Biomedical subjects

A Dia

Publications and source records attributed to A Dia.

At least 55 records · Page 3Linked to original sources

PubMed1991

Anatomic basis for conservative surgery of the spleen.

100 pancreatico-splenic blocks obtained at autopsy were treated by the injection-corrosion method. The splenic artery ended in the lienorenal ligament in 64% of cases, in the pancreatic segment in 32% and in the hilar segment in 4%. In 84% of cases, the artery divided into two lobar arteries, upper and lower. In 16% the artery trifurcated. The pedicle was 20 to 60 mm long (mean 35 mm). The branches of the splenic artery were in three successive stages: the primary or lobar arteries were each associated with a lobe; the secondary or segmental arteries each supplied one of the constituent segments of a lobe; the tertiary or subsegmental arteries supplied the various areas which made up a splenic segment. Nine cases of extraparenchymal anastomoses were found. There were 32 intraparenchymal anastomoses, being either interlobar or intersegmental. There were a few interlobar anastomoses. The findings support the notion of upper and lower intersegmental and interlobar planes. The latter is almost avascular, while the former has limited vascularity. These planes make conservative surgery of the spleen possible.

Arteries↗

PubMed1991

[Intestinal obstruction caused by postoperative adhesion. 79 cases].

The intestinal post-operative bridle represents the third most important etiology of obstructions at the clinic of the University Hospital of Dakar, behind hernia strangulations and the volvulus of the digestive tube. Between 1970 and 1989, a retrospective study has led to a sample of 79 patients with post-operative bridle obstructions. The group was made of 47 women and 32 men between 17 and 84 years of age. Stomach ache was by far the most common functional symptomatology, followed by the stoppage of the transit and vomiting. In most cases palpation revealed the presence of tympanism. For almost all the patients, the abdomen without preparation revealed either a hydroaeric level or a diffuse grey area. The initial intervention concerned mainly gynecological affections or pathologies of appendicular type. The resection of the bridles was carried out in most cases. There were 10 deaths. The intestinal obstructions by post-operative bridles continue to be a surgical emergency still characterized by a high mortality rate. The late consultation of the patients, often received when presenting considerable visceral deficiency, is one of the main causes of the high rate of fatalities.

Adolescent↗

PubMed1991

[Docimological analysis of the anatomy test for the PCEMII final exam in Dakar].

This docimological analysis is based on computer treatment of the results of the anatomy exam for the two sessions of July (159 candidates) and October (56 candidates) of the identification questions, discrimination questions, coupling (paining), grouping, association and diagram labelling. The results were appraised following certain parameters: the gross score revealed a rather low average score for the whole class (14.57 and 9.57 over 30): the low success rate in July and the average figure of October indicate, in general, either the difficulty of the questions for the students or a bad reception of the message; the bad discrimination index, since only 21% of the questions are of the discriminatory type. This finding pointed to a revision of 50 of the 68 questions of July and 53 of the 68 questions of October. On the whole, only 15 questions, over the two sessions, could have been kept unchanged for an eventual bank (stock of data): The correlation coefficient has showed a significant relation between success in the anatomy subject and success in the PCEM2 exam. This work has showed the possibilities that computers may offer in the teaching of anatomy and the evaluation of students. Besides, it emphasizes the importance of the anatomy grade in the PCEM2 exam. Finally, the mode evaluation used help exploring the various levels of the cognitive areas (memorization, interpretation of data, problem-solving) and to build up a bank of anatomy questions.

Anatomy↗

PubMed1991

[Genital prolapse in Dakar].

Genital prolapses are the result of musculo-ligamentary alterations often caused or complicated by traumatic delivery and senible atrophy of the tissues. From 1969 to 1988, we gathered 104 files of patients with genital prolapses. The age of the patients ranged from 20 to 70 years with an average age of 30. The subject between the ages of 20 and 39 were the most affected (64%). The average number of children per woman was 4. 60 patients had 5 children. No case of prolapses was found among virgin or mulliparous women. In 48 cases delivery was dystocic. The clinical symptomatology was a feeling of intravaginal globus, pelvic algia and discomfort (57 cases). Straingul urinary incontinence wax manifest in 15 patients. Colpocystocele (88 cases), rectocele (66 cases) and hysterocele (50 cases) were among the most frequently evidence lesions. On the therapeutic matter, the low passage was used 58 times and the high passage 32 times. An urinary gesture was made 33 times. There was no operatory fatality. Urinary troubles related to infection, acute retention of urine and strainful urinary incontinence were observed. Later 10 cases of recurrence were observed within an average time interval of 2 years. This work is characterized by the young age of the patients. It denotes the noticeable role played by obstétrical traumatisms in the genesis of genital prolapses in the African context. The senescence and atrophy of the tissues seem to have a less important role in contrast with the developed countries. Finally, the surgical treatment of these patients must take into account, among other things, the child bearing desire of the patients, given the social and psychological weight of maternity in our society.

Adult↗

PubMed1991

[Anatomical and coronary angiography data on coronary anastomosis].

Beyond two series of heart studies (anatomical with 150 hearts treated by injection-corosion method, and angiographic with 211 coronarography 3 days after a heart attack) the authors have noticed 92 coronary anastomosis with: 28 right homolateral 22 left homolateral 42 contralateral The existence of these anastomosis has been confirmed by coronarography of 30 out of 173 patients having a significant lesion of the artery responsible for the heart attack. The authors noticed also that these anastomosis are effective when the coronary system is deficient and the supplies are ensured by the other artery. The study permits to distinguish two groups of functional collateral: the functional collateral spontaneously observed during coronarography recruitable collaterals which are ready to be functional in case of main coronary artery obstruction.

Collateral Circulation↗

PubMed1991

[Bloodless emergent laparotomy for acute abdominal syndrome].

Bloodless laparotomy (BL) is defined as an opened exploration of the abdominal cavity that yields negative results, i.e., "provides no information as to the cause of the clinical and paraclinical symptoms responsible for prompting the surgical investigation". The authors report a retrospective study spanning January 1975 to December 1989, on the incidence of and mortality associated with emergent BL in patients with acute abdominal syndrome, with the intent of reducing its frequency. Over this period, 24 BL occurred in 3480 emergent laparotomies, i.e., 0.63%. These involved 7 men, 5 women, 5 boys and 7 girls, aged 4 to 52 years (mean age = 19.5 years). Indications for surgery were based on clinical signs, as well as on laboratory findings such as chest X-ray and plain radiography and needle-puncture of the abdomen. Surgical data indicated:liver cirrhosis--3 cases; mesenteric adenopathy--3 cases; intestinal parasitosis--1 case; bilateral adnescitis--1 case; polycystic ovaries--1 case; wall abscess--1 case; unexplained pain--14 cases. The mortality rate was 2/24. Use of other paraclinical investigations, namely ultrasonography, laparoscopy and peritoneal lavage, and of computer science methods after a prior clinical examination initiated by history-taking, might help reduce the rate of BLs, which are non-devoid of mortality.

Abdomen, Acute↗

PubMed1991

[Paravesical hemangiopericytoma. Apropos of a case].

Paravesical hemangiopericytoma is a vascular tumour that develops at the expense of the pericyts surrounding the blood capillaries. Its dim prognosis relates to its high potential of malignancy. With respect to the first case examined at the Dakar C.H.U. (the 10th case world wide), a literature review has been done. The diagnosis is based on histology while arteriography provides guiding elements. This particular case strikes especially the young individual, with no preference for a given sex. Therapy-wise, radiotherapy seems efficient. But, surgery remains, at the moment, the choice treatment of paravesical hamangiopericytoma. It consists of a large exeresis associated with radiotherapy. Chemotherapy still hold a limited place within the therapeutic arsenal against paravesical hemangiopericytoma.

Adult↗

PubMed1990

[Penetrating wounds of the chest].

The authors report on 116 chest wound cases. The initial death rate is very high--47.41%. A knife wound is the most common cause (83.64%). Among casualties brought in alive, pure thorax wounds predominated (67.21%) followed by thoraco-abdominal wounds (26.23%) and cervico-thorax wounds (6.56%). Post-mortems attribute death to the seriousness of visceral lesions with the heart wounded in over 41.81% of the cases. The seriousness of chest wounds is stressed, as is the need for full and rapid therapy.

Abdominal Injuries↗

PubMed1990

[Pancreatic pseudocyst: diagnosis, treatment. Apropos of 7 cases].

A pseudocyst of the pancreas (PCP) is a rare affliction in Africa despite widespread malnutrition and abdominal disorders. The authors cover 7 PCP observations on 3 men and 2 women between 18 and 32 years, and 2 boys of 5 and 6 years, in the clinical context of abdominal pain (7/7), an abdominal tumour (7/7) and as a sequence to abdominal contusion (4/7). In 5 cases, echotomography led the etiological investigation of the liquid mass to seek a pancreatic origin. Surgical treatment consisted of 2 termino-lateral cystojejunostomies on a shaped flexure++ and 3 latero-lateral cystojejunostomies (of which one had to be drained externally two times); and a corporeo-caudal pancreatectomy. Supervision of between 1 1/2 and 5 years (1 1/2 years: 3 patients; 2 1/2 years: 2 patients; 5 years: 1 patient; 1 patient lost track of) revealed only one recurrence after internal latero-lateral drainage, and that without clinical repercussions. The authors use this short experiment to study the clinical and paraclinical symptomatology, the etiology and the treatment of PCPs. They stress the role of medical pictures in diagnosis, and of interventional radiology in treatment, but above all the primacy of surgery to treat pseudocysts of the pancreas in Africa.

Abdominal Injuries↗

PubMed1990

[Apropos of a case of solitary left coronary artery].

The single coronary artery stems from the coronary ostium in one of the aortic Valsalva sinuses: no other coronary artery is present. On its own, it vascularized the whole myocardium. It is a very rare condition--0.36% according to anatomists. Anatomical study by injection-corrosion on 200 hearts at Dakar Medical Faculty's anatomical laboratory revealed only one case of single, left-hand coronary artery. It had come from a 45 year old adult killed in an accident, who, up to that time, had suffered no cardio-vascular pathology. The post-mortem showed no associated abnormality. This observation corresponds to Smith's type I anatomical classification. The trajectory followed the usual route for the left-hand coronary artery, and ended in a Y junction of the rear interventricular artery and the circumflex artery. No collateral branch flowed from it: its diameter was 5mm. Vascularization of the heart was provided for by branches proceeding from the rear interventricular and circumflex arteries.

Coronary Vessel Anomalies↗

PubMed1989

[Polycystic liver. Is Lin's operation still justified?].

Eleven patients with by polycystic liver disease were operated according to Lin's procedure. All cases were symptomatic forms. Sonography was diagnostic examination in 9 cases. Lin's procedure was not associated with any postoperative mortality or morbidity and no recurrences were observed after an average follow up of 4 years. Rarely, a feminale predominance and association with polycystic kidney disease are noted. Sonography establishes the diagnosis and reveals complications (most intracystic bleeding frequently). Lin's procedure is better than sonographic aspiration which must be repeated and can be complicated by severe infection. Operative aspirative drainage is necessary. Hepatectomy is rarely justified.

Adult↗

PubMed1989

[Double cystic duct. Apropos of a case].

In relation to a case of duplicated cystic duct encountered in surgical practice and based on a review of the literature, the authors stress the rarity of this condition. After reviewing the classification of the accessory hepatic ducts, they emphasise the surgical consequences of failure to recognise this type of anomaly during cholecystectomy.

Aged↗

PubMed1988

[Variations in the calcaneo-fibular ligament (lig. calcaneofibulare). Application to the kinematics of the ankle].

The authors observe variations in the calcaneo-fibular ligament because this ligament controls two articulations, the talo-crural and the subtalar. This study is based on the dissection of the ankle of 20 specimens. The calcaneo-fibular ligament is reinforced by the ventral and lateral talo-calcaneus ligaments with variations. 3 types of disposition have been described. Type A: A lateral talo-calcaneal ligament reinforces the calcaneo-fibular ligament. These two ligaments are divergent on the proximal, medial, or distal part. Type B: There is an independent lateral talo-calcaneal ligament forward of the calcaneo-fibular ligament. Type C: A ventral talo-calcaneal ligament is observed, parallel to the interosseous ligament. The authors consider the consequences of variation in the lateral ligaments of the ankle for the functioning of the tibio-tarsal articulation, the subtalar articulation and the astragalo-scaphoid articulation in order to propose specific radiographic examination of the kinematics of the ankle.

Ankle Joint↗

PubMed1987

Anatomic basis of a superior approach to the acetabulum with osteotomy of the ala of the ilium.

This study demonstrates the importance of a superior approach to acetabulum with intrapelvic osteotomy of the iliac ala in certain fractures of the acetabulum. This study is based on the dissection of 15 formolized and 5 frozen subjects, the surgical treatment of 17 acetabular fractures, and the performances of 2 Chiari-type osteotomies and 2 Salter-type osteotomies. We investigated the gluteus medius muscle and its pedicle in relation to the iliac ala. Landmarks for the osteotomy lines and the gluteal pedicles are defined in terms of the requirements of different surgical approaches. The superior approach for acetabular fractures was made using a skin incision of Smith-Petersen type. The underlying principle is the performance of an intrapelvic osteotomy of the iliac ala, the anterosuperior part of the ala being tilted outward and backward and pedicled on the gluteal muscles. This provides intra- and extrapelvic exposure of the acetabular walls. The advantages and drawbacks of this route of approach in surgery of the pelvic girdle are discussed in terms of the types of fracture treated and tumoral locations. The anatomic findings are illustrated from traumatology and tumoralpathology. This approach seems particularly suitable for acetabular fractures interrupting the pelvic ring.

Acetabulum↗

PubMed1984