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Biomedical subjects

M Chebil

Publications and source records attributed to M Chebil.

At least 19 recordsLinked to original sources
PubMed2006

[From diagnosis to treatment of gluteus medius tendon tear of the hip: a case report].

OBJECTIVE: To report a case of spontaneous gluteus medius tear repaired surgically in a 42-year-old woman patient without any other antecedent other than diabetes. PATIENT AND METHODS-RESULTS: Trochanteric pain evolving for 7 months led to scintigraphy objectifying a hyperfixation of the trochanter and ultrasonography showing an inflammatory gluteus medius tendon. These examinations were supplemented by magnetic resonance imaging and tomodensitometry visualising the tendon rupture but no marked fat degeneration of the muscle despite atrophy of this one. Surgical exploration confirmed the presence of a major rupture of the gluteus medius tendon, which was reinserted through an osseous trench. Rehabilitation involved protecting the tendon, by an installation of the member in abduction and passive mobilization from the third postoperative day, with a move to partial support on day 45. The result after 16 months was excellent, the patient returning to work 8 months after the surgery without any residual pain. CONCLUSION: The spontaneous rupture of the gluteus medius, often ignored, can occur in young subjects and induce limited function, often well corrected by reinsertion surgery.

Adult↗
PubMed2006

[Screw fixation without bone graft of calcaneal joint fractures: 35 cases].

PURPOSE OF THE STUDY: The prognosis of calcaneal joint fractures is less favorable than fractures without joint involvement. Surgical treatment is frequently recommended. The type of fixation and the usefulness of a bone graft remain subjects of debate. The purpose of this work was to present the functional and anatomic results obtained with simple screw fixation without bone grafting in a retrospective series of 35 displaced joint fractures of the calcaneus. MATERIAL AND METHODS: The series included 31 patients (four bilateral fractures), 86% men. Mean age was 36 years (17-60 years). Using the Duparc classification, there were 12% type III fractures and 88% type IV fractures. Horizontal joint impaction was observed in 36% of patients, vertical impaction in 8%, and mixted impaction in 56%. The mean Bohler angle was 2 degrees (range -25 degrees to 15 degrees ). According to the Utheza classification, 70% of the fractures had two sagittal fracture lines, 16.5% one sagittal fracture line, and 13.5% comminutive fractures. Incongruency of the subtalar joint was noted in 70%, with a conflict with the lateral malleolus in 50%. Mean time to surgery was 12 days (7-30 days). The sub- and retromalleolar approach was used to achieve simple screw fixation. Bone grafts were not used. Mean follow-up was two years (range 12-38 months). RESULTS: There were no serious complications. Functional outcome was analyzed with the Kitaoka scale, mean score 74.3 +/- 1.1 (range 46-98), with 16% excellent outcome, 56% good outcome, 25.2% fair outcome, and 2.5% poor outcome. There was a correlation between functional outcome and age, etiology, and type of fracture. Anatomic results were assessed with the Babin scale and were very good in 24%, good in 8%, fair in 28%, and poor in 40%. Secondary loss of the initial heightening of the joint surface was noted in 48% of the cases, 3 degrees on average. DISCUSSION: This series confirms the value of surgical treatment compared with conservative treatment. Compared with plate fixation, screw fixation exposes the patient to less risk of skin and infectious problems. Simple screwing generally provides satisfactory results with acceptable stability. In light of the present results, adjunction of a bone graft would not be necessary since the loss of correction of the joint surface height was often minimal. CONCLUSION: Screw fixation of calcaneal joint fractures is a reliable technique. Adjunction of a bone graft does not appear to be necessary.

Adolescent↗
PubMed2005

[Retroperitoneal fibrosis].

OBJECTIVE: We studied the clinical, therapeutic and progressive characteristics of retroperitoneal fibrosis. METHODS: We analysed the observations of retroperitoneal fibrosis diagnosed between 1980 and 2002 in our hospital, from the summaries of 15 patients exhibiting retroperitoneal fibrosis (RPF). Therapeutical supervision was based on biology and radiology. RESULTS: There were 11 men and 4 women with a mean age of 44.5 years ranging from 28-64 years. Pain was predominantly lumbar or abdominal in all patients. An inflammatory syndrome was observed in all patients and renal failure in 11. Radiological examinations revealed single or bilateral in 14 cases and the fibrosis plaque in 13 cases. Treatment consisted in corticosteroids alone in 9 patients, surgery alone in 3 cases and surgery with corticosteroids in 3 patients. Ten relapses (range: 1-5) occurred in 4 patients when corticosteroids were stopped. After a mean follow-up of 36 months (range:18 days-11 years), one death was observed, 12 patients had normal renal function and 2 patients had persistent moderate renal failure. CONCLUSION: This study confirms the rarity of retroperitoneal fibrosis, the difficulty in its diagnosis, the frequency of pain, inflammatory syndrome and renal failure. Corticosteroids are efficient and regular follow-up is required.

Abdominal Pain↗
PubMed2004

[Distal radius anterior marginal fractures treated with anterior plating. Mid-term results].

PURPOSE OF THE STUDY: We report a retrospective series of anterior marginal fractures of the distal radius treated by anterior plating in order to analyze results and identify prognostic factors. MATERIAL AND METHODS: This continuous series included 22 patients with an anterior marginal fracture of the distal radius treated between 1993 and 1999. Three patients were lost to follow-up. This analysis thus concerned 19 fractures in 15 men and 4 women, mean age 39 years. Surgical reduction and T-plate anterior fixation was used in all cases. RESULTS: Mean follow-up was 26 months. Anatomic results were satisfactory in 15 patients and poor in one. Function was satisfactory in 17 patients and poor in one. We noted two types of complication: spontaneously regressive reflex dystrophy (n=2) and osteoarthritis which developed in two patients after incomplete reduction. DISCUSSION: Anterior plating can provide satisfactory results for anterior marginal fractures of the distal radius if anatomic reduction is achieved. This method remains our preferred therapeutic approach with special attention being required for anatomic reduction.

Adolescent↗
PubMed2002

[Treatment of urinary incontinence in epispadias at the beginning of the third millenium].

The treatment of urinary incontinence in epispadias is delicate. Urinary continence is generally obtained after onerous and repetitive surgery. Different publications show a variable results. After the study of the results of our series (nine cases) and the results published in the literature, we propose a clarification on the therapeutic modalities of urinary incontinence associated to this malformation.

Child↗
PubMed2002

[The female urethral diverticula: apropos of 21 cases].

PURPOSE: Our goal is to study the clinical, radiological and therapeutic particularity of the female urethral diverticula via a retrospective study of 21 cases. PATIENT AND METHODS: Twenty one females, with a mean age of 37 years (range 15 to 62 years) presenting an urethral diverticula, were treated between 1988 and 2000. Clinical examination made diagnosis in all cases. Cystorethrography shown a direct image of diverticula in 100% of cases and intravenous Pyelography in only 24% of cases. The urethral diverticula was excised via a transvaginal approach in all cases. RESULTS: Eighteen patients had favourable immediate outcome. Three patients presented an urethrovaginal fistula treated surgically in one case and by bladder drainage in one case. The last patient refused treatment and she was lost to follow-up. After a median follow-up of 54 months (range 18 to 120) only three patients have some urinary urgency that was treated by anticholinergics. CONCLUSION: Female urethral diverticula is a rare disease, the diagnosis is easy and only surgical excision gives good results.

Adolescent↗
PubMed2002

[Perineo-transpubic approach to the management of posterior urethral post-traumatic rupture].

OBJECTIVE: To study the place of the perineal-trans-pubic approach in the treatment of the posterior urethral post-traumatic rupture operated late, and to evaluate its results. PATIENTS AND METHODS: Twenty-four patients whose had a total posterior urethral post-traumatic rupture were treated in our department in a stage of urethral strictures. All patients underwent perineal transpubic urethroplasty. In this study we detailed a technique description of the approach and a clinical evaluation of our results. RESULTS: This technique allows having a direct approach of the posterior urethra, to perform a tension free end to end urethral suture. The backward is about 3 years. We assessed 3 cases of recurrent urethral strictures. The cases of erectile dysfunction assessed were mainly related to the initial pelvic trauma. Finally this approach had not orthopaedic squall in all cases. CONCLUSIONS: Comparing to others, the perineal transpubic approach is the best one to manage the posterior urethral injuries treated with late. It gives a satisfactory results with a few disadvantages.

Adolescent↗
PubMed2002

[Giant retroperitoneal liposarcoma: report of a case].

Liposarcoma is a rare and primary malignancy developed from mesenchymal tissue. We report the case of a 32-year-old woman who had a complete exeresis of a 15 cm retroperitoneal myxoid liposarcoma. Three months later, a 9 cm local recurrence was excised and radiotherapy was performed. In 2000, a local recurrence and an intestinal localisation of the liposarcoma were observed. The retroperitoneal tumor could not be removed and she had an intestinal resection followed by chemotherapy. With the literature data, we review the pathological, therapeutic and prognostic aspects of this tumor.

Adult↗
PubMed2001

[Retroperitoneal ganglioneuroma. Report of a case].

Retroperitoneal ganglioneurom is a primitive, rare and benign tumor originating in the neural sheath. We report the case of a 27-years old man. An abdominal sonography had revealed accidentally a 60 mm, well demarcated tumor. The left renal vein was compressed an forced back. This tumor was located in front of and internal to the left kidney. The CT scan confirmed this tumor. A left subcostal laparotomy was done. The tumor was soft and movable. A total exeresis was performed. The pathology examination had conclude in a benign ganglioneuroma. The follow-up was six years and half. Retroperitoneal ganglioneuroma is a benign tumor with a good prognosis. The treatment is surgical.

Adult↗
PubMed2001

[Retroperitoneal schwannoma. Case report].

Retroperitoneal schwannoma is a rare tumor originating in the neural sheath. We report the case of a 48 year-old women. She had a ten year history of lumbal pain. The abdominal sonography had revealed a left retroperitoneal tumor that compresses the left renal cavities. The abdominal CT scan visualized a 56 mm, homogenous, well demarcated, retroperitoneal mass with a low attenuation. This mass with multiple enhanced septa is separated from the left adrenal gland. The diagnosis of a cystic lymphangioma is made. We perform surgical exeresis of the tumor by a left lumbal laparotomy. The pathology examination concludes in an altered schwannoma with Antoni B patterns. Retroperitoneal schwannoma is a primary neural benign tumor with a good prognosis. The management is surgical.

Back Pain↗
PubMed2001

[Retroperitoneal neuroblastoma in the adult: case report and review of the literature].

Retroperitoneal neuroblastoma is a rare embryonic tumor of the sympathetic nervous system that is specific to the child. In this study, the case is reported of an infant who underwent median laparotomy at the age of 14 months for a tumor which occupied the left half of the abdomen. The lesion was large, hard, and not very mobile. It was considered to be unresectable, and the histological findings after biopsy showed it to be a neuroblastoma. Radiotherapy was then initiated, which successfully reduced the tumor size. A second investigation at the age of three years detected an unresectable tumor of 5 cm. A further biopsy was performed, and the histological findings showed the lesion to be a partially developed ganglioneuroblastoma. The patient has been followed up regularly by ultrasonography which has shown no increase in tumor size. She is now 20 years old, and is asymptomatic. The last computed tomography scan visualized a 62-mm retroperitoneal mass with no metastases. Surgery was decided against in favor of regular monitoring. This case is particular due to the prolonged survival of the patient, regression of histological stage, and reduction in size of the tumor after radiotherapy. It is remarkable that the diagnosis of neuroblastoma was made when the patient was 14 months old, and that she is still alive at 20 years old.

Adult↗
PubMed2001

[Isolated, spontaneous hematoma of the kidney. Report of 2 cases].

Spontaneous hematoma under the renal capsula is a rare pathology. The authors report two cases with one male and one female aged respectively of 50 and 63 years. The symptomatology is presented by right renal aches associated with repetitive and total hematuria in male and atypical abdominal aches in female. The radiological explorations (IVP, renal sonography and Computered Tomography) had conclude in a renal cancer in the two cases. The diagnosis is made by the pathologic study. Some etiology may be searched such as malignant tumor, an angiomyolipoma, vascular abnormalities and disturbance to the hemostasis. If no etiology is find, a nephrectomy or a simple supervision can be discussed.

Adult↗
PubMed2000

[Diagnostic and therapeutic advantages of rigid ureteroscopy: retrospective study of 304 cases].

Uretroscopy has become a common tool for the diagnosis and management of the upper urinary tract. Between April 1994 and Decembre 1999, 304 ureteroscopy procedures were performed. The most common therapeutic procedure was stone manipulation in 299 cases (distal ureter 259 cases, mid-ureter 23 cases, lumber ureter eight cases and staged in nine cases). Procedure was made by a rigid ureteroscope 8.5 Ch or 11.5 Ch. Dorinia was used in 175 cases (57.5%) with or without fragmentation by ultrasound. Therapeutic ureteroscopy was also used to remove a double-J stent that had migrated into the pelvic ureter in one case and in three cases of ureteral tumor. It was used in one case to confine the extrinsic compression of a ureteral stenosis. Median follow up was 12 months (6-36 months). The overall success rate was 87.6%. Results are comparable in men and women (P = 0.8). Success rate was 90% in single lithiasis and 76.2% in case of numerous stones (P = 0.0094). There was a statistically significant difference in success rate between stones 15 mm or under in size (89% stone-free) and those 15 mm (66% stone-free) or larger. In conclusion, rigid ureteroscopy is a minimally invasive and reliable technique for the management of ureteric calculi and for the diagnosis and treatment of other ureteric lesion.

Adolescent↗
PubMed1998

[Results of BCG in the treatment of pTa and pT1 bladder tumors. Evaluation of a long protocol using 75 mg of Pasteur strain BCG].

OBJECTIVES: Evaluation of a protocol of intravesical BCG therapy using 75 mg of Pasteur strain BCG with 2 years of maintenance treatment, and a follow-up of up to 60 months. MATERIAL AND METHODS: 189 patients treated by transurethral resection (TUR) for a pTa (N = 80) or pT1 (N = 109) bladder tumour were included in the study. The local and general safety was excellent. We retrospectively compared this series to a group of patients treated by TUR alone (N = 42) another group treated with TUR and Mitomycin C (MMC) (N = 81). The 3 groups were statistically comparable. RESULTS: At 48 months, 62% of patients treated with BCG were recurrence-free, versus only 18% for patients treated with TUR alone and 38% for patients treated with TUR and MMC (p = 0.001). At 42 months, 11% of pT1 tumours treated with BCG had progressed to invasive carcinoma, and this progression occurred during the first 18 months in every case. In comparison, this progression was observed in 25% of pT1 tumours treated by TUR alone and 21% of tumours treated with TUR and MMC. CONCLUSIONS: Our study confirms the efficacy of our BCG protocol ro reduce the potential for recurrence and progression of superficial bladder tumours, despite reduction of the dose to 75 mg. It also suggests the superiority of BCG compared to MMC in terms of recurrence and progression.

Actuarial Analysis↗
PubMed1998

[Aspects of evolving urogenital tuberculosis. 60 cases].

Based on the results of a retrospective study of 60 patients treated between January 1984 and December 1994, the authors review the current clinical features of urogenital tuberculosis. The sex-ratio shows a male predominance of 65%. The mean age is 48 years. Cystitis and low back pain are the main symptoms of the disease. IVU, performed in all patients, showed pathological images in 98.3% of cases. Urine culture was positive in 23 out of the 50 cases in which it was performed. Serious forms were relatively frequent, with bilateral lesions in 12 cases, associated with renal failure in 4 of them, or unilateral renal destruction in 43 cases. All patients were treated with triple- or quadruple-agent tuberculostatic therapy. 54 patients required one or several surgical procedures: 43 nephrectomies, 7 ureterovesical reimplantations, 11 augmentation enterocystoplasties, 1 Bricker ureteroileostomy, 3 ureterostomies, 1 ureteric resection and 4 epididymectomies. Two patients admitted in a context of deterioration of the general state died during the days following admission. 56 patients were reviewed with a minimum follow-up of 6 months. Two were cured by medical treatment alone. Among the 54 operated patients, clinical improvement was obtained in 43 patients (91%) and radiological improvement was obtained in 33 of the 36 cases in which IVU was performed (91%). In conclusion, despite the various anti-tuberculosis campaigns, urogenital tuberculosis remains a serious disease, essentially because of the delayed diagnosis.

Adolescent↗