Publications by authors named "Mounir Bouali"

17 Publications

  • Page 1 of 1

Strangulated Spiegel hernia: About a case and literature review.

Ann Med Surg (Lond) 2021 Jun 28;66:102453. Epub 2021 May 28.

Visceral Surgical Emergency Department, Universitary Hospital Center Ibn Rochd, Casablanca, Morocco.

The anterolateral abdominal Hernias are a frequent reason for consultation; Spiegel's hernia is a rare spontaneous abdominal anterolateral hernia (0.12% of abdominal hernias) for patients between 40 and 70 years old, There are risk factors such as intra-abdominal hyperpressure secondary to morbid obesity, multiple pregnancies and chronic cough. The surgery is the standard treatment; whether by raphy or prosthetic mesch. We report the case of a 42 year old male admitted to the emergency room for an occlusion syndrome due to the strangulated spiegel hernia with caecal and appendicular contents.
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http://dx.doi.org/10.1016/j.amsu.2021.102453DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8188248PMC
June 2021

Strangulated internal supravesical hernia associated with left inguinal hernia: A very rare case report of acute intestinal obstruction.

Ann Med Surg (Lond) 2021 Jun 13;66:102393. Epub 2021 May 13.

Visceral Surgery Emergency Department, University Hospital Center Ibn Rochd, Casablanca, Morocco.

Internal hernias are a rare cause of acute intestinal obstruction. Supravesical hernia is an exceptional form of hernia that is often diagnosed intraoperatively. The abdominal CT scan performed in the emergency guides the preoperative diagnosis. Our work concerns a patient admitted to the visceral surgical department of the university hospital ibn Rochd of Casablanca for an occlusion dating back to 05 days, the abdmonial x-ray objectified hydro-aerial levels in the small intestine, and the CT scan found an invagination at the left fossa iliaca associated with a double hernia: internal supravesical and left inguinal. The patient was then operated after conditioning and the diagnosis of an internal supravesical hernia was retained per operatively. Internal supravesical hernia is a very rare cause of acute intestinal occlusion and is often diagnosed at the time of surgical exploration.
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http://dx.doi.org/10.1016/j.amsu.2021.102393DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8167154PMC
June 2021

Retrocecal hernia: A case report.

Ann Med Surg (Lond) 2021 Jun 12;66:102390. Epub 2021 May 12.

Visceral Surgery Emergency Department, University Hospital Center Ibn Rochd, Casablanca, Morocco.

Introduction: Retroperitoneal Retrocecal hernias are a rare variety of internal hernias and represent an unusual cause of bowel obstruction. Early diagnosis is based on CT scan and requires knowledge of the pathology in order to avoid small bowel resection. We report a case of retrocecal hernia treated surgically and review the characteristics and treatment of retrocecal hernias in the literature.

Materials And Methods: Our work is a retrospective case report with a descriptive aim concerning a patient operated for retrocecal hernia within the department of general surgery of CHU Ibn Rochd Casablanca.

Case Report: A 72-year-old man presented to the emergency department with abdominal pain and vomiting that have been evolving for 9 days complicated by an occlusive syndrome 36 hours before the admission. The patient was apyretic, and the abdominal examination noted abdominal meteorism predominantly in the right iliac fossa, absence of abdominal scarring, and free hernial orifices. The abdominal X-ray showed air-fluid levels and the abdominopelvic CT scan found clumping of the dilated small intestines posteriorly and below the cecum. The diagnosis of retrocecal hernia was suspected and the patient was taken to the operating room. The operation was performed by laparotomy through a midline incision. On exploration, the cecum and ascending colon were pushed forward and viable bowel loops were incarcerated in a fossa located posteriorly and below the cecum. The procedure consisted of a collapse of the retrocecal ligaments by right coloparietal collapse.

Conclusion: A bowel obstruction in an apyretic patient without abdominal scarring or parietal hernia should suggest the diagnosis of internal hernia, which must be investigated.
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http://dx.doi.org/10.1016/j.amsu.2021.102390DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8141675PMC
June 2021

Ischemic volvulus of the transverse colon caused by intestinal malrotation: A case report.

Int J Surg Case Rep 2021 Jun 18;83:105971. Epub 2021 May 18.

Departement of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco; Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco.

Introduction: Congenital Intestinal malrotation is a complex disorder caused by incomplete or abnormal rotation of the intestine during fetal development. Volvulus of the transverse colon secondary to intestinal malrotation is a rare cause of acute abdomen in adults. It has a high risk of mortality, hence the need for an urgent diagnosis and surgical intervention.

Case Report: We report an unusual case of volvulus of the transverse colon caused by intestinal malrotation. A 21-year-old women presented abdominal pain with nausea and vomiting. On clinical examination, the abdomen was tympanic to percussion with peritoneal sensitivity. The abdominal X-ray revealed a massive obstruction of the distended large intestine with a "U-shaped" loop. He underwent an exploratory laparotomy that revealed the diagnosis of transverse colon volvulus with intestinal malrotation. His condition was treated surgically by transverse colectomy with colostomy. The patient died on the second day following a hemodynamic instability.

Conclusion: Transverse colonic volvulus is a rare entity with a high mortality, so it requires urgent diagnosis and surgical intervention.
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http://dx.doi.org/10.1016/j.ijscr.2021.105971DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8163956PMC
June 2021

Fish bone perforation of the small bowel: A case report.

Ann Med Surg (Lond) 2021 May 27;65:102348. Epub 2021 Apr 27.

Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco.

Introduction: Fish bone is one of the most common accidently ingested foreign bodies. Normally, it is eliminated from the gastrointestinal (GI) system without any symptomatology, only 1% of the cases will develop a perforation of the GI tract requiring surgical intervention.

Presentation Of Case: A 70-year-old man, presented with a 48h evolving abdominal pain, important abdominal distension, nausea, vomiting, and a last bowel movement reported 2 days ago, The abdomino-pelvic CT-scan objectified a distension of the terminal ileum measured at 30mm, The exploration revealed a sharp foreign body,at the 15 proximal centimeters of the terminal ileum, which penetrated through the wall of the ileum. The foreign body was removed and we noticed that it is a fish bone. The patient recovered well.

Discussion: Clinical manifestations are determined by the location of the perforation and the preoperative diagnosis is always difficult to reach. Computed tomography (CT) scan is the indicated method to identify ingested foreign bodies and surgery is the treatment of choice.

Conclusion: Delay in diagnosis and treatment can be associated with significant morbidity and mortality.
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http://dx.doi.org/10.1016/j.amsu.2021.102348DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8111590PMC
May 2021

Gastrointestinal manifestations related to infection with SARS-COV-2: Appendicular syndrome (A case report).

Ann Med Surg (Lond) 2021 May 14;65:102288. Epub 2021 Apr 14.

Department of Visceral Surgical Emergency (P35), UHC Ibn ROCHD, Casablanca, Morocco.

Introduction: The clinical symptomatology of SARS-CoV-2 disease may manifest as an appendicular syndrome. The abdominal CT scan can be used to rule out or confirm the diagnosis of acute appendicitis and a chest CT scan can make the diagnosis of SARS-CoV-2 infection.

Observation: We report the observation of a 30-year-old patient, with no particular pathological history, who presented with appendicular syndrome without extra-digestive signs, and especially, without respiratory syndrome. The CRP was at 35mg/l. A thoracoabdominal CT scan was requested to detect an eventual appendicitis. With three straight frosted glass areas on the thoracic area suggesting COVID 19 infectious pneumopathy, a PCR was requested to detect a positive SARS-CoV-2 viral RNA, then the patient was appendectomized. Post-operative follow-up was simple and the patient was transferred to a department dedicated to covid-19-positive patients for further management.

Conclusion: CT scan is necessary before considering emergency surgery for acute appendicitis because it can change the patient's management circuit.
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http://dx.doi.org/10.1016/j.amsu.2021.102288DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8043916PMC
May 2021

Stercoral perforation of the colon: a mortal consequence of chronic constipation in the elderly (a case report).

Pan Afr Med J 2021 18;38:48. Epub 2021 Jan 18.

Department of Visceral Surgical Emergency, Ibn Rochd University Hospital, Casablanca, Morocco.

The stercoral perforation is a mortal condition. It affects elderly patients who have a long history of chronic and severe constipation as well as constitutes a surgical emergency whose prognosis, often grim, depends on the early diagnosis and treatment. We report the case of a stercoral colon perforation which occurred in an 89-year-old patient. The clinical symptomatology was that of an acute peritonitis evolving for four days. The diagnosis was only made intraoperatively and the surgical gesture was a resection of the involved left colon segment and Bouilly Volkmann colostomy. The consequences were unfortunately marked by a resistant septic shock resulting in the death of the patient on the 1 postoperative day. The diagnosis of stercoral colon perforation, which is often difficult and delayed, must be known by all physicians who manage an increasingly older patient population.
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http://dx.doi.org/10.11604/pamj.2021.38.48.22948DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8017362PMC
April 2021

Pneumatosis cystoides intestinalis with pneumoperitoneum secondary to stenosing pyloro-duodenal peptic ulcer: Case series of three patients and literature review.

Int J Surg Case Rep 2021 Apr 13;81:105772. Epub 2021 Mar 13.

Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco; Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.

Introduction: Pneumatosis cystoides intestinalis (PCI) is a rare condition, which can affect the entire gastro-intestinal tract. It can be idiopathic or most often secondary to various diseases. The causes remain multiple and the stenosing peptic ulcer is one of them. We report three case reports of pneumatosis cystoides with pneumoperitoneum intestinalis secondary to stenosing pyloro-duodenal peptic ulcer.

Case Presentation: We report a case series of three patients with PCI that presented to the emergency department with a reassuring clinical picture with the discovery in imaging of a pneumoperitoneum. All our patients presented with a pyloro-duodenal stenosis secondary to a complicated peptic ulcer, one of which was treated surgically and the other two endoscopically.

Discussion: The objective of this report is to provide an update on pneumatosis cystoides intestinalis secondary to stenosing pyloro-duodenal peptic ulcer, by specifying its etiopathogenic, diagnostic and therapeutic characteristics.

Conclusion: Knowledge of this pathology is necessary in order to avoid unnecessary abusive surgery.
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http://dx.doi.org/10.1016/j.ijscr.2021.105772DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8010462PMC
April 2021

Sub-acute transverse colon volvulus an exceptional cause of large bowel obstruction: Case report.

Ann Med Surg (Lond) 2021 Mar 3;63:102154. Epub 2021 Feb 3.

Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.

Introduction: The sub-acute form of transverse colon volvulus manifests with signs and symptoms of large bowel obstruction. The diagnosis is most often done intraoperatively. We report a rare case of transverse colon volvulus in a 65-year-old female patient with no particular pathological or surgical history.

Case Presentation: Sub-acute transverse colon volvulus in an elderly woman with no pathological or surgical history. Manifested with signs and symptoms of colonic obstruction. Surgically treated by a two-stage procedure with good postoperative outcomes.

Discussion: The transverse colon volvulus represents only 2-4% of all colonic volvulus. We discuss the diagnostic and therapeutic approach of our case of transverse colon volvulus through a literature review.

Conclusion: Transverse colon volvulus should be considered as a differential diagnosis in the face of large bowel obstruction. Early diagnosis and treatment improve the prognosis.
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http://dx.doi.org/10.1016/j.amsu.2021.01.102DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7890129PMC
March 2021

Acute colonic occlusion over endometriosis: About a case.

Int J Surg Case Rep 2021 Mar 3;80:105615. Epub 2021 Feb 3.

Anatomopathology Department, University Hospital Center Ibn Rochd, Casablanca, Morocco; Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco.

The gastrointestinal tract is the most common site of extra pelvic endometriosis, with the rectum and sigmoid colon being the most frequently affected areas. Its diagnosis is still very difficult, especially when it manifests itself as an acute occlusion. We report the case of a patient admitted to the emergency room for an occlusive syndrome on a sigmoid process and who was operated on with colorectal resection and it was the anatomopathological examination that led to the diagnosis of endometriosis.
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http://dx.doi.org/10.1016/j.ijscr.2021.02.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7893450PMC
March 2021

Phytobezoar: An unusual cause of small bowel obstruction.

Ann Med Surg (Lond) 2021 Feb 25;62:323-325. Epub 2021 Jan 25.

Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco.

Phytobezoars are concretions of indigested fruit and vegetables fibers in the gastrointestinal tract. The past of gastric surgery is most common risk factor of phytobezoar. We present the case of a 39-year-old female was admitted to the emergency department and who presented with small bowel obstruction due to phytobezoar, her past medical history was marqued by truncal vagotomy and simple suture recurrent perforated gastric ulcer 15 years earlier. Her postoperative recovery was uneventful.
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http://dx.doi.org/10.1016/j.amsu.2021.01.048DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7847810PMC
February 2021

Total gastric necrosis following acute pancreatitis in a patient with COVID -19: Case report and literature review.

Ann Med Surg (Lond) 2021 Feb 21;62:362-364. Epub 2021 Jan 21.

Visceral Surgical Emergency Department, Faculty of Medicine and Pharmacy, Universitary Hospital Center Ibn Rochd, Hassan II University, Casablanca, Morocco.

The Coronavirus Disease Pandemic - 2019 (COVID-19) has spread to more than 200 countries worldwide, affecting more than 2 million people and >120,000 deaths, Acute pancreatitis of infectious origin can be caused by different viruses but currently no study has concluded that COVID-19 is directly responsible for acute pancreatitis. We report the case of a COVID-19 patient admitted to the emergency room in a state of respiratory distress associated with stage E pancreatitis according to the classification of balthazar whose surgical exploration found total necrosis of the stomach. A total gastrectomy was performed with an esophagostomy and a wide drainage of the abdominal cavity, the postoperative sequelae were marked by the death of the patient at D6 postoperatively by cardiorespiratory arrest.
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http://dx.doi.org/10.1016/j.amsu.2021.01.061DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7826052PMC
February 2021

Ansa pancreatica: a rare cause of acute recurrent pancreatitis.

Pan Afr Med J 2020 29;37:202. Epub 2020 Oct 29.

Service des Urgences Chirurgicales Viscérales, CHU Ibn Rochd, Université Hassane II, Faculté de Médecine et de Pharmacie (FMPC), Casablanca, Maroc.

Acute pancreatitis is an inflammation of the pancreas that can be caused in rare situations by ansa pancreatica, it is a rare anatomic variation of the pancreatic ducts. It is a communication between the main pancreatic duct (Wirsung) and the accessory pancreatic duct (Santorini). We report a case of the patient, in a 44-year-old, non-alcoholic, hospitalized for acute pancreatitis stage C of Baltazar. A magnetic resonance Cholangiopancreatography (MRCP) was performed which showed a gallstone and ansa pancreatica, than an endoscopic retrograde cholangiopancreatography (ERCP) revealed an ansa pancreatica with a common bile duct clear, a sphincterotomy of the major papilla was performed. It is still not clear whether the presence of these two pathologies is a coincidence or if the ansa pancreatica is the cause of acute pancreatitis. New studies are necessary to clarify these points.
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http://dx.doi.org/10.11604/pamj.2020.37.202.23218DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7813647PMC
February 2021

Nutcracker syndrome due to aorto-mesenteric compression in adults: Case report and literature review.

Int J Surg Case Rep 2020 20;77:730-732. Epub 2020 Nov 20.

Visceral Surgical Emergency Department, Faculty of Medicine and Pharmacy, Universitary Hospital Center Ibn Rochd, Hassan II University, Casablanca, Morocco.

Nutcracker syndrome is a rare entity that corresponds to an abdominal pain following compression of the left renal vein during its passage between the aorta and the superior mesenteric artery, with a peak prevalence in adults between 20 and 30 years old, The typical clinical presentation includes hematuria, orthostatic proteinuria with or without flank pain. doppler ultrasound has a sensitivity of 78% and specificity of 100%, Both CT and MRI can show the compression of the left renal vein between the aorta and the superior mesenteric artery. We report the case of a young patient admitted to the emergency room for abdominal pain mainly localized in the left hypochondrium, with microscopic hematuria, a CT scan was performed showing a reduced aorto mesenteric angle with a compression of the left renal vein and collateralization of venous circulation of left gonadal vein.
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http://dx.doi.org/10.1016/j.ijscr.2020.11.088DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7718136PMC
November 2020

Primary appendiceal Burkitt's lymphoma presenting as acute appendicitis: An extremely rare case report and review of the literatture.

Ann Med Surg (Lond) 2021 Jan 14;61:16-18. Epub 2020 Dec 14.

Department of General Surgery, University Hospital Centre Ibn Rochd, Casablanca, Morocco.

Primary lymphomas of appendix are extremely rare tumors. The incidence is 0.015% out of all gastrointestinal lymphomas; furthermore, limited data is available in literature. The appendiceal neoplasms are most commonly presented as acute appendicitis followed intestinal obstruction, intussusception or perforation. We present a case of a 22 year-old male patient who presented with acute appenditis and underwent emergency laparotomy. On abdominal exploration, swollen and enlarged appendix measured 3cm was present for which appendectomy were performed. The histopathological examination of appendectomy specimen revealed a Burkitt's Lymphoma. The patient received R-COPADEM protocol of chemotherapy. Primary gastrointestinal lymphoma is a extremely rare neoplasm without guidelines for therapy.
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http://dx.doi.org/10.1016/j.amsu.2020.11.083DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7750439PMC
January 2021

Polysplenia with agenesis of the dorsal pancreas and preduodenal portal vein, about a case.

Int J Surg Case Rep 2020 7;76:357-360. Epub 2020 Oct 7.

Department of Visceral Surgery, University Hospital Center Ibn Rochd, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco. Electronic address:

Purpose Of The Study: Polysplenia is a complex polymalformative syndrome that is frequently accompanied by an inconsistent spectrum of visceral and vascular anatomical abnormalities and is extremely undiscovered in adulthood. The objective of this article is to limit the intraoperative risks generated by the lack of knowledge of these anatomical variations by insisting on the inconstancy of all these variations and the perfect knowledge of the reference anatomy and the exploration of the anatomical variations in imaging before the surgery.

Patient And Methods: The patient was 50-year-old who was hospitalized in our department for gastric adenocarcinoma. During her extension assessment, a polysplenia syndrome was accidentally discovered on the scan images, which showed an exceptional association between preduodenal portal vein, agenesis of the dorsal pancreas, and polysplenia.

Conclusion: There are neither specific clinical symptoms of the polysplenia syndrome, nor any biological sign; hence, the interest of recognizing this pathology is to avoid diagnostic errors, but also to guide the surgeon during the surgical act performed.
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http://dx.doi.org/10.1016/j.ijscr.2020.10.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7569255PMC
October 2020

Hepatic fascioliasis presenting with bile duct obstruction: a case report.

Pan Afr Med J 2017 18;28:44. Epub 2017 Sep 18.

Department of Parasitology, University Teaching Hospital Ibn Rochd, Casablanca, Morocco.

Fascioliasis is a zoonotic infection caused by a liver trematode: fasciola hepatica; which commonly affects cattle and sheep, humans are accidental hosts. Several cases have been reported in the literature worldwide with a large geographical distribution. We present a case of bile duct obstruction due to a hepatic fascioliasis, successfully treated with both a combined surgical and medical approaches. A high index of suspicion should be kept in mind for all cases of obstructive jaundice, especially in areas in which human fascioliasis infection is repeatedly reported.
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http://dx.doi.org/10.11604/pamj.2017.28.44.11532DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5687870PMC
December 2017
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