Physiology and Anatomy

Benign tracheoesophageal fistula is a rare clinical entity and a rare complication of prolonged intubation and tracheostomy, we report the case of 20-year-old woman with a tracheoesophageal fistula secondary to mechanical ventilation. Ventilation difficulties and the recurrent lung infections were the mean symptoms, Early diagnosis was confirmed by bronchoscopy then the patient underwent a surgical repair of the fistula and interposition of a muscle flap. Acquired nonmalignant tracheoesophageal fistula is a preventable disease but this complication can still occur. The surgical treatment remains the best option.

The monosodium glutamate is commonly used food flavoring agent used worldwide. The present experimental study investigated the effects of orally administered monosodium glutamate (MSG) on the histology of testes of adult male Wistar rat model. Forty adult male Wistar rats were divided into three groups; Group A served as controls, Group B. received MSG orally (1 mg/kg), Group C. received MSG orally (2mg/kg) and Group D. received MSG orally (4 mg/kg). Tissue sections of testis from rats in the control (Group A), showed the normal histological features for the seminiferous tubules and interstices. Group B rats revealed normal spermatogenic cells, many spermatids, and edematous interstitial spaces with mild hyperemia. The Group C rats showed inflammatory exudates in interstitial spaces, spermatids were fewer and changes of degeneration of Leydig cells. Group D rats showed severely reduced spermatogonia, very few to totally absent spermatids in the tubules. Sertoli cells were reduced in the tissue sections. The Leydig cells were also diminished in count with severe vacuolar degeneration. Overall, the MSG treated rats showed altered histology of testicular tissue. The present study concluded that the glutamate has deleterious effects on the testicular histology in adult male Wistar rats particularly in high dose therefore caution must be taken for its frequent use in large quantities as a food flavor additive.

Type I neurofibromatosis (NF) is the most common autosomal dominant disease. It concerns one in 3000 births, the penetrance is close to 100%. Cranio-maxillofacial region is concerned in 10% of the cases. We are reporting the case of a patient who has been surgically cared for in the department of stomatology and maxillofacial surgery at the Rabat specialty hospital, for a nasal plexiform neurofibromatosis with a good post-operative evolution and a very satisfactory esthetic result.

Small lymphocytic lymphoma (SLL) is a low-grade B-cell non-Hodgkin lymphoma (NHL) characterized by a monoclonal population of mature B-cell lymphocytes. It is rarely associated with cardiac involvement. Pericardial effusion is one of the most common incidental findings in cancer patients, which significantly worsens morbidity and mortality. Thus, early detection, adequate treatment, and understanding of pericardial diseases are necessary to help improve the quality of life of cancer patients. An individual treatment plan should be established, taking into account cancer stage, the patient's prognosis, local availability and experience. We report the case of a SLL involving the pericardium.

The aim is to show through two clinical cases an anatomical variability of the cystic duct. The first clinical case of a patient admitted for endoscopic treatment of the main bile duct lithiasis while cholangiography had objectively dilated the cystic duct over its entire length, it was very low implanted in pre-papillary with the presence of a lacunar image evoking a vesicular infundibulum lithiasis. The second clinical case of a patient admitted for endoscopic retrograde cholangio pancreatography and extraction of a millimetric lithiasis of the main biliary tract visualized on the biliary Magnetic Reasoning Imaging, whereas retrograde cholangiography objectified: a thin main biliary tract and a cystic duct measuring 4 mm, long and low implanted with a doubt on a lacunar image. The anatomical variability of the cystic duct is not uncommon, therefore detailed knowledge of all these anatomical variations is essential to avoid iatrogenic lesions of the bile ducts.

External auditory canal cholesteatoma is a very rare entity, representing 0.1 to 0.5% of the otological pathology, carrying the same characteristics as that the middle ear cholesteatoma. Its location may be associated to other affections due to the large variety of differential diagnosis, benign or malignant cases which are far more frequent than the cholesteatoma. The diagnosis is mainly clinical, the therapeutic management consists on a surgical procedure which depends on the stage of the disease. Known for its slow evolution, and the risk of recurrence, the external auditory canal cholesteatoma requires a clinical and radiological surveillance that can extend over several years. Our work focuses on the study of diagnostic modalities and therapeutic management through two hospitalized cases treated in the ENT and CCF department of Rabat Specialty Hospital.

Inflammatory myofibroblastic tumor (IMT) is an uncommon condition that is rarely encountered in the urinary tract. It is considered as an intermediate neoplasm according to the WHO classification. It can occur in different organs: lung, pancreas, mesentery and uterus. The localization in the bladder is unusual. We report a case of IMT of the urinary bladder in a 32 years old male who presented with hematuria, treated by partial cystectomy and diagnosed by histopathological analysis of the operative piece.

Ventricular septal defects following myocardial infarction are a relatively infrequent complication occurring transmural myocardial infarction. The simultaneous presence of ventricular septal defects and left ventricular aneurysm in the same patient is extremely rare and usually occurs within the first week after myocardial infarction. Surgery remains the only viable treatment option. A 63-year-old man with multiple risk factors for coronary artery disease diagnosed with acute extensive anterior wall myocardial infarction, presented to our emergency room with heart failure symptoms, cardiac auscultation revealed a band-shaped systolic murmur in the left parasternal area, radiating to the whole precordium.Electrocardiography revealed sinus rhythm with persistent ST-segment elevation in leads V1–V4 with Q waves in the anterior precordial leads, and chest X-ray revealed bilateral pulmonary congestion. A Transthoracic 2D echocardiography was performed at our facility which demonstrated dilated left ventricle with severely reduced systolic function. Important regional wall motion abnormalities were present with an aneurysm of the medium and apical segments of anterior and septal wall complicated by two muscular ventricular septal defects. Colour Doppler revealed a shunt between the left and right ventricle through the aneurysmatic segment. Coronary angiogram showed a significant disease of the left anterior descending and right coronary artery. The patient underwent surgery for the simultaneous repair of the ventricular septal defect, apical aneurysm and a coronary artery bypass. Post-infarction left ventricular aneurysm associated with a double ventricular septal defect is a very unusual mechanic complication, especially five weeks after the inaugural episode with no evidence of recurrent heart attack. We present such a case that was successfully treated surgically. Rapid diagnosis and urgent surgical management significantly improves the patient's prognosis.

Lymphoma is a malignant proliferation of lymphatic system cells. Large B-cell lymphoma is one type of the large list of lymphomas. It could occur in the lymphatic system or other body organs outside it. The clinical expression of this kind of tumors can be really variable. Usely there are general signs such as fever, heavy sweating at night and losing of weight. In addition to symptoms related to the local development of the tumor. In this article, we are about to present a case of tonsillar lymphoma which clinical expression could be confused with any benign tonsillar lesion.

Nodular fasciitis is an unusual benign reactive process of the soft tissues related to the fascia and characterized by fibroblastic proliferation. Its rapid growth can be deceptively similar to that of soft-tissue sarcomas. The importance of this diagnosis is primarily in its recognition, separation from a wide differential diagnosis and avoidance of unnecessary additional surgery. We report a case of a rare localization of this tumor in the neck observed in a six years old child.