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Mongi Mekki

Publications and source records attributed to Mongi Mekki.

13 recordsLinked to original sources
PubMed2006

Segmental dilatation of the intestine.

PURPOSE: The aim of this work is to discuss the pathogenesis of the segmental dilatation of the intestine (SDI) and to review its clinical presentation and the ways to confirm the diagnosis. METHODS: Eight cases of pathologically proven SDI from 1987 to 2003 were reviewed and discussed. There were 7 newborns and a 1-year-old boy. RESULTS: Our patients are 5 boys and 3 girls. In all cases, the diagnosis was not suspected before surgery. Two patients presented with a low neonatal bowel obstruction. Six patients were operated for omphalocele, which was the most frequent associated malformation. The SDI involved the ileum in all patients. The treatment consisted on a resection of the dilated segment with an end-to-end anastomosis. Histological examination demonstrated the presence of ganglion cells in all cases. The muscular layer was hypertrophied in two cases and very thin in one case. A heterotopic gastric mucosa was observed in one case. No anomalies were observed in 5 cases. The postoperative course was uneventful in 6 cases with a mean follow-up of 5 years. CONCLUSIONS: Segmental intestinal dilatation is an exceptional pathology with an unknown etiology and a misleading clinical presentation. Several theories were proposed to explain this malformation; however, most authors are rather inclined to an embryological theory incriminating an extrinsic intrauterine intestinal compression. Most cases are neonatal discoveries. The clinical polymorphism and the lack of specificity of radiological investigations explain the difficulties to have a preoperative diagnosis. However, this difficulty is compensated by the favorable evolution after the resection of the dilated segment.

Digestive System Abnormalities↗
PubMed2005

[Giant ureteric stones: report of two cases].

Ureteric stones are generally solitary and less than 2 cm long. Exceptionally, ureteric stones can be longer than 5 cm and/or weigh more than 50 grams, and are referred to as giant ureteric stones. In the light of two personal cases and a review of the literature, the authors review the epidemiological, aetiopathogenic, clinical and therapeutic aspects of this disease with particular emphasis on the importance of the aetiological work-up. These two cases concerned two boys, aged 10 years and 4 and a half years, respectively, with no particular medical history, who presented an acute episode of pyelonephritis. The KUB plain film, renal ultrasound and IVU demonstrated a huge stone filling the right ureter in one case and the left ureter in the other case. The stones were treated surgically in both cases. The aetiopathogenesis of these large ureteric stones remains unclear. A urinary tract malformation (megaureter, ureterocele, stricture, etc.), either alone or associated with a metabolic predisposition plays an important role in the pathogenesis of these large stones. The aetiological work-up of these large stones is essential. Morpho-constitutional stone analysis provides extremely useful and even decisive information in some cases for the aetiological diagnosis. Despite the development of extracorporeal lithotripsy and endourological techniques, the treatment of giant ureteric stones often remains surgical.

Child↗
PubMed2005

[Pyelogenic cyst in children].

Pyelogenic cyst is an intraparenchymal renal cavity lined by transitional cell epithelium which communicates with a calyx via a neck. It is a rare disease, often discovered incidentally. The diagnosis is based on imaging. Asymptomatic forms require simple surveillance and surgical management is only indicated in forms complicated by urinary tract infections or stones. In the light of a case of pyelogenic cyst revealed by upper urinary tract infection in a 12-year-old girl, the authors recall the clinical, histological and therapeutic features of this rare disease.

Child↗
PubMed2004

[Rhabdoid tumour of the kidney in children].

Rhabdoid tumour of the kidney is an extremely rare cancer in children, which raises aetiopathogenic, diagnostic and therapeutic problems. Treatment of this tumour is not well defined and its prognosis remains poor despite progress in paediatric oncology. The authors report a new case of neonatal rhabdoid tumour of the kidney, with a rapidly fatal outcome and present a review of the literature.

Fatal Outcome↗
PubMed2004

[Urinary stones in Tunisian infants, based on a series of 64 cases].

OBJECTIVE: To define the epidemiological and clinical characteristics of urinary stones in infants, to study the role of stone chemical analysis in the aetiological assessment of urinary stones and to define the various treatment modalities adapted to this age-group. PATIENTS AND METHODS: Between 1984 and 2002, 64 infants (age: 5-24 months) were hospitalised for urinary stones. Urine culture was performed in all patients and metabolic assessment was performed in 24 patients. Physicochemical stone analysis was performed by infrared spectrophotometry in 37 patients. RESULTS: Upper tract and lower tract stones were equally prevalent. Urine culture was positive in 48 cases. The micro-organism most frequently isolated was Proteus mirabilis (19 cases). The metabolic assessment was normal in 15 patients and pathological in 9 patients. Infrared spectrophotometry showed that 17 stones were pure. 60 patients were treated surgically, 2 were treated by endoscopy associated with intracorporeal lithotripsy. One patient was treated medically and another patient passed the stone spontaneously while in hospital. No intraoperative or postoperative complication was observed. No recurrence was observed in this series. The mean follow-up is 16 months (range: 6 months to 94 months). CONCLUSION: The epidemiological profile of urinary stones in infants in Tunisia is situated between that observed in developed countries and that observed in developing countries. In our study, the incidence of metabolic abnormalities appears to be low despite a high rate of consanguinity in Tunisia. This can be largely explained by the absence of an aetiological survey and/or an inadequate survey when it is performed.

Child, Preschool↗
PubMed2003

[Nephroblastoma and Wilms tumor: report of 2 cases].

Nephroblastomatosis is a rare disease, considered to be a precursor of Wilms tumour. When it is isolated, recommended treatment consists of chemotherapy followed by surveillance. In the presence of associated Wilms tumour, treatment consists of preoperative chemotherapy followed by partial nephrectomy (when possible), followed by postoperative chemotherapy and surveillance.

Chemotherapy, Adjuvant↗
PubMed2003

[Cystic dysplasia of the testis].

Cystic dysplasia of the testis is an exceptional benign tumour resulting from a functional abnormality of the connection between the rete testis and the efferent ductules of the epididymis. The authors report a new case observed in a child. The frequent association with a renal abnormality is highly suggestive. Treatment usually consists of orchidectomy, but can be conservative with long-term surveillance. The prognosis is usually excellent.

Cysts↗
PubMed2003

[Intra-abdominal desmoplastic small round cell tumor in childhood: case report and review of the literature].

Desmoplastic small round cell tumor (DSRCT) correspond to a recent clinicopathological entity, individualized in 1989 into the group of tumors with small round cells. This pathology puts ethiopathogenic, diagnostic, therapeutic and prognosis problems. Indeed, the ethiopathogenic is still unknown, diagnosis is asserted only by immuno-histochimic and cytogenetic study because of the big number of differential diagnoses and the anatomopathologic polymorphism. Its treatment is not well codified and its outcome remains dark in spite of therapeutic progress. The objective of this work is to report a personal observation of a DSRCT and to proceed to a review of the literature to clarify the epidemiological, clinical, paraclinical and therapeutic aspects of this rare tumor.

Abdominal Neoplasms↗
PubMed2003

[Psoas abscess in children based on a series of 18 cases].

OBJECTIVE: Psoas abscess is very rare in children and raises problems concerning the clinical and aetiological diagnosis. The authors describe the characteristics of this rare disease and emphasize the role of imaging in the diagnostic approach and therapeutic management. MATERIAL AND METHOD: The authors report a series of 18 cases children aged 11 months to 13 years treated between 1988 and 2000 in the Monastir department of paediatric surgery. The time to diagnosis ranged from 4 days to 1 month. The clinical features comprised fever, abdominal pain and functional impairment of the homolateral lower limb in 17 cases. RESULTS: Ultrasound was performed systematically and established the diagnosis in 17 cases. Computed tomography, performed in 13 cases, confirmed the diagnosis and demonstrated the aetiology in 3 cases. The microorganism was isolated in 16 cases (Staphylococcus aureus in 13 cases). An aetiology was identified in 4 cases: acute appendicitis, Potts disease, sacro-iliitis and perirenal abscess. Treatment comprised systematic antibiotic therapy combined with drainage of the abscess in 16 cases, which was performed surgically in 4 cases and percutaneously in 12 cases. CONCLUSION: The prognosis of psoas abscess in children is generally favourable. CT- or ultrasound-guided percutaneous drainage is a valuable alternative to surgery, which must be reserved for cases of failure of percutaneous drainage.

Adolescent↗
PubMed2003

[Xanthogranulomatous pyelonephritis. Diagnostic and therapeutic problems. Report of three paediatric cases].

Xanthogranulomatous pyelonephritis (XGP) is an unusual and rare form of chronic renal suppuration in children, which appear to have a multifactorial pathogenesis. It is usually diffuse, but can remain localized to one part of the kidney, resulting in a misleading pseudoneoplastic appearance raising a problem of differential diagnosis with the other renal masses, particularly Wilms tumour. The authors present a retrospective analysis of three cases of XGP observed in the Monastir department of paediatric surgery. The preoperative diagnosis was pyonephrosis with perirenal abscess in two cases and Wilms tumour in the third case. The diagnosis of XGP was established on histological examination of the operative specimens. The aim of this study is to emphasize the diagnostic difficulties of this disease that, in localized forms, often lead to inappropriate treatment and to establish a treatment regimen for this rare disease.

Child, Preschool↗
PubMed2002

[Congenital mesoblastic nephroma].

Mesoblastic nephroma is a rare renal tumour mainly observed in neonates and young infants. The authors report a case in a 5-day-old new-born infant presenting with an isolated abdominal mass occupying the left hypochondrium and flank. Ultrasonography demonstrated a 4 cm heterogeneous mass in the lower pole and middle of the left kidney. CT showed an intensely contrast-enhanced heterogeneous mass. The patient was treated by left radical nephrectomy with an uneventful postoperative course. The outcome was favourable without recurrence with a follow-up of one year. Mesoblastic nephroma is considered to be a benign tumour. The diagnosis is suggested by clinical, ultrasonographic and CT findings. Treatment is based on radical nephrectomy. In the light of this case, the authors discuss the clinical, radiological and therapeutic aspects of this tumour.

Humans↗