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Biomedical subjects

S Ayadi

Publications and source records attributed to S Ayadi.

18 recordsLinked to original sources

[Gastric amyloidosis mimicking malignancy. A case report].

Amyloidosis is an abnormal extracellular deposition of insoluble proteins, which is associated with an involvement of the gastrointestinal tract in 50 to 70% of cases. In primary amyloidosis (light chain amyloidosis), localized gastric involvement is a rare finding which can mimic malignancy. We report the case of a 56-year-old man, admitted with upper digestive outlet obstruction. Linitis plastica with lymph node involvement was suspected by gastroscopy, barium meal and endoscopic ultrasonography but was not confirmed by gastric biopsies. The patient was treated with total gastrectomy with lymph node dissection. Pathological examination demonstrated gastric and lymph nodes amyloidosis and no malignant tumor was found. The patient died 9 months later from cardiac failure due to amyloidosis.

Amyloidosis↗

[Laparoscopic cholecystectomy in a patient with situs inversus].

Laparoscopic cholecystectomy is the standard approach to manage symptomatic gallbladder stones. However, only twelve patients with total situs invertus have been previously reported in the literature. We report a new case of a 58-year-old patient hospitalized for acute pain of the left hypochondrium with fever. The diagnosis of acute cholecystitis with situs inversus totalis was made following clinical examination and radiological investigations. Laparoscopic cholecystectomy was subsequently performed through a modification of the technique to adapt to the mirror image anatomy.

Cholecystectomy, Laparoscopic↗

[Subcutaneous rupture of hydatid cyst of liver: dealing with a rare observation].

Hydatid cyst of liver is a parasitosis of endemic proportions in Tunisia. The purpose of this report is to describe a case involving subcutaneous rupture of a hydatid cyst of liver in a 41-year-old patient. Diagnosis was established by ultrasonography and CT-scan. The patient underwent surgical treatment and recovered uneventfully. Subcutaneous rupture remains an uncommon complication. This is only the second case reported in the literature up to now.

Abdominal Wall↗

[Systemic mastocytosis. A case report].

The authors report a case of systemic mastocytosis in a 65 year-old woman. The clinical picture was generalized abdominal and extra abdominal lymph nodes, ascites, splenomegaly, and hepatomegaly. As gastro-intestinal symptoms led to suspect a digestive malignant lymphoma; the patient underwent an exploratory laparotomy. The diagnosis of systemic mastocytosis was established by demonstrating an excessive number of mast cells in the cutaneous and extracutaneous tissues (liver, mesenteric lymph, nodes, spleen and bone marrow). Bone marrow biopsy revealed extensive myelofibrosis.

Aged↗

Fatal sepsis due to Escherichia coli after second-trimester amniocentesis.

The case of a pregnant woman (16th week) needing an amniocentesis is reported. She rapidly developed a septic shock. Despite vaginal delivery, curettage and antibiotherapy, the patient deteriorated with the onset of an acute respiratory distress syndrome and a typical disseminated intravascular coagulation. Bacteriological data showed positive blood cultures to Escherichia coli. Amniotic liquid was positive to the same E. coli. Cultures obtained from instruments, disinfectant solutions and gel used during the procedure were negative. On the contrary, amniotic and fetal cultures were positive to E. coli and Clostridium perfringens. She died 2 days later. The incidence of septic shock following amniocentesis is very low but we report the first case of fatal sepsis and multiorgan failure, due to E. coli and C. perfringens. The mechanisms of infection are discussed: contamination from the instruments, systemic dissemination of bacteria coming from an asymptomatic intra-amniotic infection, and inoculation of the placenta with a needle passing through the bowel.

Adult↗

[Endoscopic hemostasis of hemorrhagic gastroduodenal ulcers].

The mortality rate for peptic ulcer bleeding has remained constant for several decades, despite advances in surgery and intensive care, and this has given rise to an interest in therapeutic hemostatic endoscopy. Thus, endoscopy in the treatment of peptic ulcer hemorrhage would be undertaken with the aim of obtaining an early and precise diagnosis of the hemorrhagic lesions, to arrest active bleeding and/or to prevent rebleeding. In the selection of patients justifying an endoscopic hemostatic treatment, intervene clinical criteria (age, concomitant pathologies, current medication, hemodynamic parameters), endoscopic criteria (active arterial bleeding, visible vessels). The most frequently employed methods are laser photocoagulation, thermal probe cauterization, electrocoagulation and sclerotherapy. None of these methods have gained supremacy. There is consensus that sclerotherapy should be the method of reference (simple and inexpensive). Endoscopic methods are capable of arresting bleeding and constitute an alternative method to surgery in cases of emergency. They should reduce recurrence of hemorrhages, but nevertheless have no influence on the prognostic parameters which are essentially clinical.

Clinical Trials as Topic↗