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Biomedical subjects

M Mehdi

Publications and source records attributed to M Mehdi.

At least 19 recordsLinked to original sources

[Treatment results of fractures of the patella using pre-patellar tension wiring. Analysis of a series of 203 cases].

Two hundred three fractures of the patella in 200 patients were treated by tension band wire fixation using one or several wire loops and 2 longitudinally directed Kirschner wires. They were reviewed with a mean follow-up of six years (range 1 to 10 years). There were 143 men and 57 women. Age at operation averaged 36 years (range 18 to 83 years). The most frequent etiology was a road traffic accident. The fractures were simple in 35.5%, slightly comminuted in 37%, and very comminuted in 27.5% of cases. Thirty-four fractures were open, and there were other associated fractures in 35 cases (17%); 12 fractures (6%) were seen in polytrauma patients. The operation was performed on the first day in 63 cases (31.5%), between 2 and 8 days following trauma in 112 cases (56%), and after the 8th day in 25 cases (12.5%). The authors used 2 Kirschner wires in 81 cases (40%), 3 in 73 cases (36%), and more than 3 in 49 cases (24%). A single wire loop was used in 99 cases and a modified tension band wiring in 104 cases; passive mobilisation of the knee was started on the second day after operation, and weight bearing was allowed after five days, except when there were associated lesions. The complications were sepsis in 11 cases (5%), loosening of material in 20 cases (10%), malunion in 9 cases (4.5%), nonunion in 8 cases (4%), femoropatellar osteoarthritis in 17 cases (8.5%). The results were excellent or good in 169 cases (83%), and fair or poor in 34 cases (17%). The authors recommend this operative technique which allows good anatomic reconstruction of the patella, early mobilisation of the knee and early weight-bearing with a high rate of consolidation.

Accidents, Traffic↗

Magnetic resonance imaging assessment of labyrinthine pathology.

Membranous labyrinth pathologies are quite rare. They were until recently difficult to demonstrate by imaging technics, CT being the modality of choice. Our purpose was to stress the interest of MR examination for investigating patients complaining of vertigo, tinnitus, and profound sensorineural hearing loss. Normal anatomy as well as the main pathologically encountered changes are illustrated.

Ear Diseases↗

[Pelvic emergencies in women].

Emergency pelvic imaging is currently based on transabdominal and transvaginal sonography. Life threatening emergencies such as ectopic pregnancy and annexial torsion can be diagnosed by these technics. Doppler imaging (pulsed Doppler and color encoded) improve the diagnostic efficacy in an emergency context. Evaluation of pelvic inflammatory disease, cyst bleeding and placental disruption in best obtained by US because of its simplicity, safety and low cost.

Adnexal Diseases↗

[Retroperitoneal vascular emergencies].

Ruptured abdominal aortic aneurysm is the major surgical emergency in the retroperitoneal compartment. Rupture of an abdominal aortic aneurysm is always fatal without urgent operative repair. Computed tomography is the reference standard for the diagnosis of ruptured abdominal aortic aneurysm in hemodynamically stable patients. At CT, the diagnosis is based on the combination of abdominal aortic aneurysm and extraluminal retroperitoneal blood. Retroperitoneal hemorrhage usually demonstrates both isodense and hyperdense areas. In most cases hemorrhage is located in psoas compartments and perirenal space. In the case of ruptured abdominal aortic aneurysm other findings may be demonstrated such as focal interruption of the aortic wall and active extravasation of contrast media in the retroperitoneal compartments. Inflammatory abdominal aortic aneurysm, that may present as acute abdominal pain, should be recognized and differentiated from ruptured abdominal aortic aneurysm. Inflammatory abdominal aortic aneurysm is characterized by a fibrotic process around the abdominal aorta that may entrap adjacent structures such as ureters, duodenum and inferior vena cava. Aortic dissection, mycotic aneurysm, and inferior vena cava thrombosis are less common. Complications occurring after emergency aneurysm replacement are also considered.

Adult↗

[Digestive perforations and occlusions].

Acute abdominal disorders are common reasons for consultation at the emergency department. The diagnosis of all acute abdominal disorders begins with a careful history and physical examination. When appropriate, the clinical examination should be supplemented by conventional plain abdominal radiography. Gastrointestinal perforation and obstruction are very commonly encountered in the diagnosis of acute abdomen. Plain abdominal radiographs are the initial diagnostic methods of choice. In some circumstances, ultrasonography and CT may be valuable for the evaluation of the cause of abdominal disorder.

Abdomen, Acute↗

[Intraperitoneal vascular emergencies].

Intraperitoneal vascular lesions constitute severe causes of acute abdomen. These disorders include ischemia and infarction of colon and small bowel and abdominal hemorrhage. In case of intestinal ischemia, the radiologic procedures are performed in order to establish the diagnostic, identify the site of ischemia, and detect the etiology of ischemia. Plain radiography of the abdomen, ultrasonography, CT scan and angiography may be performed. In case of intestinal hemorrhage, angiography may be performed when endoscopy fails to establish the diagnosis. Embolization can be performed in selected cases.

Adult↗

[Abdominal emergencies of infectious origin].

Infectious disease is a common cause of acute abdomen. The diagnosis is based on clinical examination and basic laboratory tests. However, medical imaging routinely performed according to the clinical findings is frequently useful. Hepatic and splenic abscesses are correctly demonstrated by ultrasonography and computed tomography. Ultrasonography is the reference standard for the diagnosis of acute cholecystitis. The US examination is also performed for the diagnosis of appendicitis and its complications. Ultrasonography and barium enerna are commonly performed for the evaluation of signoid diverticulitis. Computed tomography is the reference standard to determine medical or surgical procedures.

Abdomen, Acute↗

[Acute pancreatitis].

The diagnosis of acute pancreatitis is based on clinical examination and basic laboratory tests. The main role of sonography in acute pancreatitis is to evaluate gallstones and small fluid collections. However, sonography is frequently difficult due to intestinal ileus related to pancreatitis. CT is indicated early in the clinical course of acute severe pancreatitis when the diagnosis is uncertain or when complications such as abscess, hemorrhage, or necrosis, are suspected. In addition, CT may be used to assess the prognosis and follow-up of patients.

Acute Disease↗

[Abdominal injuries].

Radiologic evaluation of abdominal trauma must provide a quick and accurate assessment of the lesions in order to improve the management of the patient. The technique used varies depending on the mechanism of the trauma (blunt trauma or stab wounds) and the hemodynamic status. Radiologic evaluation is usually performed in blunt trauma whereas stab wound trauma is usually explored surgically. The various techniques available are standard radiographs, ultrasonography, computed tomography and arteriography. The role of magnetic resonance imaging in the immediate evaluation is still not well defined. It appears to be a useful method in the delayed evaluation of diaphragmatic trauma. Computed tomography is the method most commonly performed in trauma patients. This technique is accurate and allows correct assessment of the lesions. The disadvantages are the radiation induced and the need for a hemodynamically stable patient. The aim of the radiologic evaluation is to provide the clinicians with an accurate description of the lesions. It can help in the management of the patient usually in association with clinical and laboratory data. It can also guide interventional procedures (drainage, embolization...). Finally, it allows radiographic follow-up when conservative treatment is performed.

Abdominal Injuries↗

[Thrombosis of the renal vein and hemorrhagic rectocolitis].

Renal vein thrombosis was observed in a patient with acute ulcerative colitis complicated by retroperitoneal perforation. Retroperitoneal inflammation related to colonic perforation may constitute a predisposing factor for local thrombosis in combination with coagulation disorders (protein S deficiency).

Adult↗

[Extensive pseudotumoral lumbar spine lesions of vascular origin].

Extensive remodeling of the anterior aspect of the lumbar spine was observed in two patients with a ruptured aneurysm of the abdominal aorta. Both patients survived as the rupture was contained in the first case and involved a false anastomotic aneurysm in the second. The patients presented with a clinical picture compatible with advanced stage cancer and a radiologic aspect showing anterior erosion of the vertebral bodies, suggestive of very advanced spondylodiscitis. The diagnosis was made on the basis of ultrasound and CT-scan evidence. There was no parallel relationship between the size of the ectasia and the spinal remodelling. A hypothetical pathogenic mechanism involving the intermittent pulsation of the aneurysm and ischaemia of the vertebral bone is proposed.

Aortic Aneurysm, Abdominal↗

[Voluminous duplication of the cervical esophagus. Contribution of imaging].

The radiologic imaging of esophageal cysts in adults is described. These rare cysts are often an incidental finding. They can lead to severe airway or digestive obstruction. Rare cases of rupture and haemorrhage are described. The authors report a case of cervical esophageal duplication, investigated by pharyngography, sonography, CT and MRI. A cystic mass located between the esophagus and trachea was depicted. Pharyngography and MRI showed the communication of the superior pole of the mass with the cervico-esophageal junction as a midline vertical tract. The upper extremity of the tract opened at the antero-medical portion of the retro-cricoïd region. The other diagnostic possibilities were excluded, especially fourth branchial pouch fistulae.

Aged↗

[Thoraco-abdominal digestive duplication].

The authors report a case of a thoraco-abdominal duplication of the foregut, observed in a 10-year old boy. Thoraco-abdominal duplication is an expression of notochordodysraphia, as it is frequently associated with vertebral malformations. Barium meal, ultrasonography and CT-Scan should provide a preoperative diagnosis. One-stage total excision in a single stage is mandatory in order to treat the symptoms and avoid the risks of further progression.

Cardia↗

[Mondini's malformation. Apropos of a case].

Mondini's malformation is a rare internal ear malformation. It's often discovered in childhood in the course of perception deafness check up, or repetitive meningitis in some other cases. The authors report a case of complex Mondini's malformation with fistulas of cerebro-spinal-fluid in oval and round windows, and stress the interest of high resolution computed tomography.

Cerebrospinal Fluid Otorrhea↗