Biomedical subjects
Publications and source records attributed to A Benjelloun.
Hydrocarbon pneumonitis has become rare in industrialized countries. However, it remains one of the most frequent emergencies in African dispensaries, especially within children, by accidental ingestion. The case reported here is about a diesel aspiration after siphoning. As in most cases, the healing occurred without any complication.
INTRODUCTION: Osteoma of the nasosinus cavities, particularly the frontoethmoidal cavities, is often a fortuitous radiographic discovery. Potential complications include ophthalmological, sinusal, and endocranial disorders. MATERIAL AND METHODS: Nine patients (five men and four women), mean age 24.3 years (18-43) presenting orbital osteoma were managed from 1994 to 1999. RESULTS: Clinical signs were dominated by ophthalmological disorders, basically non-reducible exophthalmia (n = 8). Two patients had permanent unilateral nasal obstruction and one had acute sinusitis. The bony orbital tumefaction was located in the superior medial angle in five patients. Radiography (Blondeau view) demonstrated an opacity in the sinus with an orbital extension. Computed tomography, performed in all patients, identified the lesion location: ethmoidofrontal (n = 4), anterior ethmoidal (n = 2), frontal (n = 2), ethmoidomaxillary (n = 1). There were no endocranial extensions. Surgery was undertaken for eight patients generally via the transfacial approach (n = 7); a bicoronal approach was used for one patient. En bloc resection (n = 4) or fragmentation (n = 4) was performed. There was one postoperative complication: regressive diplopy. These patients have been followed regularly with clinical and radiographic explorations and have been free of relapse for 2 to 6 years. DISCUSSION: Frontoethmoidal osteoma is a relatively rare benign tumor. Severity depends on the orbital and endocranial extension. Imaging provides the positive diagnosis and guides the surgical approach. Therapeutic indications depend on the tumor size, its course, and the development of complications. We observed total relapse free outcome after complete resection.
Extracranial carotid aneurysms caused by Takayasu's arteritis is extremely rare. Their evolutionary risk is dominated by rupture and cerebral ischemia. We report a case of a 23 years old woman presenting bilateral common carotid aneurysm secondary to Takayasu's arteritis. Surgical treatment with the patient under steroid coverage was performed to prevent the risque of rupture. The aneurysm was resected, reconstruction was performed with prothetic aortocarotid bypass. She was discharged without major complications. The graft have remanied patent during the four years follow-up periods. A biologic inflammatory syndrome and a parietal thickening of the aneurysm in a young woman must provoke diagnosis. The surgery must be appropriate every time that the diagnosis is carried considering the evolutionary risk of these aneurysms.
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The malignant tumors of the inferior vena cava are rare. Their prognosis is bad. We report two cases of a 17-year-old and 46-year-old woman presenting the one an intimal sarcoma of the inferior vena cava and the other a metastatic of adenocarcinoma whose primary tumor was not identified. The aortic wall was invaded in both patients. The ureter repulsed in first case, was invaded in second case. The treatment consisted on resection of the tumor including the aortic wall with vein closure in both patients, with right nephrectomy in second patient. In the two cases, a prosthetic reconstruction of the arterial integrity was attempted with aortobiiliac bypass. The two patients died after relapse tumorous to the 6th month in first patient and by multisystem organ failure 5th day post-operative in second. Through these two personal cases, we try to point out the difficult problem of diagnosis that put these tumors and their bad prognosis despite an improvement of treatment.
The classification of superficial vascular anomalies of the face recognizes two major categories: hemangiomas and vascular malformations. A multidisciplinary approach to these malformations is necessary. MRI of venous vascular malformations, pulsed Doppler and arteriography of arteriovenous malformations are key examinations in the exploration strategy for superficial vascular malformations. Hemangiomas always regress. Surgery is generally needed only for late sequelae although in some cases early surgery is beneficial. Percutaneous sclerotherapy and surgery are indicated for venous malformations in order to minimize or improve skin, muscle and bone distorsions. Arteriovenous malformations are the most dangerous vascular anomalies of the face. Superselective arterial embolization prepares the surgical excision of the nidus, complete resection is essential. We review 6 cases of superficial vascular malformations of the face treated surgically and discuss the diagnosis features and the treatment modalities of these vascular anomalies.
Behçet's disease is an uncommon systemic process generally developing during the third or fourth decade of life. Recurrent inflammatory lesions are characteristic. Cardiovascular involvement, which may be arterial or venous, is rare but with particularly severe prognosis. Four cases of abdominal aortic aneurysm are reported. One patient underwent emergency surgery for acute rupture. All patients were male, age range 29-45 years, mean age 36.5 years. Three patients were followed for Behçet's disease. Surgical revascularization was performed in all four patients, mainly with prosthetic grafts, one with patch aortoplasty. The postoperative period was complicated by paraplegia and thrombosis of the prosthetic graft in the patient who underwent emergency surgery. On the basis of these cases and cases reported in the literature, it can be concluded that morbidity and mortality are high because of the etiology underlying vascular involvement in Behçet's disease.
Intra-abdominal desmoplastic small round cell tumor is an extremely rare entity with poor prognosis. The authors report a case of intra-abdominal desmoplastic small round cell tumor and describe the imaging and pathologic features of the tumor.
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An inquiry concerning the prevalence of urinary incontinence for the moroccan women has been archived about 1000 women aged more than 18 years to study prevalence, epidemiology and risk factors of urinary incontinence. 271 women among the 1000 women said that they had suffered from the mictional disorder at least one time during the last month, let 27.1%; 48.7% of the incontinent women are from 30 to 60 years; 22.5% are less than 30 years old, and 8.85% are more than 75 years old. Among these 271 women, 49.44% suffered from leakage after making an effort; 42.80% an imperiosity, and 7.76% spontaneous leakage. Seventy per cent among these women had level of study at least medium; 85.97% among these women suffered the discomfort; but 8.48% of them had been consulted for this disorder, 78.96% are able to consult a medical and to have a clinical or paraclinical exams. The elements who are responsible of this disorder are: menopause, parity, the use of forceps, the weight of first child birth over 3.5 kg, the perineal tearing. Among the medical antecedents we find: chronic bronchitis, urinary infections, chronic constipation, diabetes, and in the other way among surgical antecedents are: hysterectomy and prolapsus cure.
We report five cases of a persistent sciatic artery. The lesion was unilateral in all cases. Four patients were treated by exclusion of the aneurysm with ligature of the internal iliac artery with an associated femoropopliteal bypass in two. Surgical treatment was declined by one patient. We discuss the embryology, pathology, clinical aspects and surgical procedures involved.
We report a case of sarcoidosis with mediastinal and pulmonary localizations associated with diffuse antineutrophil cytoplasmic antibodies (c-ANCA). This led to discuss the differential diagnosis with vascularitis and the specificity of c-ANCA in Wegener's granulocytosis.
Significant controversy persists in the classification of giant cell lesions of the maxillofacial skeleton. Multifocal giant cell lesions are strongly suggestive of hyperparathyroidism brown tumors. Maxillary localization is extremely rare. We report a case of primary hyperparathyroidism manifesting in the form of giant cell tumors of the maxilla, the hard palate and long bones. Biochemistry confirmed the diagnosis. Computed tomography localized the parathyroid tumor at the cervicothoracic junction in the retrosternal area. We discuss the clinical features of skeletal involvement in primary hyperparathyroidism and stress the need for ionized serum calcium assay in case of giant cell tumors of the cranial bones.
Exostosis is a benign bony process arising from cortical bone. It is generally localized at the fertile metaphysis of long and some flat bones. Localization to the zygoma and/or the coronoid process is exceptional (5 cases in the world literature). We report an original case of exostosis with isolated zygomatic localization in a 14-year-old girl and review the literature. We emphasize the clinical features and the diagnostic and therapeutic approach in this condition.
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Bronchial atresia is a short and juxtahilar bronchus interruption. This uncommon malformation leads to an obstructive and systematized emphysema, often associated with mucoid impaction. The authors report the case of a 5-year-old boy and review the literature in order to recall the radiologic features of this affection, which are characterized by an obstructive segmental or lobar emphysema often located in the upper lobe. The modern imaging means are not necessary for diagnosis. Bronchography confirms the atresia. Neonatal bronchial atresia appears as an opaque segment or lobe with retention of the alveolar liquid.
UNLABELLED: Abdominal injuries are frequent in children. Their early assessment is the best guarantee for an accurate management. PATIENTS AND METHODS: Seventy children with abdominal trauma were evaluated by early ultrasonography. RESULTS: This investigation found abnormalities in 52 patients, with hematic peritoneal effusion in 26 cases, renal lesion in 20 cases, hepatic lesion in ten cases, splenic lesion in seven cases and a lesion involving liver, spleen and pancreas in one case. Based on these results, surgery was performed in six cases. The remaining cases were simply supervised with a good prognosis. CONCLUSION: Ultrasonography represents the main investigation in children's abdominal trauma, allowing an early, efficient and non-costly morphological diagnosis. Computerized tomography (CT) scan has some particular indications.
Jaw osteoradionecrosis (ORN) is one of the most serious complications of cervico-facial cancer irradiation. Severity is related to major bone lysis and the difficult medical and surgical treatment. We report our experience in seven cases over a ten-year period. Mandibular localization was predominant (85%). The mean age of the patients was 36 years. The average delay to development of ORN was 5.5 years. The treatment was medico-surgical, based on wide surgical exeresis (6/7), frequently via endobuccal surgical approach (4/7). Prevention remains the best treatment of ORN associated with an accurate management of all patients who need radiotherapy.