[Epidemiology of acute hematogenous osteomyelitis in children: a prospective study over a 32 months period]

To determine the demographic, clinical, biological and bacteriological profile of acute community acquired hematogenous osteomyelitis [AHO] in children. Prospective study including children admitted for AHO. We noted the demographic parameters of patients and the clinical, biological and radiological characteristics of the infection. Blood cultures and local specimen in operated children were systematically performed. 70 patients were included. The mean age was 7.7 years. The mean time between onset of symptoms and admission was 3.2 days. Distal tibia was the most frequent localization [18.66%]. Fever higher than 38[degree sign] on admission was found in 92.8% of patients. Creactive protein [CRP] was superior to 20 mg / L in 95.8% and ESR superior to 20 mm in the first hour in 92% of cases. A deep venous thrombosis was found in 7 patients and a pleuropulmonary Staphylococcus infection in 4 patients. Amicroorganism was isolated in 64.7% of cases. Staphylococcus aureus methicillin susceptible [SAMS] was the predominant germ. Staphylococcus aureus methicillin resistant [SAMR] accounted for 15.7% of staphylococcus aureus infections. The importance of CRP on admission and time to resolution of fever after the start of treatment were significantly higher in SAMR infections. The existence of deep venous thrombosis and a pleuropulmonary Staphylococcus infection and the need for surgical drainage were significantly more frequent in SAMR infections. The existence of a severe form of AHO should lead to a high suspicion of SAMR infection and prompt the prescription of an appropriate antibiotiotherapy

Bilateral stress fractures of the femoral neck with no risk factor: a case report

Stress fractures of the femoral neck are uncommon. They are caused by either excessive stress or bone fragility. To report a case of bilateral stress fracture of the femoral neck in a 15-year-old girl without any risk factors. We report a case of bilateral stress fracture of the femoral neck in a 15-year-old girl in whom no risk factors were found. One of the fractures was displaced at first diagnosis and was successfully treated by closed reduction and valgus subtrochanteric osteotomy. The other fracture was initially undisplaced but displacement occurred later despite internal fixation with a dynamic hip screw. A high index of suspicion of stress fractures of the femoral neck must be kept in mind even without risk factors. Delays in diagnosis and displacement should therefore be avoided

[Pancreatic pseudocysts complicated by hemorrhage and infection]

The occurrence of bleeding complications secondary to the development of pancreatic pseudocysts is rare but associated with high mortality. To report a case of pancreatic pseudocyst complicated by hemorrhage and infection A 62 years old patient with history of severe acute pancreatitis two months ago consulted for abdominal pain associate with fever and internal bleeding. CT scan showed a heterogeneous PK complicated by hematoma of the ACE and hemoperitoneum. The emergency surgical treatment showed a PK superinfected with erosion of the splenic artery. It was directed by a left splenopancreatectomy Therapeutic management of hemorrhagic complications of pancreatic pseudo cysts is surgery despite the contribution of art‚rio-embolisation

[Obstetric Vesicovaginal fistulas, about 131 cases]

Vesicovaginal fistulas are the most frequent type of urogenital fistulas. Obstetrical cause remains the dominant etiology. They still represent a public health problem. to study epidemiological aspects of obstetric vesico-vaginal fistulas and their management. a retrospective multicentric study among 19 hospital departments from February 1982 to January 2007. 131 VVF [92% of urogenital fistulas]. The vaginal route for surgical repair was used in 2/3 cases. The mean diameter of the fistula was 11.35mm. In 122 cases [86.5%], the fistula was unique. IVU findings were normal in 83% cases. All patients had normal renal function apart one who had acute renal failure. 177 interventions were performed [1.37 intervention per patient]. Our findings suggest a regression in obstetrical VVF. However many efforts on institutional, socioeconomic and obstetrical levels have to be done in order to eradicate this pathology that is of major handicap for women regarding socioeconomic, functi6nal and psychological effects

Synchronous association of ileal carcinoid and recto-colonic carcinoma. a case report

Multiple primary malignant neoplasm in a single patient have been well documented in the literature. The lesions can be limited to a single organ or involve multiple organ systems and can be synchronous or metachronous. Report of a new case. We report the case of a 63 year old women with a rectocolonic carcinoma; during surgery an ileal nodule was discovered also as liver metastasis. The final pathologic report on the specimen revealed an adenocarcinoma of the colon and a carcinoid tumor of the small bowel with liver metastasis. Tumoral association is relatively common for patients with small intetinal carcinoids. The association carcinoide of hail with primitive tumour not carcinoide is reported primarily with carcinomes of the digestive tract in particulary recto colics carcinoma

Une cause rare d'hemorragie digestive haute. le leiomyome duodenal

Leiomyoma of the duodenum is a benign smooth muscle tumors. The most frequent symptom is upper gastrointestinal haemorrhage. It causes many problems [of diagnosis, histological analysis, therapeutic] we report a case revealed by an upper gastrointestinal haemorrhage. Then we review the clinical aspects and treatments of this tumor