Abdominal wall hernias after trauma have been recognized for more than a century, with the first case reported as occurring after a fall. Traumatic abdominal wall hernias (TAWHs) after blunt trauma are uncommon. The timing of definitive repair, early or delayed, is not clear. We report a case on TAWH and mesenteric avulsion, highlighting the reasons for immediate or delayed repair. A single case study can hardly be considered as a basis for profound changes in the management of post traumatic hernias. However, damage to all layers of the abdominal wall indicates high-energy trauma. In such cases, the damage is not, in all probability, limited to the integumentary system. For the moment, the timing of surgery in any TAWH should be considered differently according to the trauma, the wall defect, clinical and radiological findings, associated injuries, and the clinical status of the patient.
A primary hemangiopericytoma (HP) of the bone is rare, because the vast majority of these tumors arise in soft tissue. This report presents a case of a hemangiopericytoma in the sacrum (S1-S2) with extension to the retrorectal space. Only a few cases of osseous hemangiopericytomas in the sacrum and involving the retrorectal space have so far been reported. The difficult diagnosis of HP and the surgical strategy was chosen according to the location of the lesion in the sacrum and retrorectal space. A local excision was indicated. A sacral resection should be considered for tumors below S4. This report demonstrated the safety of this strategy. Adjuvant radiotherapy is useful in HP. The value of chemotherapy is still doubtful, although patients with high-grade tumors or metastatic spread seem to gain substantial benefit. Due to the often unpredictable behavior of this neoplasm, extended follow-up is strongly recommended.
Introduction : Les chambres à cathéter implantables (CCI) se sont imposées comme outils indispensables dans la prise en charge des patients ayant besoin de traitement intraveineux de longue durée. L'objectif de ce travail est d'évaluer la pose des CCI sur le plan technique ainsi que les incidents et complications pouvant survenir au cours de la mise en place ou pendant la période d'utilisation. Matériel et méthode : Étude rétrospective sur six ans incluant toutes les CCI posées entre janvier 2003 et décembre 2008 dans le but d'instaurer une chimiothérapie pour cancer. Résultats : Cinq cent quatre-vingts CCI étaient placées, chez 412 hommes et 168 femmes, la moyenne d'âge des patients était de 43 ans avec des extrêmes de 16 et 76 ans. Quatrevingt-dix des sites étaient posés à droite et 10 % à gauche dont la moitié pour échec de la pose à droite. Le site de la pose était de 42 % en céphalique, 31 % en jugulaire externe, 17 % en jugulaire interne et 10 % en sous-clavier. La durée d'utilisation moyenne des cathéters était de sept mois avec des extrêmes de 10 jours et de 36 mois. Dix-sept pour cent des patients avaient présenté au moins une complication dominée par l'infection ou la thrombose. La mortalité liée au geste de pose était nulle dans notre série. Conclusion : En comparant nos résultats aux données de la littérature, nous recommandons l'utilisation de cathéter en polyuréthane, de préférer la voie jugulaire et la pose par un opérateur expérimenté.
Mots clés Site veineux implantable · Cathéter · ComplicationsAbstract Introduction: Implantable venous catheters have become indispensable tools in the management of patients requiring long-term intravenous treatment. The objective of this work is to evaluate the implantable venous catheter technique, and incidents and complications that may arise during installation or during use. Methods: Retrospective study over six years covering all implantable venous catheters laid between January 2003 and December 2008 in order to establish chemotherapy for cancer. Results: A total of 580 implantable venous catheters were placed in 412 men and 168 women. The average age of the patients was 43 years, with ages ranging from 16 to 76 years. Ninety percent of the catheters were placed on the right and 10% on the left, of which half were due to failure of insertion on the right. The sites of the insertion were 42% cephalic, 31% external jugular, 17% internal jugular, and 10% subclavicular. The average duration of catheter use was 7 months, with duration ranging from 10 days to 36 months. Seventeen percent of the patients presented at least a complication dominated by infection or thrombosis. In our series, there was no mortality due to the insertion. Conclusion: Comparing our results with that of the literature, we recommend the use of polyurethane catheter, to prefer the jugular route, and the insertion be done by an experienced operator.
We evaluated medical exposure and risk estimation during routine radio-diagnostic examinations in Agadir City during the year 2012. The frequency data were collected from four main Radiological departments of the city performing radiography as well as computed tomography (CT) procedures. The estimated annual number of examinations was approximately 100.000. Eighty percent of diagnostic examinations were conventional radiology procedures while CT exams represent only 20%. The evaluated annual number of examinations was 206 per 1000 people. The estimated annual collective and per inhabitant effective doses from medical X-ray procedures mount 23,207 man Sv and 0.24 mSv, respectively. These results allow us to classify Agadir City at healthcare III according to UNSCEAR classification. As for the average effects during medical exposure, it is 132 10 −7 and 5 10 −7 additional cancer risks and the hereditary effects, respectively. The study presented the first assessment of frequency and population dose from medical expositions in Agadir City and it provides estimates of the impact of the medical x-ray procedures.
Introduction: Desmoid tumors are rare entities, can occur at any age and may be located intra or extra-abdominal. Their recidival locally nature without metastasis remains a subject of discussion especially if it is necessary to decide on a surgical or medical treatment. Case report: In the present report, it was described the case of a 25-year-old male with no specific medical or surgical history who consulted for a mass of the abdominal wall evolving for a few months and having caused intermittent pain and discomfort. The physical examination was unremarkable apart from an arch and a palpable large mass in the left para-umbilical. The abdominal Computer Tomography (CT) scan confirmed the existence of a large tumor developing at the expense of the left rectus muscle. The patient underwent a surgical treatment. The resection of the tumor was the cause of a significant loss of substance. So, a synthetic prosthesis had to be used to reconstruct the abdominal wall. Conclusion: Although desmoid tumors are benign, radical treatment should be undertaken given their recurrent nature.
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