Papers by Hazem Ben Ameur
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[Treatment of acute colonic pseudo-obstruction (Ogilvie's Syndrome). Systematic review]
PubMed, Oct 1, 2013
Background: Ogilvie's syndrome is acute colonic dilatation without organic obstacle in a previous... more Background: Ogilvie's syndrome is acute colonic dilatation without organic obstacle in a previously healthy colon. Surgery is the only treatment of cases complicated by necrosis or perforation. In contrast, treatment of uncomplicated forms is not unanimous, and is the subject of this literature review. Aims: Determine the results of different therapeutic methods of uncomplicated forms of Ogilvie's syndrome in terms of efficiency of removal of colonic distension, recurrence, morbidity and mortality. Clarify their respective indications. Methods: An electronic literature search in the "MEDLINE" database, supplemented by hand searching on the reference lists of articles, was conducted for the period between 1980 and 2012. Results: Conservative treatment is effective in 53 to 96% of cases with a risk of colonic perforation less than 2.5% and a mortality of 0 to 14% % (level of evidence 4, recommendation grade C). Neostigmine is effective in 64 to 91% of cases after a first dose, with a risk of recurrence of 0 to 38%. It remains effective in 40 to 100% of cases after a second dose (evidence level 2, grade recommendation B). Endoscopic decompression is a safe and effective technique with a success rate of 61 to 100% at the first attempt , a recurrence rate of 0 to 50%, a rate of colonic perforation less than 5% and a mortality less than 5% (level evidence 4, recommendation grade C). PEG may be recommended for the prevention of recurrence of the ACPO after successful treatment with neostigmine or endoscopic decompression (evidence level 2, recommendation grade B). The cecostomy is more effective and safer than conventional colostomy (level of evidence 4, recommendation grade C). The cecostomy is highly effective in colonic decompression but associated with a high mortality (level of evidence 4, recommendation grade C). Conclusion: Conservative treatment is recommended in first intention. In case of failure, neostigmine should be tried. If unsuccessful, the endoscopic decompression is proposed. The cecostomy is indicated as a last resort after failure of endoscopic decompression.
Incidental Finding of Bilateral Ovarian Adrenal Rest Tumor in a Patient With Congenital Adrenal Hyperplasia: A Case Report and Brief Review
Pediatric and Developmental Pathology, Jan 12, 2021
Ovarian adrenal rest tumors (OART) are tumors that develop in females with congenital adrenal hyp... more Ovarian adrenal rest tumors (OART) are tumors that develop in females with congenital adrenal hyperplasia (CAH). In contrast to their counterpart in testicles, they are exceptional and few cases have been reported in the literature. In this report, we present clinicopathological findings of a female patient with CAH due to 21-hydroxylase deficiency who was incidentally diagnosed with OART with a review of the literature. The 14-year-old patient, who was raised as a boy, developed a virilizing syndrome with high testosterone levels that were attributed to non adherence to her replacement corticosteroid therapy. She consulted for sex reassignment surgery. Pelvic ultrasound was normal. She underwent hysterectomy and bilateral adnexectomy. No abnormalities were noticed during the operation. Grossly, both ovaries were variegated with well circumscribed and lobulated, brownish-yellow nodules. Histologically, the nodules were composed of nests of large polygonal cells with centrally located nuclei and prominent nucleoli. There was mild atypia and no crystals of Reinke. Thus, the findings of the histopathological examination were consistent with bilateral OART. Histological differential diagnosis of OART can be challenging particularly with leydig cell tumor, stromal luteoma and steroid cell tumors, not otherwise specified. OART must be considered in women with CAH and persistent virilizing symptoms despite negative imaging results.
Authorea (Authorea), Jul 15, 2021
Jejunal diverticulitis is a rare condition and usually occurs in the elderly. Its association wit... more Jejunal diverticulitis is a rare condition and usually occurs in the elderly. Its association with extensive diverticulosis is exceptional and makes the management more challenging. We report a case of a 74-year-old man with perforated jejunal diverticulitis with extensive diverticulosis who underwent a surgical management.
Iconography : Duodenal diverticulum associated with annular pancreas: A rare cause of severe cholangitis
Laparoscopic repair of the broad ligament hernia: A case report
International Journal of Surgery Case Reports
A rare case of small intestinal metastasis from lung cancer
Clinical Case Reports
Les péritonites biliaires d'origine lithiasique. (A propos de 39 cas)
La peritonite biliaire lithiasique est une urgence abdominale rare et grave de diagnostic souvent... more La peritonite biliaire lithiasique est une urgence abdominale rare et grave de diagnostic souvent difficile et son pronostic est pejoratif en raison de sa survenue chez des sujets âges et tares. Durant une periode de 21 ans, de 1983 a 2003, nous avons collige 39 cas de peritonites biliaires lithiasiques. Elles representent 1,4 % des interventions biliaires colligees au cours de la meme periode d'etude. Les donnees anamnestiques, cliniques et radiologiques ont contribue au diagnostic positif de peritonite dans 24 cas soit 61,5% dont 15 cas des peritonites biliaires llthiasiques soit 38.4%. L'exploration per-operatoire a conclu a une peritonite biliaire generalisee dans 23 cas et localisee dans 16 cas. Cette peritonite etait secondaire a une perforation de l'arbre biliaire chez 22 malades (56.4 %) et par diffusion chez 17 malades (43,5 %). Une lithiase de la voie biliaire principale a ete associee dans 14 cas (35,8%). L'etude histologique a montre une cholecystite gang...
Journal de Chirurgie Viscérale, 2019
Journal Africain d'Hépato-Gastroentérologie, 2014
Le carcinome épidermoïde de l'estomac est rare, représentant moins de 1% des cancers de l'estomac... more Le carcinome épidermoïde de l'estomac est rare, représentant moins de 1% des cancers de l'estomac. Sa pathogénie reste mal élucidée et plusieurs hypothèses histopathogéniques ont été proposées. Le diagnostic histologique requière des critères morphologiques stricts. Le traitement est mal codifié. Son pronostic parait plus sombre que celui des autres types histologiques notamment l'adénocarcinome. Nous rapportons l'observation d'un patient âgé de 67 ans présentant un carcinome épidermoïde primitif de l'estomac. A travers cette observation, nous discutons les aspects épidémiologiques, pathogéniques, cliniques, anatomo-pathologiques, thérapeutiques et évolutifs de cette exceptionnelle variante histologique du cancer de l'estomac.
Journal of Medical Case Reports
Background Hydatid disease is endemic in Mediterranean countries and most commonly occurs in the ... more Background Hydatid disease is endemic in Mediterranean countries and most commonly occurs in the liver followed by the lung. A primary localization in the retroperitoneum is extremely rare. Case presentation We report the case of a 29-year-old Tunisian patient presenting with progressive left flank pain and skin urticaria. On abdominal ultrasonography and computed tomography scan, a ruptured retroperitoneal hydatid cyst was diagnosed, which was confirmed by positive hydatid serology. The treatment consisted of resection of protruding dome. The evolution was favorable. No local recurrence was detected during postoperative follow-up. Conclusions Primary retroperitoneal hydatid cyst is extremely rare and has uncommon presentation, but we should learn the keys to its diagnosis. In endemic regions, high suspicion for this disease is justified regardless of localization.
Tératome mature de l'ovaire fistulisé dans le colon sigmoïde. A propos d'un cas
Les teratomes ovariens sont des tumeurs germinales considerees comme malignes lorsqu'elles so... more Les teratomes ovariens sont des tumeurs germinales considerees comme malignes lorsqu'elles sont de type immature, ils peuvent se compliquer de rupture intraperitoneale, de torsion ou de compression des organes de voisinage. L'ouverture de cette tumeur dans le tube digestif adjacent en l'occurrence le recto-sigmoide represente une complication rare, voir exceptionnelle. A travers une nouvelle observation de teratome ovarien ouvert dans le sigmoide, nous soulignons les difficultes diagnostiques que peut presenter cette complication et ses modalites therapeutiques.
L'insulinome pancréatique. A propos de 3 cas
L'insulinome est la plus frequente des tumeurs neuroendocrines pancreatiques Il peut etre a l... more L'insulinome est la plus frequente des tumeurs neuroendocrines pancreatiques Il peut etre a l'origine d'accidents hypoglycemiques majeurs qui peuvent engager le pronostic vital et fonctionnel Son diagnostic est biologique. La determination de sa topographie a grandement beneficie des progres de l'imagerie moderne. En rapportant 3 nouvelles observations, nous essayons de proposer une strategie diagnostique et therapeutique adequate de cette affection.
Annals of Pancreatic Disorders & Treatment, 2017
Background: Internal fi stula with adjacent viscera during acute pancreatitis is a rare complicat... more Background: Internal fi stula with adjacent viscera during acute pancreatitis is a rare complication. Due to their anatomic localization, colon, duodenum or stomach may be involved. Pancreatico-colonic fi stula is associated with a higher septic risk and surgery is usually mandatory. We report a new case in 71-year-old man diagnosed by CT with rectal water soluble contrast media and managed conservatively. To our knowledge, this is the second case in the literature treated in this way. Conservative treatment may be offered to selected patients who have a rapid improvement of symptoms associated with a signifi cant regression of the collection.
Indian Journal of Surgery, 2013
Hydatid disease is a parasitic infection caused by Echinococcus granulosus. Splenic involvement i... more Hydatid disease is a parasitic infection caused by Echinococcus granulosus. Splenic involvement is rare even in endemic areas. The aim of this study is to specify epidemiologic features, diagnostic tools, and therapeutic modalities of this uncommon entity. This is a retrospective study of 21 patients operated on for a splenic hydatid cyst between January 1996 and December 2011. The mean age was 43.8 years (range 15-72 years). Sixteen patients (76.2 %) had symptoms related to a splenic location of hydatid disease. While splenic hydatid disease was solitary in 8 patients (38.1 %), other locations were present in 13 patients (61.9 %), mainly in the liver. Most splenic cysts were type I (39.3 %) or III (42.8 %). Nine patients (42.8 %) underwent resection of the protruding dome with one postoperative complication (suppuration of residual cavity). Total and partial splenectomies were performed in nine and three patients, respectively, without any complication. No death was noted. After a mean follow-up period of 36 months (range 2-108 months), no recurrence was observed. Splenic hydatid cyst is a rare location. The diagnostic is usually easy, based on serology and imaging. The surgery is the mainstay of treatment. The type of surgical procedure depends on size, number, and location of the cyst. Total splenectomy is more effective but may have high morbidity and mortality and must be reserved to specific situations. Conservative procedure is safer but could increase the rate of recurrence and postoperative collection. Puncture aspiration injection reaspiration could be proposed for small cyst in inoperable patients.
[Treatment of acute colonic pseudo-obstruction (Ogilvie's Syndrome). Systematic review]
BACKGROUND Ogilvie's syndrome is acute colonic dilatation without organic obstacle in a previ... more BACKGROUND Ogilvie's syndrome is acute colonic dilatation without organic obstacle in a previously healthy colon. Surgery is the only treatment of cases complicated by necrosis or perforation. In contrast, treatment of uncomplicated forms is not unanimous, and is the subject of this literature review. AIMS Determine the results of different therapeutic methods of uncomplicated forms of Ogilvie's syndrome in terms of efficiency of removal of colonic distension, recurrence, morbidity and mortality. Clarify their respective indications. METHODS An electronic literature search in the "MEDLINE" database, supplemented by hand searching on the reference lists of articles, was conducted for the period between 1980 and 2012. RESULTS Conservative treatment is effective in 53 to 96% of cases with a risk of colonic perforation less than 2.5% and a mortality of 0 to 14% % (level of evidence 4, recommendation grade C). Neostigmine is effective in 64 to 91% of cases after a first...
Traitement de la Pseudo-Obstruction Colique aigue (sy ndrome d' Ogilvie) revue sy sté matique de la Litté rature
summaryBackground: Ogilvie’s syndrome is acute colonic dilatation withoutorganic obstacle in a pr... more summaryBackground: Ogilvie’s syndrome is acute colonic dilatation withoutorganic obstacle in a previously healthy colon. Surgery is the onlytreatment of cases complicated by necrosis or perforation. Incontrast, treatment of uncomplicated forms is not unanimous, and isthe subject of this literature review. aims: Determine the results of different therapeutic methods ofuncomplicated forms of Ogilvie's syndrome in terms of efficiency ofremoval of colonic distension, recurrence, morbidity and mortality.Clarify their respective indications. methods: An electronic literature search in the "MEDLINE"database, supplemented by hand searching on the reference lists ofarticles, was conducted for the period between 1980 and 2012. results: Conservative treatment is effective in 53 to 96% of caseswith a risk of colonic perforation less than 2.5% and a mortality of 0to 14% % (level of evidence 4, recommendation grade C).Neostigmine is effective in 64 to 91% of cases after a first dose...
[Surgical complications of colostomies]
La Tunisie médicale, 2014
The colostomy may be terminal or lateral, temporary or permanent. It may have psychological, medi... more The colostomy may be terminal or lateral, temporary or permanent. It may have psychological, medical or surgical complications. reporting the incidence of surgical complications of colostomies, their therapeutic management and trying to identify risk factors for their occurrence. A retrospective study for a period of 5 years in general surgery department, Habib Bourguiba hospital, Sfax, including all patients operated with confection of a colostomy. Were then studied patients reoperated for stoma complication. Among the 268 patients who have had a colostomy, 19 patients (7%) developed surgical stoma complications. They had a mean age of 59 years, a sex ratio of 5.3 and a 1-ASA score in 42% of cases. It was a prolapse in 9 cases (reconfection of the colostomy: 6 cases, restoration of digestive continuity: 3 cases), a necrosis in 5 cases (reconfection of the colostomy), a plicature in 2 cases (reconfection of the colostomy) a peristomal abscess in 2 cases (reconfection of the colostom...
Perforated jejunal diverticulitis with extensive diverticulosis: A case report
Clinical Case Reports
Exceptional evolution of hepatocellular carcinoma
Pan African Medical Journal
Hémocholécyste compliquée d’une rupture de la vésicule biliaire
Pan African Medical Journal
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Papers by Hazem Ben Ameur