PubMed Health⌕ Search

Biomedical subjects

A Belmahi

Publications and source records attributed to A Belmahi.

At least 19 recordsLinked to original sources
PubMed2006

[Efficiency of the combination of Mersilene-musculocutaneous flap in the reconstruction of full-thickness chest wall defects. A retrospective study of 14 cases].

SUBJECT: The tumors of chest wall can be responsible of large full-thickness defects. The skeletal stabilization by different synthetic materials with numerous modalities of use and the superficial coverage of the defect by a musculocutaneous flap are the two imperatives parts of this reconstruction. PATIENTS AND METHODS: From January 1997 to January 2006, 14 patients, 10 males and 4 females, aged between 17 and 63 years old and suffering from full-thickness chest wall defects secondary to tumor resection have benefited from a simple reconstruction, wherever the defect, by a Mersilene Mesh and a muscular or musculocutaneous flap. These defects measured between 8 x 12 cm and 14 x 16 cm and were located in the anterior part of the chest in 3 cases, with resection of the upper half of the sternum and the internal part of both clavicles and the first three ribs, and in the lateral part of the chest in 11 cases with resection between 3 and 5 ribs. The histological diagnoses of these tumors were 3 chondrosarcomas, 3 sternum and 1 rib metastases, 2 desmoid tumors, 1 Ewing's sarcoma, 4 benign tumors. The flaps used were pedicled in 13 cases and based on the latissimus dorsi muscle, the serratus muscle and the pectoralis major muscle; in 1 case, the latissimus dorsi musculocutaneous flap was free. RESULTS: The skeletal stabilisation seems satisfying. There was no problems with the pulmonary function except in 4 cases where a dyspnea appears in sustained effort. No vascular complication on these flaps was noted. With a mean follow up of 46 months, there was no local recurrence of the malignant tumors. Two patients were deceased 1 year after surgery.0. CONCLUSION: The Mersilene mesh associated with a locoregional musculocutaneous flap represent a simple and efficient solution for the treatment of such defects.

Adolescent↗
PubMed2006

[A simple way to secure the distally based fascio-cutaneous flap of the leg: the lesser sapheneous-greater sapheneous vein anastomosis. Report of 15 clinical cases].

PURPOSE: The distally based fasciocutaneous flaps of the leg are very useful for the treatment of skin defects at the lower third of the leg and the foot, but the venous congestion due to the reverse flow can be responsible of necrosis at the distal part of the flap. The anastomosis of the lesser saphenous vein which is included in the flap's dissection to the greater saphenous vein near the defect avoid this venous congestion and the necrosis of the most useful part of the flap for the coverage of these defects. MATERIAL AND METHODS: From January 1999 to June 2005, 15 patients aged between 22 and 64 years old have benefited for the treatment of soft tissue defects secondary to trauma with a mean diameter of 7 x 10 cm and located in 7 cases at the lower third of the leg and in 8 cases at the posterior side of the heel, from distally based posterior fasciocutaneous flaps where the venous reverse flow has been changed in a physiological one by the terminolateral anastomosis between the lesser and greater saphenous vein. The dissection of these flaps was classical except that the lesser saphenous vein was dissected 6 cm beyond the proximal part of the flap in the popliteal region. RESULTS: In all these flaps, there was no venous congestion and no arterial problems. With a mean follow-up of 40 months, the coverage's quality of these defects was very satisfactory. No sequellae are reported. CONCLUSION: The anastomosis between the lesser and the greater saphenous veins seems to eliminate the main source of failure of the distally based fasciocutaneous flap of the leg and can reinforce the indications of these flaps for the treatment of such defects.

Adult↗
PubMed2006

[Liposarcoma of the thumb].

Liposarcoma is the most common malignant deep soft-tissue tumor in adults. however, primitive cutaneous liposarcoma is very rare. We report the observation of a patient who presents a liposarcoma of the thumb.

Humans↗
PubMed2004

[Splenomegaly and splenic pseudotumor due to tuberculosis: six new cases].

INTRODUCTION: Splenic tuberculosis is rare. The aim of this study was to remind diagnostic problems in this disease, and to evaluate the value of surgery in its management. MATERIAL AND METHODS: Retrospective study of data of six patients (three male and three female, whose mean age was 50 years) admitted in surgical department from 1980 to 2000 for splenic tuberculosis. RESULTS: In six cases, symptoms were poorly specific; splenomegaly and anemia were constant. In imaging studies, splenomegaly was homogeneous in four cases and heterogeneous in two. Diagnosis of tuberculosis was done without need for splenectomy in four patients. Five patients were operated on: two had diagnostic laparotomy without splenectomy, two underwent diagnostic splenectomy and one had splenectomy indicated for splenic abcess refractory to medical treatment. Four of the five operated patients recovered. The two other patients were lost of follow-up. CONCLUSIONS: In our experience, surgery is useful in diagnosis and treatment of splenic tuberculosis.

Adult↗
PubMed2004

[The protected tendinous graft in zone 2 or fibroblast trap].

INTRODUCTION: We present a simple technique for preventing adhesions to tendon grafts in zone 2. A silicone tube is cut longitudinally and the third of its diameter is removed. It is then introduced under the pulley with the slot towards the skeleton. The tendon graft is introduced into this tube which will protect it from adhesions except at the slot level where fibroblasts create a new vasculature. MATERIALS AND METHODS: Between April 2002 and April 2003, we have used this technique in three patients, two in their thumbs and one in the long finger. In the Boyes classification, one thumb lesion corresponded to stage 1 and the other two cases to stage 4. The main pulleys were preserved. The tube measured 12 cm in length, and extended from the proximal juncture to the distal one (Pulvertaft technique). After 5 weeks of strict immobilization, the tube was withdrawn and the patients began active mobilization. RESULTS: After 8 weeks, comparison of the results with the opposite hand showed: Normal extension in all cases. Flexion deficit of 15 degrees in the thumb interphalangeal joints. Flexion deficit of 20 degrees in the proximal and distal interphalangeal joints of the long finger. There were no reported complications. With a mean follow-up of 1 year, these results were stable. CONCLUSION: These results support the contention that a good blood supply to the tendon and a good gliding surface have been developed with this technique. The tube seems to work as a fibroblast trap and blocks harmful adhesions.

Adult↗
PubMed2003

[The fasciomusculocutaneous flap at the leg. About 9 clinical cases].

The fasciomusculocutaneous flap at the leg (FMC) include a muscle strip in the classic dissection of the fasciocutaneous flap (FC); this muscle survives only by the musculocutaneous vessels perforators. This muscle improves the trophic quality of the classic FC flap and allows him to bring easily muscle to the lower third of the leg and sole of the foot. From october 96 to january 2001, 9 posterior FMC flaps have been used in 9 men, their ages were between 22 and 61-years-old, 8 of these flaps were distally based and 1 was proximally based. The muscle strip came from the medial gastrocnemius muscle, its lengh and its width corresponded to the dimension of this muscle but the depth has never exceeded 10-12 mm. The skin defects have a diameter ranging from 7 to 10 cm and were localised in 3 cases in the sole of the foot, in 5 cases in the lower third of the leg with 1 case of tibial osteomyelitis and in 1 case in the external part of the knee. All these defects were secondary to trauma. No complications were reported with this technique. There was no vascular problems with the muscle strip: its bleeding was checked at the operating room and at 3 weeks when the pedicle was severed. All these patients were hospitalized between 4 and 5 weeks. With an average of 30 months follow-up all the defects covered were very satisfying and the case of the osteomyelitis was healed. There is no functional sequellae and the aesthetic sequellae are those of the classic FC flaps at the leg.

Adult↗
PubMed2003

[The bilobed flap: a very efficient method in aesthetic reconstruction of small skin defects at the alar and tip regions of the nose].

From October 1996 to January 2001, 20 patients (14 men and six women) ranging from 36 to 75 years old have been treated for their small skin defects of the nose by using the bilobed flap. These skin defects were located in 15 cases at the alar region and in five cases at the tip region. They were secondary to the resection of basal cell carcinoma in 17 cases and benign tumors in three cases. Their diameter ranged from 8 to 17 mm and in all these cases there was no involvement of the lining or cartilage. The design used for this bilobed flap was the Zitelli one, based on some mathematical principles; its base was medial or lateral depending on the site of the defect. With this method, the skin defects were reconstructed esthetically without any distortion of local anatomy of the nose with skin having the same color, texture and thickness. With an average of 28 month follow-up, all these reconstructions were stable with discreet scars and without the trapdoor phenomenon. No complications were reported. Esthetic reconstruction of such subunit nasal skin defects is easily done by this technique and is better than that obtained by the majority of others methods.

Adult↗
PubMed2002

[Cicatrix endometriosis of the abdominal wall].

Endometriosis is a rare entity, related after operation on the uterus or uterine tubes or a laparotomy procedures or other extrapelvic procedures, when seeding of endometrial fragments were shed into the peritoneal cavity. We report the case of a menopaused woman with a subcutaneous incisional scar mass that appeared 22 years after a caesarean section. The diagnosis was made by histological examination.

Aged↗
PubMed2002

[Hibernoma: a rare case of massive weight loss].

Hibernoma is a rare soft tissue benign tumor composed of cells similar to those of brown fat observed in fetus and hibernating animals. Brown fat has thermogenous properties, by the way of carbohydrates and lipid catabolism, and can be of an important mean in thermoregulation. A massive weight loss is a rarely reported sign in patients with hibernoma. We report herein the case of a 47 man with a history of isolated weight loss, of 16 kg over 4 months. Clinical examination has shown a swelling of the right flank. Surgical resection has been made and histopathological examination has shown hibernoma. The post-operative weight gain confirmed the relationship between hibernoma and weight loss.

Adipose Tissue↗
PubMed2002

[Perineo-scrotal gangrene: apropos of 31 cases].

Fournier's gangrene is a fascitis of the perineum and of the external genitalia. It is a serious infection with rapid evolution and a severe prognosis. It is also unpredictable towards the necrosis. It concerns a series of 31 cases of the perineal scrotal gangrene supervised in the department of surgical visceral emergency of the Ibn Rochd University hospital of Casablanca between 1992 and 2000. In this investigation, the male predominance is important and the mean age is 49 years. The diagnostic delay is 12 days. The symptomatology was dominated by edema and erythema signs, fever and pain. The skin necrosis was seated in the perineum and the scrotum. A septic shock was noticed in six patients and a condition of deep coma in two other patients. Etiology of gangrene was of coloproctologic origin in 15 cases and of urogenital origin in five patients. The bacteriological parietal swabs was positive in 11 cases. The therapeutic take-in-charge consisted of urgent measures of reanimation for six patients. The likely wide spectrum antibiotic therapy consisting of a triple association (beta lactam antibiotic, nitrite-imidazole compound and aminoglycoside) with a secondary adaptation that was recommended for all patients. All the patient underwent surgical debridement of the necrotic tissue with incisions and drainage of the involved areas of the of all the operated-on patients, 26 had colostomy, five among them had both colostomy and cystostomy. The overall evolution was favorable except in eight cases of death. In all, the authors insist on the positive diagnosis as well as the early take-in-charge of the disease to avoid complications of local or general order and recommended the preventive treatment with the precocious treatment of the causing infection.

Adult↗
PubMed2002

[Reconstruction of large scalp and calvarium defects by using the semi-free latissimus dorsi flap associated with methylmethacrylate implant for cranioplasty].

The semi free latissimus dorsi flap is characterized by a temporary vascular anastomosis on a pedicle not belonging to the loco-regional anatomy of the skin defect; after a period of autonomy, the section of the flap pedicle is obligatory. Its advantage compared to the classic free flap is the great microsurgical security avoiding complex, and stressful supervision in the postoperative period. From June 1998 to January 2001, 7 patients ranging from 18 to 65 years old and suffering from large scalp defects going between 20 x 13 cm and 27 x 18 cm have benefited from this surgical method. The etiology of these defects was: in 4 cases dermatofibrosarcoma protuberans involving the periost, in 1 case destruction of the near entirety of the scalp and calvarium by electrical burn, in 1 case an instable scar of burn with osteomyelitis and in the last case an osteomyelitis on a frontal cranioplasty. Three stages have been used:--The thoraco-dorsal artery was anastomosed on the wrist to the radial artery in a termino-lateral way and the thoraco-dorsal vein to the superficiel radial vein in a termino-terminal way;--The flap was fixed to the forearm for 2 weeks, then, the debridement which has always exposed the dura was done; The flap was sutured to the defect after reconstruction of calvarial defect with the méthylmétacrylate implant;--After 3 weeks the pedicle was sectioned and the flap tailored exactly to the defect. No postoperative complications were reported. With a mean follow-up of 18 months, the scalp coverage was very satisfactory.

Adolescent↗
PubMed2002

[The square pronator: an "aspirin" strip in antalgic surgery for painful neuromas of the wrist].

From June 96 to January 2001, 25 patients have been operated on for painful neuromas localised at the wrist. They were between 10 and 52 years of age. These neuromas were located in at the median nerve 17 cases, at the ulnar nerve in seven cases and at the radial nerve in one case. In all cases the pain was not spontaneous but triggered off by external stimulus. All these neuromas were in continuity except 1 case at the median nerve where a total severing was present. After external neurolysis, the quadratus pronatus muscle is wrapped around the neuromas in 24 cases and around epineurial suture in one case. No internal neurolysis was done. This flap was vascularized by the anterior interosseous artery in 23 cases and by the posterior interosseous artery in two cases of distal ulnar nerve neuroma. All patients have been improved by using this method. In 21 cases (84%) (17 median, 4 ulnar nerves) the pain has completely disappeared and in four cases (3 ulnar, 1 radial), the pain has considerably decreased but without total disappearance. In the cases of median nerve neuromas the dysaesthesia has greatly decreased. No complications and no sequelae on the donor site are reported.

Adolescent↗
PubMed2001

[A rare complication of ileal pouch anal anastomosis: superior mesenteric artery syndrome].

The aim of this study was to report a new case of superior mesenteric artery syndrome following total proctocolectomy and ileal pouch-anal anastomosis for chronic ulcerative colitis. Diagnosis was made following a prolonged gastric stasis and was based on upper gastrointestinal X-ray series. Medical treatment was unefficient and gastro-jejunostomy was performed. The early outcome was good.

Adult↗
PubMed2001

[A simple and effective technique for reconstructive surgery of medium-sized scalp defects].

From June to December 1999, eight patients aged from 16 to 30 years with scalp defects ranging from 9-11 cm in the tonsural region secondary to high-voltage electrical burns underwent scalp reconstruction via a technique based on the Orticochéa method, but which was less complicated in design, easier to carry out, and also more efficient. The entire scalp was prepared for surgery subgalea, but in no case was the dura mater exposed. Then four local flaps were taken, i.e., two temporal, one frontal, and one occipital flap. The width of each flap was the same size as the diameter of the scalp defect, and the base of each flap included the main regional blood vessels: A straight-forward advancement technique for the four flaps was not sufficient to completely cover such scalp defects, and a rotational approach was also introduced. In fact, the originality of the presently-described technique lies in the rotational approach, which is extremely efficient. It is carried out via three backcuts, beginning with the first temporal flap, then the second temporal flap, and if necessary the occipital flap; but never the frontal flap. These backcuts are performed in such a way that they are subsequently hidden by hair growth. In the present study, no skin graft was necessary, and no complications were reported. All the patients were satisfied with the results of surgery, both as regards the cosmetic aspect and regrowth of hair, and also as regards scalp sensitivity.

Adolescent↗
PubMed1990

[Carcinoid liver tumors. Apropos of a case].

The authors report here a case of a young 35 years-woman presenting a probably primitive liver carcinoid tumor, surgically managed by hepatectomy followed by a complete disappearance of the carcinoidal syndrome. Through this case, the authors discuss the diagnostic difficulties, actuality of primitive hepatic carcinoids, their course, prognosis elements and the therapeutical management means.

Adult↗