrosequencing in pretreated biopsy tissues from 57 patients diagnosed for rectal cancer. Clinical features and pathological criteria for postneoadjuvant treatment surgical resection specimen's data were collected. Immunohistochemical expression and mutational status were correlated with therapeutic response, overall survival, and disease progression. The mean age of patients was 56 years. Seven (12.3%) out of 57 patients had a complete therapeutic response. Our analysis showed that when using complete therapeutic response (Dworak 4) and incomplete therapeutic response (Dworak 3, 2, and 1) as grouping factor, high p53 expression at the pretreatment biopsy was significantly associated to an incomplete response ( = 0.002). For 20 and 2 out of 57, KRAS and NRAS mutations were detected, respectively. The majority of these mutations affected codon 12. KRAS mutations detected at codon 146 (A146T, A146V) was associated with the appearance of recurrence and distant metastasis ( = 0.019). A high expression of HER-2 corresponding to score 3+ was observed in 3 pretreatment biopsy specimens. This class was significantly associated with a short relapse-free survival ( = 0.002). Furthermore, the high expression of Ki67 was moderately correlated with an older age ( = 0.016, = 0.319). In addition, this shows that high p53 expression in the pretreatment biopsy was associated with an incomplete response in surgical resection specimens after neoadjuvant treatment, and a HER-2 score 3+ can be a predictive factor of distant metastasis and local recurrence. Larger, prospective, and more studies are needed.
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http://dx.doi.org/10.1155/2020/8459303DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6977322PMC
September 2020

[Voluminous colorectal foreign bodies inserted voluntarily: about a case].

Pan Afr Med J 2019 13;34:142. Epub 2019 Nov 13.

Service de Chirurgie Viscérale, CHU Hassan II, Fes, Maroc.

Insertion of foreign bodies is a curiosity and a taboo in our country. It is characterized by the severity of possible complications and the different therapeutic opportunities. We report the case of a patient with rectal incarceration of a vouminous object introduced voluntarily. He underwent manual extraction. Extraction, when possible, allow to avoid surgery that is necessary in the case of failure or complications.
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http://dx.doi.org/10.11604/pamj.2019.34.142.20793DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7906543PMC
March 2021

[Acute intestinal intussusception revealing intestinal T-cell lymphoma in adults].

Pan Afr Med J 2019 1;33:153. Epub 2019 Jul 1.

Service de Chirurgie Viscérale A, CHU Hassan II, Fès, Maroc.

Acute intestinal intussusception occurs primarily in infants and young children. It uncommonly occurs in adults. It can have various causes. In the vast majority of cases, it is secondary to a benign or malignant tumor. Intestinal T-cell lymphoma revealed by intestinal intussusception is very rare. We report the case of a 43-year old patient admitted with intestinal occlusion to the Emergency Department at the University Hospital Hassan II, Fes, Morocco. Abdominal CT scan showed acute intestinal intussusception associated with incarcerated bowel loop with bowel wall thickening. Treatment was based on open carcinological resection. Anatomopathological and immunohistochemical examination of the surgical specimen showed large T-cell anaplastic lymphoma. After surgery, chemotherapy was indicated to improve prognosis and to avoid a potential relapse. Intestinal intussusception rarely occurs in adults. It most often leads to the detection of an organic cause such as a tumor. This study and literature review aim to highlight the clinical and diagnostic features as well as the therapeutic approaches for this rare disease.
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http://dx.doi.org/10.11604/pamj.2019.33.153.18758DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6754853PMC
October 2019

Physiological parameters for Prognosis in Abdominal Sepsis (PIPAS) Study: a WSES observational study.

World J Emerg Surg 2019 15;14:34. Epub 2019 Jul 15.

Department of Surgery, Lumbini Medical College and Teaching Hospital Ltd., Tansen, Palpa Nepal.

Background: Timing and adequacy of peritoneal source control are the most important pillars in the management of patients with acute peritonitis. Therefore, early prognostic evaluation of acute peritonitis is paramount to assess the severity and establish a prompt and appropriate treatment. The objectives of this study were to identify clinical and laboratory predictors for in-hospital mortality in patients with acute peritonitis and to develop a warning score system, based on easily recognizable and assessable variables, globally accepted.

Methods: This worldwide multicentre observational study included 153 surgical departments across 56 countries over a 4-month study period between February 1, 2018, and May 31, 2018.

Results: A total of 3137 patients were included, with 1815 (57.9%) men and 1322 (42.1%) women, with a median age of 47 years (interquartile range [IQR] 28-66). The overall in-hospital mortality rate was 8.9%, with a median length of stay of 6 days (IQR 4-10). Using multivariable logistic regression, independent variables associated with in-hospital mortality were identified: age > 80 years, malignancy, severe cardiovascular disease, severe chronic kidney disease, respiratory rate ≥ 22 breaths/min, systolic blood pressure < 100 mmHg, AVPU responsiveness scale (voice and unresponsive), blood oxygen saturation level (SpO) < 90% in air, platelet count < 50,000 cells/mm3, and lactate > 4 mmol/l. These variables were used to create the PIPAS Severity Score, a bedside early warning score for patients with acute peritonitis. The overall mortality was 2.9% for patients who had scores of 0-1, 22.7% for those who had scores of 2-3, 46.8% for those who had scores of 4-5, and 86.7% for those who have scores of 7-8.

Conclusions: The simple PIPAS Severity Score can be used on a global level and can help clinicians to identify patients at high risk for treatment failure and mortality.
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http://dx.doi.org/10.1186/s13017-019-0253-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6631509PMC
September 2019

[Internal hernia through the falciform ligament: a rare cause of intestinal obstruction].

Pan Afr Med J 2019 28;32:48. Epub 2019 Jan 28.

Service de Chirurgie Viscérale A, CHU Hassan II, Fès, Maroc.

Internal hernias are a rare cause of acute intestinal obstruction. Hernias through the falciform ligament is uncommon. Diagnosis is often made intraoperatively. Abdominal CT scan, performed in an emergency situation, can enable preoperative diagnosis and guide the therapeutic approach. In this respect, we here report a case whose data were collected in the Department of Visceral Surgery at the University Hospital Hassan II in Fez. The study involved a 48-year old patient, with no particular previous history, admitted to the Emergency Department with occlusion evolving over 4 days. Abdominal x-ray without treatment objectified multiple hydroaeric levels in small bowel some of which projected towards the hepatic region as well as the presence of a flat intestinal loop in continuity with distended intestinal segment. Abdominal CT scan was not performed due to altered renal function. The patient then underwent emergency surgery after stabilization of his condition and the diagnosis of internal hernias through the falciform ligament was made intraoperatively. In adults, internal hernia through the falciform ligament is a rare cause of acute intestinal obstruction in our daily practice. The diagnosis is most often made intraoperatively. It is necessary to suspect it in young patients with no history of abdominal surgery or intraperitoneal infectious process and with hydroaeric levels in the right upper quadrant.
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http://dx.doi.org/10.11604/pamj.2019.32.48.17845DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6522209PMC
June 2019

Transverse colon volvulus presenting as bowel obstruction: a case report.

J Med Case Rep 2019 May 25;13(1):156. Epub 2019 May 25.

Visceral Surgery Department A, CHU Hassan II, Fez, Morocco.

Background: Transverse colon volvulus is an uncommon cause of bowel obstruction. The total number of cases reported in the literature is 100. It constitutes a surgical emergency since it can lead to bowel infarction, peritonitis, and death if not diagnosed at once. It seemed appropriate to report this case that was treated at the Department of Visceral Surgery A, University Hospital Center Hassan II of Fez in Morocco.

Case Presentation: We report a rare case of transverse colon volvulus in a 42-year-old Arabic man, with no particular history, who presented to our emergency department with a 5-day history of constipation, progressive abdominal pain, nausea, and vomiting. His last bowel movement had been 3 days ago. Abdominal radiography showed a large bowel obstruction with a "U-shaped" loop in the left upper abdomen. Abdominal computed tomography was not performed because of impaired renal function. He was operated on urgently after conditioning and the diagnosis of a transverse colon volvulus was done intraoperatively. Rotated in a 360° clockwise direction on its mesentery, the bowel was intact without signs of ischemia. An extended right hemicolectomy was carried out with end-to-side ileocolic anastomosis. Through this case, we will try to discuss its physiopathology, etiologies, diagnosis, and management in emergencies.

Conclusion: This case is unusual because no etiological factor has been found. Its diagnosis can be difficult and management effectiveness remains controversial. It is important to highlight this case and those of the literature, as many surgeons may have never seen a case of transverse colon volvulus. Volvulus of the transverse colon may therefore not be considered in the differential diagnosis of recurrent intermittent abdominal pain or acute intestinal obstruction. Prompt recognition with emergency intervention constitutes the key to a successful outcome.
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http://dx.doi.org/10.1186/s13256-019-2080-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6534884PMC
May 2019

Applicability and outcome of laparoscopic adrenalectomy for large tumours.

Pan Afr Med J 2018 11;31:23. Epub 2018 Sep 11.

Department of Visceral and Endocrine Surgery, Hassan II University Hospital, Fez, Morocco.

Laparoscopic adrenalectomy has been shown to be as safe and effective as conventional open surgery for small and benign adrenal lesions. With increasing experience with laparoscopic adrenalectomy, this approach has become the procedure of choice for the majority of patients requiring adrenalectomy. In our department, from 2011 to 2016, a total of 28 patients with 31 adrenal tumours underwent laparoscopic adrenalectomy regardless of tumour size. Our policy in the department is to exclude adrenal tumours that are potentially malignant or metastatic adrenal tumours for laparoscopic resection. In this a retrospective study, we divided patients into two groups according to tumour size: < 5 or ≥ 5 cm, which was considered as the definition of large adrenal tumours. We compared demographic data and per- and postoperative outcomes. There was no statistical difference between the two groups for per-operative complications (16,6% vs 18,75% , P = 0.71), postoperative complications (16,6% vs 18,75% , P = 0.71), postoperative length of hospital stay (5 vs 8 days P = 0.40), mortality (0% vs 0%) or oncologic outcomes: recurrence and metastasis (8.3% vs 6.25% P = 0.70). The only statistical difference was the operating time, at a mean (SD) 194 (60) vs 237 (71) min (P = 0.039) and the conversion rate (0% vs 12.5% P < 0.01). Laparoscopic adrenalectomy can be done for all patients with adrenal tumours regardless of tumour size, even it needs more time for large tumour but appears to be safe and feasible when performed by experienced surgeons.
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http://dx.doi.org/10.11604/pamj.2018.31.23.15153DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6430842PMC
April 2019

[Gastroduodenal trichobezoar: about a case].

Pan Afr Med J 2018 15;30:25. Epub 2018 May 15.

Université Sidi Mohamed Ben Abdellah, Service de Chirurgie Viscérale A (C3), CHU Hassan II Fes, Maroc.

Gastroduodenal trichobezoar ulcer is rare. Its diagnosis is easy in the presence of an evocative context. We report the case of a 21-year old patient followed up for schizophrenia, admitted with acute abdominal pain, vomiting and epigastric mass. Abdominal CT scan suggested the diagnosis of bezoar on the basis of heterogeneous, non-enhanced lesions occupying the entire stomach and appearing to be separated from the gastric wall. Surgical removal of trichobezoar by gastrotomy was performed without complications. The patient was referred to the Department of Psychiatry.
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http://dx.doi.org/10.11604/pamj.2018.30.25.12239DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6110540PMC
September 2018

Prospective Observational Study on acute Appendicitis Worldwide (POSAW).

World J Emerg Surg 2018 16;13:19. Epub 2018 Apr 16.

28DEA, La Sapienza Università di Roma, Policlinico Umberto I, Rome, Italy.

Background: Acute appendicitis (AA) is the most common surgical disease, and appendectomy is the treatment of choice in the majority of cases. A correct diagnosis is key for decreasing the negative appendectomy rate. The management can become difficult in case of complicated appendicitis. The aim of this study is to describe the worldwide clinical and diagnostic work-up and management of AA in surgical departments.

Methods: This prospective multicenter observational study was performed in 116 worldwide surgical departments from 44 countries over a 6-month period (April 1, 2016-September 30, 2016). All consecutive patients admitted to surgical departments with a clinical diagnosis of AA were included in the study.

Results: A total of 4282 patients were enrolled in the POSAW study, 1928 (45%) women and 2354 (55%) men, with a median age of 29 years. Nine hundred and seven (21.2%) patients underwent an abdominal CT scan, 1856 (43.3%) patients an US, and 285 (6.7%) patients both CT scan and US. A total of 4097 (95.7%) patients underwent surgery; 1809 (42.2%) underwent open appendectomy and 2215 (51.7%) had laparoscopic appendectomy. One hundred eighty-five (4.3%) patients were managed conservatively. Major complications occurred in 199 patients (4.6%). The overall mortality rate was 0.28%.

Conclusions: The results of the present study confirm the clinical value of imaging techniques and prognostic scores. Appendectomy remains the most effective treatment of acute appendicitis. Mortality rate is low.
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http://dx.doi.org/10.1186/s13017-018-0179-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5902943PMC
September 2018

Raising concerns about the Sepsis-3 definitions.

World J Emerg Surg 2018 25;13. Epub 2018 Jan 25.

29Division of Trauma Surgery, Department of Surgery, School of Medical Sciences, University of Campinas (Unicamp), Campinas, SP Brazil.

The Global Alliance for Infections in Surgery appreciates the great effort of the task force who derived and validated the Sepsis-3 definitions and considers the new definitions an important step forward in the evolution of our understanding of sepsis. Nevertheless, more than a year after their publication, we have a few concerns regarding the use of the Sepsis-3 definitions.
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http://dx.doi.org/10.1186/s13017-018-0165-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5784683PMC
September 2018

Antimicrobials: a global alliance for optimizing their rational use in intra-abdominal infections (AGORA).

World J Emerg Surg 2016 15;11:33. Epub 2016 Jul 15.

Department of Infectious Diseases, Alfred Hospital, Melbourne, VIC Australia.

Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients. The cornerstones in the management of complicated IAIs are timely effective source control with appropriate antimicrobial therapy. Empiric antimicrobial therapy is important in the management of intra-abdominal infections and must be broad enough to cover all likely organisms because inappropriate initial antimicrobial therapy is associated with poor patient outcomes and the development of bacterial resistance. The overuse of antimicrobials is widely accepted as a major driver of some emerging infections (such as C. difficile), the selection of resistant pathogens in individual patients, and for the continued development of antimicrobial resistance globally. The growing emergence of multi-drug resistant organisms and the limited development of new agents available to counteract them have caused an impending crisis with alarming implications, especially with regards to Gram-negative bacteria. An international task force from 79 different countries has joined this project by sharing a document on the rational use of antimicrobials for patients with IAIs. The project has been termed AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections). The authors hope that AGORA, involving many of the world's leading experts, can actively raise awareness in health workers and can improve prescribing behavior in treating IAIs.
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http://dx.doi.org/10.1186/s13017-016-0089-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946132PMC
May 2018

Global validation of the WSES Sepsis Severity Score for patients with complicated intra-abdominal infections: a prospective multicentre study (WISS Study).

World J Emerg Surg 2015 16;10:61. Epub 2015 Dec 16.

Department of Surgery, University Hospital of Larissa, Larissa, Greece.

Background: To validate a new practical Sepsis Severity Score for patients with complicated intra-abdominal infections (cIAIs) including the clinical conditions at the admission (severe sepsis/septic shock), the origin of the cIAIs, the delay in source control, the setting of acquisition and any risk factors such as age and immunosuppression.

Methods: The WISS study (WSES cIAIs Score Study) is a multicenter observational study underwent in 132 medical institutions worldwide during a four-month study period (October 2014-February 2015). Four thousand five hundred thirty-three patients with a mean age of 51.2 years (range 18-99) were enrolled in the WISS study.

Results: Univariate analysis has shown that all factors that were previously included in the WSES Sepsis Severity Score were highly statistically significant between those who died and those who survived (p < 0.0001). The multivariate logistic regression model was highly significant (p < 0.0001, R2 = 0.54) and showed that all these factors were independent in predicting mortality of sepsis. Receiver Operator Curve has shown that the WSES Severity Sepsis Score had an excellent prediction for mortality. A score above 5.5 was the best predictor of mortality having a sensitivity of 89.2 %, a specificity of 83.5 % and a positive likelihood ratio of 5.4.

Conclusions: WSES Sepsis Severity Score for patients with complicated Intra-abdominal infections can be used on global level. It has shown high sensitivity, specificity, and likelihood ratio that may help us in making clinical decisions.
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http://dx.doi.org/10.1186/s13017-015-0055-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4681030PMC
December 2015

[Large intra-rectal foreign body : a case report].

Pan Afr Med J 2014 4;18:273. Epub 2014 Aug 4.

Service de Chirurgie Viscérale, CHU Hassan II - Fès, Université Sidi Mohamed Ben Abdellah, Faculté de Médecine et de Pharmacie de Fès, Fès, Maroc.

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http://dx.doi.org/10.11604/pamj.2014.18.273.4226DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4258213PMC
July 2015

[Small bowel volvulus on peritoneal hydatid disease: a rare cause of obstruction].

Pan Afr Med J 2014 24;18:79. Epub 2014 May 24.

Service de Chirurgie Viscérale, CHU Hassan II - Fès, Université Sidi Mohamed Ben Abdellah, Faculté de Médecine et de Pharmacie de Fès, Maroc.

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http://dx.doi.org/10.11604/pamj.2014.18.79.4205DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4231250PMC
July 2015

Pedunculated lipoma causing colo-colonic intussusception: a rare case report.

BMC Surg 2013 Oct 30;13:51. Epub 2013 Oct 30.

Surgery Departement, University Hospital Hassan II, BP 1893; Km 2,200, Sidi Harazem Road, Fez 30000, Morocco.

Background: Intussusception is a relatively common cause of intestinal obstruction in children but a rare clinical entity in adults, representing fewer than 1% of intestinal obstructions in this patient population. Colonic lipomas are uncommon nonepithelial neoplasms that are typically sessile, asymptomatic and incidentally found during endoscopy, surgery, or autopsy.

Case Presentation: A 55-year old man visited our emergency department with severe abdominal pain, multiple episodes of vomiting, abdominal distension. Abdominal ultrasound sonography and computed tomography showed a sausage-shaped mass presenting as a target sign, suggestive of intussusception. Surgery revealed a hard elongated mass in the right colon wihch telescoped in the transverse colon and caused colo-colonic intussusception. Rhigt hémicolectomy was performed and pathology documented a mature submucosal lipoma of the colon. We describe the difficulties in diagnosis and management of this rare cause of bowel obstruction and review the literature on adult intussusceptions.

Conclusion: A large submucosal lipoma is a very rare cause of colon intussusception that presents as intestinal obstruction in patients without malignancy. CT and magnetic resonance imaging remain the methods of choice for studying abdominal lipomas, particularly those rising into the layers of the colonic wall. Surgical resection remains the treatment of choice and produces an excellent prognosis.
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http://dx.doi.org/10.1186/1471-2482-13-51DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3818566PMC
October 2013

Benign cystic mesothelioma of the peritoneum: a case report and literature review.

World J Emerg Surg 2013 Oct 13;8(1):43. Epub 2013 Oct 13.

Department of Surgery, School of Medicine and Pharmacy of Fez, Sidi Mohammed Ben Abdallah University, University hospital HASSAN II, BP: 1893, Km2,200, Route de Sidi Hrazem FEZ 30000, Morocco.

Benign cystic mesothelioma of the peritoneum (BCM) is an uncommon lesion with some 130 cases reported since the first case described by Smith and Mennenmeyer in 1979. It is a rare intra abdominal tumor occurring predominantly in women of reproductive age. Due to the rarity of this tumor, similarity of patient presentation, and comparable features on imaging, the diagnosis of this pathology is difficult, and is based on histological findings. This tumor is known for local recurrence. It's agreed that surgery is the only effective treatment, but there are no evidence-based treatment strategies for BCM.
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http://dx.doi.org/10.1186/1749-7922-8-43DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3853709PMC
October 2013

Acute intraperitoneal rupture of hydatid cysts: a surgical experience with 14 cases.

World J Emerg Surg 2013 26;8:28. Epub 2013 Jul 26.

Surgery Department, Hassan II Hospital, University Sidi Mohamed Ben Abdellah, BP 1893; Km 2.200, Sidi Harazem Road, Fez 30000, Morocco.

Introduction: Hydatidosis is endemic in the Mediterranean region including morrocco, the Middle and Far East, Australia, New Zealand, and South America-all areas where animal husbandry is common. Rupture into the abdominal cavity is a rare but serious complication of hydatid disease. The cysts may be ruptured after a trauma, or spontaneously as a result of increased intracystic pressure. Rupture of the hydatid cyst requires emergency surgical intervention.

Methods: Fourteen patients received surgical treatment for intraperitoneal rupture of the cysts over a period of 5 years. Age, gender, time to surgery from the onset of the symptoms, laboratory findings, diagnostic procedures, surgical treatment modalities, in-hospital stay, morbidity, mortality and recurrence were evaluated retrospectively.

Results: Eight of the patients were men and six were women. All of the patients had signs of peritoneal irritation. One patient (7,14%) had a history of blunt abdominal trauma. Ultrasonography scans revealed intra-abdominal fluid in all cases, intraperitoneal multiple cysts in 11 cases and heterogeneous cavity or cystic structures in the liver in 12 cases. Computed tomography showed multiple cystic lesions in the liver and peritoneum with intra-abdominal free fluid. The ruptured cysts were located in the right lobe of the liver in seven patients, in the left lobe in six patients and in both lobes in one patients. Procedures to fill the cystic cavities were applied after removal of the intraperitoneal fluid. Partial pericystectomy and drainage was the most frequent surgical procedure. No patients died in the early postoperative period. A total of seven morbidities developed in six patients (35.3%). Median hospital stay was 08 days and median follow-up was 12 months. Intra-abdominal recurrence occurred in one case (7.7%).

Conclusions: Rupture of hydatid cysts into the peritoneal cavity, although rare, presents a challenge for surgeons. This pathology should be included in the differential diagnosis of acute abdomen in endemic areas. The operative procedures, either radical or conservative, should be based on the patient's condition, the regional characteristics, and the surgeon's experience. The morbidity and mortality rates of surgical interventions for ruptured hydatid cysts are higher than the rates for elective uncomplicated cases.
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http://dx.doi.org/10.1186/1749-7922-8-28DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3725171PMC
May 2014

A large gastrointestinal stromal tumor of the duodenum treated by partial duodenectomy with Roux-en-Y duodenojejunostomy: a case report.

J Med Case Rep 2013 Jul 15;7:184. Epub 2013 Jul 15.

Surgery Department, University Hospital Hassan II, Fez, Morocco.

Introduction: Duodenal gastrointestinal stromal tumors are uncommon and a relatively small subset of gastrointestinal stromal tumors whose optimal surgical procedure has not been well defined. Because submucosal spread and local lymph node involvement are infrequent in gastrointestinal stromal tumors, wide margins with routine lymph node dissection may not be required. Various surgical procedures for duodenal gastrointestinal stromal tumor, pancreatoduodenectomy, pancreas-sparing duodenectomy, segmental duodenectomy, or local resection, have been described depending on the size and exact site of the lesion.

Case Presentation: We present the case of a 65-year-old African woman with a giant gastrointestinal stromal tumor involving the second and third portion of the duodenum successfully treated by partial duodenectomy with duodenojejunostomy. This surgical technique is ideal when a gastrointestinal stromal tumor does not involve the ampulla because it avoids a pancreatoduodenectomy, and has not been previously described for the management of this malignancy. Duodenal gastrointestinal stromal tumor should be suspected in any patient with a duodenal wall mass.

Conclusions: Gastrointestinal stromal tumors of the duodenum should be suspected in any patient with a duodenal wall mass. Extramural growth and central ulceration with or without bleeding should alert the endoscopist to the possibility of a duodenal gastrointestinal stromal tumor diagnosis.
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http://dx.doi.org/10.1186/1752-1947-7-184DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3726472PMC
July 2013

A rare tumor of the thyroid gland: report on one case of leiomyosarcoma and review of literature.

Updates Surg 2014 Jun 20;66(2):165-7. Epub 2013 Jan 20.

Surgery Department «A», Ibn Sina University Hospital, Rabat, Morocco,

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http://dx.doi.org/10.1007/s13304-013-0196-1DOI Listing
June 2014

Adult intussusceptions caused by a lipoma in the jejunum: report of a case and review of the literature.

World J Emerg Surg 2012 Aug 22;7(1):28. Epub 2012 Aug 22.

Surgery Department, University Hospital Hassan II, Fez 30000, Morocco.

Intussusceptions in adults is rare. Gastrointestinal lipomas are rare benign tumors and intussusceptions due to a gastrointestinal lipoma constitutes an infrequent clinical entity. Lipoma may develop as a benign tumor in all organs and rarely in large or small intestine. The present report describes a case of jejunojejunal intussusceptions in an adult with a history of colicky upper abdominal pain. Ileo-ileal invagination was diagnosed by computed tomography scan. Exploratory laparotomy revealed jejunojejunal intussusceptions secondary to a lipoma which was successfully treated with segmental intestinal resection. A review of the literature is also performed regarding this rare association revealing the diagnostic and therapeutic debates that exist. ABSTRACT (FRENCH): L'invagination chez les adultes est rare. Les lipomes gastro-intestinaux sont de rares tumeurs bénignes et l'invagination intestinale due à un lipome gastro-intestinal constitue une entité clinique trés rare. Le lipome peut se développer comme une tumeur bénigne dans tous les organes et rarement dans l'intestin grêle ou le colon. Le présent rapport décrit un cas d'invagination jéjunojéjunale chez un adulte avec une histoire de douleurs abdominales. Iléo-iléale invagination a été diagnostiquée par tomodensitométrie. Une laparotomie exploratrice a révélé l'existence d'une invagination jéjunojéjunale secondaire à un lipome qui a été traitée avec succès par une résection intestinale segmentaire. Une revue de la littérature est également effectuée au sujet de cette association rare révélant les débats diagnostiques et thérapeutiques qui existent.
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http://dx.doi.org/10.1186/1749-7922-7-28DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3502287PMC
August 2012
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