RESUMEN
The aim of this study was to assesss epidemiological, clinical and the therapeutic aspects of annexial masses. We have performed a retrospective study from 15/09/1994 up to 31/12/1997 including 74 patients. The prevalence rate was 18.40% of the overall gynecologic surgery in our department. Mean age was 36 years old. The range 30-41 years represented 40.5% of our cases. The mean gestity was 4 and the average parity 4. The most common clinical features were pelvic pains (75.57%) and hypogastric masses (50%). The duration of the disease ranged from 1 to 10 years. The general status was good in 94.59% of cases, bad with ascites in 5.41%. The annexial masses were cystic in 87.83%. The ovarian cysts were located at the both sides in 45.94, and bilateral in 8.10%. The annexial masses were solid in 9.45%. An abscess was found in 6.75%. We have performed an annexectomy in 66.1% and a cystectomy in 16.21%. The post operative complications were wound suppuration in 13.51%. The mortality rate was 1.35%. At the long-term follow up we have noticed an eventration in 1.35% and a recurrence with need of reintervention in 16.21%. The pathologic exam found a benign tumor in 95.16% and a carcinoma in 4.84%. The annexial masses are very common in our practice. They involve young multipare women. The main clinical outcome is pelvic pains. Annexectomy is the principal treatment.
Asunto(s)
Enfermedades de los Anexos/epidemiología , Enfermedades de los Anexos/cirugía , Neoplasias de las Trompas Uterinas/epidemiología , Neoplasias de las Trompas Uterinas/cirugía , Quistes Ováricos/epidemiología , Quistes Ováricos/cirugía , Neoplasias Ováricas/epidemiología , Neoplasias Ováricas/cirugía , Centros Médicos Académicos , Enfermedades de los Anexos/complicaciones , Enfermedades de los Anexos/diagnóstico , Adolescente , Adulto , Anciano , Ascitis/etiología , Neoplasias de las Trompas Uterinas/complicaciones , Neoplasias de las Trompas Uterinas/diagnóstico , Femenino , Número de Embarazos , Humanos , Persona de Mediana Edad , Quistes Ováricos/complicaciones , Quistes Ováricos/diagnóstico , Neoplasias Ováricas/complicaciones , Neoplasias Ováricas/diagnóstico , Ovariectomía , Paridad , Dolor Pélvico/etiología , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Factores de Riesgo , Senegal/epidemiología , Factores de TiempoRESUMEN
The aim of our study was to find a way of preserving the ilioinguinal nerve during surgical procedures for the repair of inguinal hernias. 40 inguinal regions were dissected, 37 ilio-inguinal nerves studied. The emergence of the nerve was at 4.21 cm of the anterior superior iliac spine, at 0.78 cm of the inguinal ligament on average. Its course was parallel to the inguinal ligament, always lay under the aponevrosis of the external oblique abdominal muscle, it passed through the superficial abdominal ring in 67.56% before proceeding on anterior side of spermatic cord. This result allowed us to examine the possibility of the nerve course variation's, of anastomosis with iliohypogastric nerve and particularly the best way to identify it when surgical procedures are performed in the lower portion of the abdomen.
Asunto(s)
Conducto Inguinal/inervación , Hernia Inguinal/cirugía , Humanos , Vías Nerviosas/anatomía & histología , Traumatismos de los Nervios Periféricos , Nervios Periféricos/anatomía & histologíaRESUMEN
The authors report the results of a chronological study of anatomo-pathological aspects observed in the autopsy of subjects who died after a heavy ammonia poisoning. It is about a retrospective study based on the medico-legal autopsies of 91 cases of death an industrial ammonia tank explosion which occurred inside a factory in Dakar (SONACOS), on the 24th of March 1992. The census of the dead has been made during the three months following the explosion. The victims were between 3 months and 74 years old. Among the 91 dead there were 15 women and 76 of the male sex. The recent lesions were discovered in the subjects who died during the first three days. The consisted of some extended cutaneomucous burns, a sharp lung oedema sometimes associated with a pulmonary emphysema. Later on, results show that deaths are rather caused by the after effects of a pneumopathy (pulmonary infection, bronchiectasis, pulmonary fibrosis). Ammonia belong to the irritating and caustic gas. The intensity of the lesions and the mortal risk are proportional to the quantity of gas per m3 of air. If the lesions described in our research have similarities with the published description, the latter mentions only a few cases of death. The originality of our series is particularly found in the intensity of the lesions and the number of deaths. This shows the insufficiency of both means of prevention and emergency assistance.
Asunto(s)
Accidentes de Trabajo , Amoníaco/envenenamiento , Traumatismos por Explosión/patología , Quemaduras por Inhalación/patología , Industria Química , Explosiones , Adolescente , Adulto , Anciano , Autopsia , Traumatismos por Explosión/etiología , Traumatismos por Explosión/mortalidad , Bronquiectasia/inducido químicamente , Bronquiectasia/etiología , Bronquiectasia/patología , Quemaduras Químicas/etiología , Quemaduras Químicas/mortalidad , Quemaduras Químicas/patología , Quemaduras por Inhalación/etiología , Quemaduras por Inhalación/mortalidad , Causas de Muerte , Niño , Preescolar , Femenino , Humanos , Pulmón/patología , Masculino , Persona de Mediana Edad , Membrana Mucosa/patología , Síndrome de Dificultad Respiratoria/inducido químicamente , Síndrome de Dificultad Respiratoria/mortalidad , Síndrome de Dificultad Respiratoria/patología , Senegal , Piel/patologíaRESUMEN
INTRODUCTION: An uncommon form and a rare localization of mycetoma is reported. The aim of this report was to distinguish this inhabitual form of mycetoma from some tropical diseases like onchocerca and other fungal diseases. CASE REPORT: A 55 year old man was admitted 10 years after a septic worm-hole for a scapulo-thoracic tumor. This encapsulated mass was a bending and rounded polyfistular one attached to the dorsal aspect of left shoulder. The fistula discharge a serosanguineous or purulent exudate. The characteristic red granule was not visible. The tumor was removed and histological examination was performed. A typical granuloma of red granule of streptomyces pelletieri was found. A good result was obtained with associated cotrimoxazole treatment. DISCUSSION: Scapulo-thoracic form included: scapular, axillary and chest form of mycetoma. All these localizations are rare. One of them can be complicated by osteitis or pleuro-pulmonary localization. Streptomyces pellitieri is the actinomycetic causal agent. This encapsulated form is uncommon. CONCLUSION: Scapulo-thoracic mycetoma is rare. Encapsulated and pedicular form is uncommon. Around Sahel areas, differential diagnosis must be evoked such as parasitic and mycobacterial infections.
Asunto(s)
Dermatomicosis/patología , Micetoma/patología , Dermatomicosis/clasificación , Dermatomicosis/microbiología , Humanos , Masculino , Persona de Mediana Edad , Micetoma/clasificación , Micetoma/microbiología , Hombro , Streptomyces/aislamiento & purificaciónRESUMEN
The authors report the case of a 30 year old man with a left ventricular aneurysm who was seropositive to HIV 1 and HIV 2. The patient was stage IVC 1 (AIDS related complex) by the "Center for Disease Control" classification. The clinical presentation was pyrexia, loss of weight, micropolyadenopathy and cardiac failure. The electrocardiogramme showed low voltage in the peripheral leads with a QS morphology in S2, S3 and aVF and abrasion, of the R wave in the precordial leads. Doppler echocardiography demonstrated a large left ventricular aneurysm with a wide neck. Despite treatment with a diuretic, angiotensin converting enzyme inhibitor and anticoagulants, the patient died suddenly. Autopsy confirmed the wide necked left ventricular aneurysm. This would appear to be the first report of this form of cardiac disease during HIV infection. However, a simple coincidence of the two pathologies cannot be excluded.
Asunto(s)
Infecciones por VIH/complicaciones , Aneurisma Cardíaco/complicaciones , Adulto , Resultado Fatal , Aneurisma Cardíaco/diagnóstico , Aneurisma Cardíaco/patología , Humanos , MasculinoRESUMEN
Based on a prospective study on a continuous series of women admitted on emergency for post-coitus hemorrhage. The authors present an epidemiology and prognosis of vaginal injuries in to coitus in the Dakar University Teaching Hospital. Over a period of 33 months (October 1991 to December 1994), 106 cases were recorded, giving an incidence rate of 32 cases per year. The average profile is that of young women (26 years), usually during the post-partum period (41.5%) or in the second phase of menstrual cycle (32%). The main influencing factors found included: chronic vaginal infection (74%), position during coitus (especially that dorsal decubitus with hyperflexion and abduction of the lower members (56%), sexual abstinence of 3 months on average (21 days to 2 years), and use of aggressive product "aphrodisiac" for vaginal mucus. The damage was most often located at the bottom of dead end of Douglas and could be estimated at 5 cm long and 5 mm deep. The immediate prognosis was favourable, after stitching with absorbable thread, healing was obtained within 8 to 15 days. Given a retrospective view about 2 to 5 years, morbidity was represented by 3 recurrent cases and 13% after effects of the deep dyspareunia type.
Asunto(s)
Coito , Vagina/lesiones , Adolescente , Adulto , Servicio de Urgencia en Hospital/estadística & datos numéricos , Femenino , Hospitales Universitarios , Humanos , Incidencia , Persona de Mediana Edad , Morbilidad , Pronóstico , Estudios Prospectivos , Recurrencia , Factores de Riesgo , Senegal/epidemiología , Técnicas de Sutura , Heridas y Lesiones/epidemiología , Heridas y Lesiones/etiología , Heridas y Lesiones/terapiaRESUMEN
This prospective study was carried out in Dakar, Senegal, to assess the prevalence of Helicobacter pylori infection in symptomatic patients undergoing endoscopy and to evaluate the factors of risk for infection by this type of bacteria in the population. From October to December 1995, 134 patients were included in this study and replied to a standardized questionnaire designed to determine socioeconomic level and living conditions. Diagnosis of Helicobacter pylori infection was based on the combined results of the urea breath test (Clo-test) and histological findings. Helicobacter pylori infection was detected in 82.8% of patients with no significant difference according to sex, age, ethnic group, or living environment (urban or rural). The incidence of infection was also the same in all socioeconomic groups. It was already high in the age group between 11 and 20 years (90.9%). Helicobacter pylori was identified in 76.2% of patients with normal endoscopic findings and in 100% presenting ulcers, erosions, or gastritis. This study shows that the incidence of Helicobacter pylori infection is extremely high regardless of socioeconomic level and that infection begins at a young age. These findings are consistent with the poor hygiene of most people in Senegal.
Asunto(s)
Infecciones por Helicobacter/epidemiología , Helicobacter pylori , Gastropatías/epidemiología , Adolescente , Adulto , Distribución por Edad , Niño , Femenino , Infecciones por Helicobacter/complicaciones , Infecciones por Helicobacter/diagnóstico , Infecciones por Helicobacter/microbiología , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Prevalencia , Estudios Prospectivos , Factores de Riesgo , Senegal , Factores Socioeconómicos , Gastropatías/complicaciones , Gastropatías/diagnóstico , Gastropatías/microbiología , Encuestas y CuestionariosRESUMEN
The authors report the study of the cytological screening for cervical cancer in Africa on the basis of the experience from four West African countries (Ivory Coast, Guinea, Mali and Senegal). The study reveals that in all these countries, the yearly coverage is inferior to one cervical vaginal cytological screening per 100 women of 15 years of age and above. This rate (< 1%) is too weak to act on the rate of mortality and morbidity of cervical cancer. Consequently, the authors advise like WHO the African authorities to define and to apply cervical cancer screening programs to reach the following goal: carry out one cervical vaginal cytology in each woman near the age of 40. Cervicography can be associated.
Asunto(s)
Cuello del Útero/patología , Neoplasias del Cuello Uterino/epidemiología , Frotis Vaginal , Adolescente , Adulto , Anciano , Côte d'Ivoire/epidemiología , Femenino , Guinea/epidemiología , Humanos , Malí/epidemiología , Tamizaje Masivo , Persona de Mediana Edad , Senegal/epidemiología , Neoplasias del Cuello Uterino/patologíaRESUMEN
Case of bronchogenic cyst associated with extralobar pulmonary sequestration is presented in a 10-month-old baby. At thoracotomy, the tumor was an extralobar pulmonary sequestration with a central cyst surrounded by two pulmonary lobes vascularised by systemic vessels. Resection was easy. The cyst had a respiratory mucosa and was benign. The pathogenesis of the malformation is discussed.
Asunto(s)
Quiste Broncogénico/complicaciones , Secuestro Broncopulmonar/etiología , Quiste Broncogénico/diagnóstico por imagen , Quiste Broncogénico/cirugía , Bronconeumonía/etiología , Secuestro Broncopulmonar/diagnóstico por imagen , Secuestro Broncopulmonar/cirugía , Femenino , Humanos , Lactante , Radiografía , ToracotomíaAsunto(s)
Carcinoma Hepatocelular/virología , Hepatitis B/complicaciones , Hepatitis C/complicaciones , Neoplasias Hepáticas/virología , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma Hepatocelular/epidemiología , Estudios de Casos y Controles , Enfermedad Crónica , Femenino , Hepatitis B/epidemiología , Hepatitis B/inmunología , Antígenos de Superficie de la Hepatitis B/sangre , Antígenos e de la Hepatitis B/sangre , Hepatitis C/epidemiología , Hepatitis C/inmunología , Anticuerpos contra la Hepatitis C/sangre , Humanos , Incidencia , Neoplasias Hepáticas/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Senegal/epidemiología , Estudios Seroepidemiológicos , Población UrbanaRESUMEN
Keratosis diffusa fetalis is a rare autosomic recessive disorder, in which infants are covered with large parchment-like scales, split by deep fissures. Most affected infants die a few weeks after birth because of infections and respiratory problems. The authors present the clinical, histological and ultrastructural aspects of two cases of Ichthyosis congenita fetalis observed in negro-African newborns.
Asunto(s)
Queratosis/congénito , Femenino , Humanos , Ictiosis/patología , Recién Nacido , Queratosis/patología , Masculino , Piel/patología , Piel/ultraestructura , Timo/patología , Timo/ultraestructuraRESUMEN
Les cancers de vessie sont d'observation courante en pratique quotidienne urologique a Dakar. Entre janvier 1970 et decembre 1993; 82 cas de cancer vesical ont ete colliges au Laboratoire d'Anatomie et de Cytologie Pathologiques du CHU de Dakar. La prevalence de cette pathologie est situee a 2;3 pour cent de l'ensemble des cancers au Senegal. L'age moyen de survenue est de 46 ans avec atteinte plus precoce de la femme. Le carcinome malpighien est le type histologique le plus frequent (62;2 pour cent) et n'est pas toujours associe a des lesions bilharziennes
Asunto(s)
Neoplasias de la Vejiga Urinaria/patologíaRESUMEN
Tumor seeding of the abdominal wall during fine needle puncture-aspiration of the liver is a very rare complication. The authors report a case of this complication affecting a 50-year-old Senegalese woman. She underwent echo-guided fine needle cyto-puncture of a hepatocellular carcinoma arising from the left lobe, followed by left lobectomy. The subcutaneous nodule was discovered 42 months after cyto-puncture. Histology following its excision revealed infiltration of carcinomatous hepatocytes between the fibers of rectus abdominis. There was no recurrence and the patient was well 10 months after excision of the subcutaneous nodule. With a review of 10 others cases reported in the literature, the authors feel that, although rare, this complication must be avoided and suggest a system for the protection of structures through which the needle passes.
Asunto(s)
Biopsia con Aguja/efectos adversos , Carcinoma Hepatocelular/patología , Neoplasias Hepáticas/patología , Hígado/patología , Neoplasias de los Músculos/patología , Siembra Neoplásica , Recto del Abdomen , Femenino , Humanos , Persona de Mediana Edad , Recto del Abdomen/patología , Factores de TiempoRESUMEN
De 1983 a 1993; 111 cas histologiquement prouves de mycetomes ont ete observes a la Clinique Dermatologique de l'Hopital Le Dantec; Dakar; Senegal. L'etiologie a ete etablie d'apres l'aspect histologique des grains; l'identification par culture a pu etre faite dans quelques cas. Les actinimycetomes sont majoritaires : 79 cas (71;2 pour cent) ayant pour etiologie: Actinomadura pelletieri; 65; Actinomadurae; 12; streptomyces somaliensis; 2. Les 32 cas (28;8 pour cent) de mycetomes fongiques sont dus a Madurella mycetomatis; 19; Leptosphaeria spp; 5; grains fongiques; 5; Phialophora jeanselmi; 1; Rhinocladiella atrovirens; 1; dermatophyte; 1. Comme cela avait ete decrit il ya une trentaine d'annees les patients proviennent de deux zones d'endemie. La premiere est representee par les rives du fleuve Senegal ou les mycetomes fongiques a grains noirs sont legerement predominants. La deuxieme zone est centrale; humide; avec des pluies annuelles allant de 500 a 800 mm. La predominance des mycetomes a A. pelletieri est tres nette
Asunto(s)
Micetoma/epidemiología , Micetoma/etiologíaRESUMEN
Arterial supply to the sino-atrial and atrioventricular node is studied after coronary RHODOPAS injection on 15 adult hearts taken off during autopsy. Both coronaries were injected in 7 cases, left ostium in 2 cases and the right on in 6 cases. The sino-atrial node is supplied by the right sino atrionodal artery (S.A.N.A) in 6 cases upon 7 and in 3 cases by the left S.A.N.A. Anastomoses exist in 2 cases between the right S.A.N.A. and the left S.A.N.A. The atrio-ventricular nodal artery arises from the retro-ventricular trunk branching from the right coronary artery mainly. The authors emphasize that care must be taken to protect the vascular supply to the conduction tissue during cardiac surgery.
Asunto(s)
Arterias/anatomía & histología , Nodo Atrioventricular/anatomía & histología , Nodo Sinoatrial/anatomía & histología , Adulto , HumanosRESUMEN
The authors report the results of a retrospective and comparative study of anatomo-clinical aspects of ganglionic tuberculosis carried out over two periods of five years each: first period: 1962-1966; second period: 1988-1992. This study shows a higher prevalence of this disease among children during the first period with an odd ratio of 4.36. In the second period, young adults are the most affected particularly the age group between 30 and 39. The possible role of the HIV virus in this phenomenon has been pointed out. The most common histological forms were the subacute ones with a distinct prevalence during the second period, on the opposite of the acute and chronic forms.