Hirschsprung's Disease in Adults, A Case Report
M.Haida, H.Ouaya, M.Michouar, A. Ait Errami, S.Oubaha, Z. Samlani, K. Krati
Sch J App Med Sci | 1427-1430
DOI : 10.36347/sjams.2021.v09i09.022
Hirschsprung's disease (HD) is a rare congenital disease characterized by the absence of ganglion cells in the distal rectum and which is usually diagnosed in early childhood. We speak of Hirschsprung’s disease of adults in patients where the diagnosis was made after the age of 10 years, it is a rare but not exceptional condition. This should be borne in mind in young adults with a history of chronic constipation. Due to the rarity of Hirschsprung’s disease in adults, patients are rarely referred for evaluation, including rectal biopsy, further delaying diagnosis. The elements of the diagnosis are primarily clinical. The basic treatment for Hirschsprung's disease recognized in adulthood is surgical resection of the lymph node segment of the intestine with the intention of creating an anastomosis with healthy and properly innervated tissue. In this regard, we present the case of a 22-year-old young man, followed in the gastro-entero-hepatology department at the Arrazi hospital of the Mohammed VI University Hospital in Marrakech for aetiological assessment of a chronic constipation of terminal appearance, complicated by 2 episodes of sigmoid volvulus resolved by rectal probe detorsion, the rectal biopsy of which revealed aganglion in favor of Hirschsprung’s disease.
Erector Spinae Plane Block for Different Abdominal Surgeries: Case Series
Mouad Lagdani, Youssef Elouardi, Mohamed Khallouki
Sch J App Med Sci | 1424-1426
DOI : 10.36347/sjams.2021.v09i09.021
The ultrasound guided erector spinae plane (ESP) block is a recent block described for various surgeries for postoperative analgesia. ESP block has effect on both visceral and somatic pain; therefore, its use in laparoscopic cholecystectomy and other abdominal surgeries can be advantageous. The technique is considered a quality standard because it provides good control of the anticipated pain. The local anesthetic is injected between the erector spinae muscle and the transverse process and it spreads cranially and caudally into the paravertebral space, affecting the ventral and dorsal branches of the thoracic spinal nerves and the rami communicants that contain sympathetic nerve fibers. This relatively simple and safe block dramatically reduced the amount of IV pain medication we usually administer for the specific procedure. The overall result was increased satisfaction of the patient and avoidance of opioid use. We described five case series of ESP blocks successfully performed for postoperative analgesia in various abdominal surgeries.
Plummer-Vinson Syndrome. A Case Report
O. Hadadia, M. Jarti, A. Ait Errami, S. Oubaha, Z. Samlani, K. Krati
Sch J App Med Sci | 1421-1423
DOI : 10.36347/sjams.2021.v09i09.020
Plummer-Vinson syndrome (PVS) is characterized by a triad of symptoms comprising microcytic hypochromic anemia, esophageal webs, and dysphagia. PVS is commonly found in women of middle age especially in the fourth and fifth decade of life and is rarely reported in males. We report a case of a 53-year-old female patient who had a classic presentation of PVS. PVS is precancerous with high malignant potential; early diagnosis is of utmost importance for better prognosis and surveillance endoscopy is recommended. Iron repletion oftentimes improves the dysphagia; seldom esophageal dilatation is used to provide symptomatic relief.