Tumeur glomique de la face postérieure du poignet : à propos d’un cas

Extra-digital glomus tumors are extremely rare and difficult to diagnose. The authors report a case of glomus tumor of the dorsal aspect of the wrist, discovered incidentally after surgical resection in a 71-year-old patient.     

Utilisation du lambeau cerf-volant pour le traitement d’un sarcome épithélioïde du pouce. À propos d’un cas

Epithelioid sarcoma is a rare lesion usually involving extremities. We report the case of a patient presenting with an epithelioid sarcoma of the dorsal aspect of the thumb. Surgical treatment consisted in a wide resection, arthrodesis of the metacarpophalangeal joint of the thumb and skin coverage with a kite flap. This case report illustrates a rare diagnosis potentially encountered by hand surgeons and the possible use of a kite flap in a non-traumatic context.     

Contribution à l’étude de la mortalité dans un service d’urologie: Le cas du service d’urologie du CHU de Cocody d’Abidjan de 2000 à 2006

Objective

To analyze the incidence and main causes of mortality in the Department of Urology of the University Hospital of Cocody.

Patients and Methods

This retrospective analysis included 117 patients who died in the Department of Urology of the University Hospital of Cocody between April 2000 and December. Based on the data collected from the patient files, the hospital registry and the death certificates we studied the frequency and causes of death.

Results

The overall mortality rate was 10.1% with a male-to-female sex ratio of 14:1. The patients’ mean age was 63.4 (range 18–94) years. The main cause of death was cancer (87.5%). Cancer of the prostate which was the second most frequent reason for consultation after benign prostatic hyperplasia was the commonest cause of death encountered in 62.4% of the patients, followed by bladder and renal cancer with 16,2% and 6%, respectively. Prostatic adenoma (52%) was the most frequent and urethral stricture (8%) the third most frequent reason for hospitalization and led to death in 3.4% and 4.3%, respectively. Moreover, death mainly occurred in the second half of the month (53.9%) and during the night (57.3%).

Conclusion

The incidence of mortality in urology remains high and is almost exclusively related to urological cancers.     

La luxation bipolaire de l’avant-bras ou avant-bras flottant (à propos d’un cas)

Bipolar dislocation of the forearm or floating forearm is a rare injury. It combines concomitant elbow and wrist dislocation. Only six cases have been reported in the literature. The diagnosis of wrist dislocation may initially be missed and therefore the prognosis will be worse. The authors report a case of a bipolar dislocation with a posterior dislocation of the elbow and a perilunate dislocation of the wrist.     

Est-il possible de faire un diagnostic positif du syndrome de l’intestin irritable ?

The diagnosis of irritable bowel syndrome (IBS) is a clinical diagnosis, based on Rome III criteria. The identification of alarm signs, red flags, associated with an organic digestive disease is a key-point during the initial screening. Age higher than fifty, blood in faeces and diarrhoea seem to be the 3 most specific red flags. Biological and morphological examinations must be performed cautiously, their profitability is weak in patients having Rome criteria. In the majority of clinical situations during daily clinical practice, a positive diagnosis of IBS can be performed.     

Compression du rameau superficiel du nerf radial par un kyste synovial du coude (À propos d’un cas et revue de littérature)

Compression of the radial nerve at the elbow is quite rare; entrapment of its superficial branch is exceptional. Extrinsic compression is the most frequent etiology. Magnetic resonance imaging plays a major role in the diagnosis, and early surgical excision or echoguided drainage – in case of synovial ganglion – allows a total recovery. The authors report the case of a compression of the superficial branch of radial nerve by an elbow synovial cyst treated by surgical resection.     

Traitement d’un déficit congénital bilatéral de flexion du coude chez un enfant classé arthrogrypose

The authors report the case of a child presenting with bilateral upper limb arthrogryposis due to agenesis of the biceps. Physical examination revealed a bilateral deficit of active elbow flexion although passive flexion was possible. Echography confirmed bilateral biceps agenesis. The treatment was surgical, one side at a time. An ipsilateral pedicle latissimus dorsi muscle transfer was used to restore elbow function. The second procedure took place 7 months after the first. After each operation, the patient's limb was immobilised in plaster for 6 weeks before rehabilitation was commenced. Six months postoperatively, elbow flexion measured 100° on both sides. The functional sequelae at the donor site were negligible, apart from some persisting hypertrophic scars. Bilateral biceps brachii agenesis has not previously been reported in the literature. The surgical treatment undertaken enabled restoration of function with minimal sequelae.     

PTT ou SHU atypique ? À propos d’un cas révélant une maladie de Berger

Thrombotic microangiopathy includes a set of conditions characterized by the association of mechanical hemolytic anemia, thrombocytopenia and organ failure which accurate diagnosis is sometimes difficult. We report the case of a patient who presented a thrombotic microangiopathy (TMA) due to an atypical hemolytic and uremic syndrome (HUS) associated with an immunoglobulin A (IgA) nephropathy with a favorable outcome under corticosteroid.     

Métastases osseuses d’un épendymome d’emblée de double localisation. À propos d’un cas

A case of cerebral and sacral ependymoma revealed by cerebellar syndrome and sciatica in a 68-year-old man is reported. Bone metastases were diagnosed seven months after surgical excision of the brain tumor.     

L’hyperprolactinémie dans le syndrome de Gougerot-Sjögren est-elle une caractéristique d’un sous-groupe de patients ou fait-elle partie de la maladie ?

Objective. – To investigate the prevalence of hyperprolactinemia in patients with primary Sjogren’s syndrome (SS), its clinical significance and its implication to our understanding of the disease pathogenesis.Materials and methods. – Forty-nine patients with primary SS syndrome (44 females and 5 males) age range 37–66 years were included in this study. All patients underwent clinical assessment for disease manifestations in addition to the laboratory assessment for serum prolactin, sex hormones and immunological profile. Fifty healthy subjects (44 females and 6 males) of matched age were studied as control group.Results. – The mean prolactin serum level was significantly higher in SS patients compared to the control group (P < 0.01). This significant difference was persistent after subgrouping the patients and the controls based on their menstrual history. Hyperprolactinemia (>20 ng/ml) was prevalent in 16.3% of SS patients. There was no correlation between serum prolactin levels and hormonal status, auto-antibodies as well as systemic manifestations of the disease.Conclusion. – Patients with primary SS have moderately increased the levels of prolactin. Hyperprolactinemia reflects the disease pathology rather than being present in a subset of patients. The presence of elevated prolactin levels was not associated with hormonal status, clinical or immunological manifestations of primary SS.     

Tumeur glomique de la capsule antérieure du coude. À propos d’un cas

Glomus tumors are rare tumors, benign but painful and responsible for a major functional impairment. Although their preferential localization is digital, 35% of glomus tumors are extradigital. Ignorance of this disease characterized by atypical clinical signs and the absence of specific imaging are responsible for a significant diagnostic delay, 7 to 10 years in extradigital forms. Treatment by surgical excision simply ensures immediate disappearance of pain without recurrence in 90% of cases. It is therefore necessary to emphasize the existence of this sometimes debilitating condition benefiting from effective therapeutic solution. We report the case of a glomus tumor of the anterior capsule of the left elbow in a 24-year-old woman with a diagnostic delayed by 12 years.