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Biomedical subjects

M Chebil

Publications and source records attributed to M Chebil.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Emphysematous cystitis: apropos of 2 cases].

Emphysematous cystitis is a rare infectious disease of the lower urinary tract. Its reputedly serious prognosis is related to treatment failures revealing ignorance concerning its pathophysiological mechanisms. Two cases of this disease were seen in our department, both in diabetic men over the age of 70 years with a history of prostatism. They presented to the emergency department with complete urinary retention and alteration of the general state and fever. Urine culture isolated Klebsiella pneumoniae in both cases. Treatment consisted of bladder drainage associated with adapted antibiotic therapy and control of diabetes. A suprapubic prostatectomy was subsequently performed in one case and transurethral prostatic resection was performed in the other case. The prognosis of this disease depends on early diagnosis and rapid introduction of effective treatment.

Aged↗
PubMed1997

[Urinary fistula after transplantation: eleven cases].

OBJECTIVES: To specify the anatomical features of urinary fistulas and to evaluate the results of percutaneous and surgical treatment of post-transplantation urinary fistulas. PATIENTS AND METHODS: 11 urinary fistulas were observed after 160 renal transplantations, corresponding to an incidence of this complication of 6.8%. Urinary fistulas were treated percutaneously in three cases and surgically in eight cases. THE FOLLOWING COMPLICATIONS WERE OBSERVED DURING SURGICAL TREATMENT: extensive necrosis of the urethra in four cases, rupture of the sutures in two cases, a punctate pelvic fistula in one case. RESULTS: The incidence of fistula was 5.8% for Leadbetter reimplantation and 8.1% for Lich-Gregoir extravesical reimplantation. We obtained one success in three patients treated percutaneously and one death and seven successes out of eight patients treated surgically. We performed ureteropelvic anastomosis with the native ureter in the case of extensive necrosis of the ureter (4 cases), a new reimplantation in three cases and suture of the pelvic fistula in one case. CONCLUSION: More than one half of post-transplantation urinary fistulas observed in our department are secondary to ischaemic necrosis of the ureter. We emphasize the value of preservation of the ureteric blood supply during organ harvesting. Post-transplantation urinary fistulas must be treated surgically, as soon as possible, to avoid infectious complications.

Follow-Up Studies↗
PubMed1995

[Value of extracorporeal shockwave lithotripsy in primary hyperoxaluria type I].

BACKGROUND: Application of extracoporal shock wave lithotripsy (ESWL) has revolutionized the management of many types of urolithiasis, including that observed in primary hyperoxaluria where surgical attempts to remove calculi sometimes result in worsening of renal function. CASE REPORTS: Three unrelated patients aged 8, 10 and 11 years, respectively, with type I primary hyperoxaluria, suffered from recurrent bouts of abdominal pain (two patients) or anemia (one patient). Two patients had chronic renal failure. Plain abdominal films and ultrasonography showed several large bilateral stones. ESWL was applied to the three patients permitting complete removal of stones following three sessions in one patient and partial removal following four sessions in the second patient who developed infection after the first session with transitory increase in creatinemia. Several sessions of ESWL failed to fragment stones in the third patient. CONCLUSION: ESWL may represent a safe procedure for attempting stone removal in patients with primary hyperoxaluria.

Child↗
PubMed1995

[Lymphoma with bladder involvement and renal transplantation].

Based on the case of a renal transplant recipient who developed a monoclonal B cell lymphoma with plasma cell differentiation, arising in the bladder, the authors discuss the responsibility of intensive immunosuppressant protocols in the development of post-transplantation lymphoproliferative syndromes. The Epstein-Barr virus favours the development of these lymphomas. The bladder is a rare site. Diagnosis was based on endoscopic resection with immunohistochemical analysis. The prognosis depends on the stage at the time of diagnosis. At an early stage, resection of the tumour combined with reduction of immunosuppressant therapy may be sufficient, but more aggressive treatment is required for more advanced stages. Anti-B lymphocyte monoclonal antibodies (CD21, CD24) give good results, especially in polyclonal forms and Epstein-Barr virus primo-infections. Anti-CD38 monoclonal antibodies are currently being investigated and appear to be very promising. Conventional radiotherapy and chemotherapy are disappointing.

Herpesviridae Infections↗
PubMed1995

[Adrenal myelolipoma. Apropos of 3 cases].

The authors report 3 cases of adrenal myelolipoma arising in 3 women who were respectively 36, 47 and 48 year old. The diagnosis was made on the surgical specimen in 3 cases, and the clinical symptomatology was dominated pain seen in all 3 cases. 2 patients have presented hypertensive access. After surgery, the evolution was favourable in all 3 cases.

Adrenal Gland Neoplasms↗
PubMed1995

[Trans-symphyseal approach in the treatment of cervico-urethro-vaginal fistulas. Apropos of 2 cases].

We opted for a symphysiotomy approach in the management of cervico-urethro-vaginal fistulae in two patients. This approach offers an excellent exposure of the region of the bladder neck. After section of the symphysis pubis with a Gigli's wire saw, the anterior wall of the bladder was taken down to the fistulae and we excised the fistulous tract. Longitudinal closure of the fistulae and the bladder followed. Results were satisfactory and there were no urinary incontinence.

Adult↗
PubMed1993

[Retrovesical hydatid cyst. Apropos of 2 cases].

A hypogastric mass compressing the bladder in an adult, in a zone endemic for hydatid disease, should raise to suspicion of a retrovesical cyst, especially as the cyst sometimes opens into the bladder resulting in haematuria and hydatiduria. Intravenous urography and ultrasonography facilitate the topographical diagnosis. Treatment is surgical: transperitoneal cystectomy and pericystic resection as extensive as possible with exploration of the abdomen looking for other sites (liver, mesentery, omentum). This treatment was successful in the two cases reported here. In conclusion, a stable cure can be obtained by adopting a well defined therapeutic approach to these rare lesions.

Adult↗
PubMed1991

[Urinary tuberculosis and bladder tumors. A case report].

The authors report the case of a patient presenting with both a bladder tumor and urinary tract tuberculosis. The bladder tumor was treated by transurethral resection and instillation of mitomycin C. The author describes this case and discusses this unusual association.

Biopsy↗
PubMed1987

[Evaluation of the results of endoscopic internal urethrotomy in the treatment of urethral stricture. Apropos of 163 controlled cases].

Results are reported of 294 internal urethrotomies performed over 5 years to treat 196 urethral strictures. In this series the predominant etiology was sclero-inflammatory (55% of cases) but there was also a fairly high incidence of iatrogenic (52 cases) and post-traumatic (30 cases) lesions. The length of the narrowed segment varied between 0.5 and 3 cm, the most frequent site the bulbar region. Results at 1-year follow up or longer were assessed by quality of micturition and flowmeter curve. Of the 163 cases controlled good results exceeded 60% of patients treated by this method. Mastery of internal urethrotomy has allowed almost complete elimination of blind instrumental dilatation, and has markedly decreased number of urethroplasties since adoption of this therapeutic procedure.

Endoscopy↗