[Digestive stomas: which professional impact?].

Introduction: digestive stomas result from a certain number of surgical interventions. They may be temporary or definitive. The patient with stoma has potentially damaging physical and psychological problems.

Predictive factors for histological response to neo-adjuvant treatment in rectal cancers.

Introduction: The complete histological response represents the goal of neo-adjuvant treatment of locally advanced rectal cancer. This objective is a real challenge requiring the research of predictive factors for this response, from the perspective of targeted therapeutic strategies. The results of the various studies focused on these predictive factors are discordant.

A disconcerting false gastric diverticulum mimicking malignancy.

Gastric diverticula are the most uncommon form of gastrointestinal diverticula. They can either be of true or false type with different pathogenesis. They may be very challenging to diagnose as symptoms are nonspecific and imaging can simulate a malignant lesion.

[Unexpected discovery of isolated osteochondroma in the pubic symphysis].

Osteochondroma is the most common benign bone tumor. It usually affects the metaphyses of the long bones, in particular around the knee and the proximal humerus. It very rarely affects the pubic symphysis, usually with an atypical symptomatology.

Extracapsular involvement in nodal metastasis as a prognostic factor in colorectal cancer.

Background: Extracapsular extension of nodal metastasis has recently emerged as an important prognostic factor in different malignancies. In colorectal cancer (CRC), only a limited number of studies have been published and its prognostic value has not yet been completely established.

Aims: To assess the incidence of extracapsular invasion (ECI) in lymph node (LN) metastasis in colorectal adenocarcinoma and to investigate the correlation between this parameter and other clinico-pathological factors.

Resected colorectal cancer liver metastases : Prognostic study about 110 patients.

Introduction: The prognosis of hepatic metastases in colorectal cancers is constantly being improved at the cost of multidisciplinary care, allowing each patient to have an adapted strategy. The prognostic factors make it possible to recognize patients needing further treatment after resection and closer monitoring.

Objective: The aim of our study was to conduct a prognostic study to identify factors influencing survival at 5 years for patients operated of colorectal liver metastases.

[Post traumatic anterior abdominal wall hernia].

Post traumatic anterior abdominal wall hernia can be ignored in emergency settings. We here report the case of a 32-year-old patient with a BMI of 30 kg/m, suffering from anterior abdominal wall hernia as a result of a road accident. This lesion wasn't detected during clinical examination.

[Primary renal carcinoid metastasizing to distant sites 12 years after the initial diagnosis].

Primary renal cancinoids are rare, with one hundred cases reported in the literature. Histologically, it is a well-differentiated tumor which shares a morphological pattern similar to that seen in carcinoids identified at other anatomic locations. We report a case of a 45-year-old man with primitive renal carcinoid, with diagnosis made after the detection of liver metastases.

Surgical treatment of Crohn's disease: indications, results and predictive factors of recurrence and morbidity.

Background: Crohn's disease management represents a major problem in gastroenterology and general surgery because it affects young subjects and has a major impact on their quality of life. The aims of our study were to identify the indications for surgery in Crohn's disease, the results and the complications of surgery in our series, and to identify possible predictive factors of recurrence and postoperative morbidity.

Methods: A retrospective descriptive study including 38 cases of patients with Crohn's disease who underwent surgical treatment in the department of surgery in Mongi Slim Hospital, during the period between January 1992 and December 2011 was performed.

Solid pseudopapillary tumor of the pancreas with concomitant Bochdalek's hernia. The first reported case.

Background: Solid pseudopapillary tumors of the pancreas are rare. The diagnosis is difficult because of its clinical and radiological polymorphism. It was described in the literature that this entity can be associated with congenital malformation.

Percutaneous treatment versus hepatic resection for the treatment of small hepatocellular carcinoma.

Background: Hepatocellular carcinoma is the first liver tumor worldwide. Therefore, it is a matter of debate whether surgical treatment or percutaneous treatment should be preferred for the treatment of patients with small hepatocellular carcinoma. The aim of our study was to compare the long-term outcome and the survival between surgically and percutaneously treated small hepatocellular carcinomas.

Autoimmune pancreatitis. A report of 5 cases from Tunisia: diagnostic challenge.

Background: In this study, we aimed to review retrospectively the records of 5 patients who were treated in our hospital and to review the current approaches in diagnosis and management of autoimmune pancreatitis (AIP).

Methods: The series of patients diagnosed with AIP during the last seven years (January 2006 - August 2012) was the basis of this study. All records were retrieved and analyzed.

Ischemic colitis in five points: an update 2013.

Background: Ischemic colitis is the most common form of intestinal ischemia. The presence of diarrhea and mild lower gastrointestinal bleeding should guide the diagnosis. Although many laboratory tests and radiographic images may suggest the diagnosis, colonic endoscopic with histological analysis of biopsies is the gold standard for identification of colonic ischemia.

Toxic megacolon complicating a first course of Crohn's disease: about two cases.

Toxic megacolon is a rare and serious complication of Crohn's disease. Because of the associated high morbidity and mortality, early recognition and management of toxic megacolon is important. Through two cases of toxic megacolon complicating Crohn's disease, we assessed the clinical, radiologic and therapeutic characteristics of this complication.

Leiomyosarcoma of the inferior vena cava.

Vascular leiomyosarcoma (LMS) are unique. The inferior vena cava (IVC) is the most affected organ (about 38% cases). We report the observation of a 50-year old woman who consulted for right upper quadrant pain.

Relationship between MDM2 and p53 alterations in colorectal cancer and their involvement and prognostic value in the Tunisian population.

Background: The prevalence of p53 mutations in colorectal cancer could reach 90%. The most important regulator of this protein that was identified originally was the Murine Double Minute2 (MDM2) oncoprotein, by which the levels of p53 were fixed through an autoregulatory feedback loop. In cancer cases, the overexpression of MDM2 deregulates this feedback, and the signaling pathway between MDM2 and p53 is blocked.

Impact of MDM2 polymorphism: increased risk of developing colorectal cancer and a poor prognosis in the Tunisian population.

Introduction: MDM2 was originally identified as an oncoprotein that binds to p53 and inhibits p53-mediated transactivation. Scientists have described functional single-nucleotide polymorphisms (SNP) in the MDM2 gene. They showed that the genotype of SNP 309 induces an increase in the level of MDM2 protein, which causes attenuation of the p53 pathway.

[Isolated splenic metastasis revealing colon cancer].

Splenic metastasis of colon cancer is uncommon especially when isolated. In fact, they are usually associated to multi visceral location. Malignant melanoma, cancer of breast and lung and ovarian carcinoma are the most common cancer which metastases in spleen.

[Treatment of primary and secondary malignant tumor of the liver. Opinion of the surgeon].

Hepatocellular carcinoma is the most frequent primitive cancer of the liver. This tumor mainly develops in cirrhotic liver that is a true precancerous state. Treatment can be surgical or not surgical.

[Intestinal T cell lymphoma in coeliac disease. A case report].

Primary intestinal T-cell lymphomas account for about 5% of all primary gastrointestinal lymphomas and are mostly associated with coeliac disease. Intestinal lymphomas are usually discovered during the 4th to 5th decade and constitute an exceptional complication of coeliac disease. This lymphoma is generally a high grade pleomorphic cell lymphoma with large cells.