Pituitary adenoma apoplexy presenting with bilateral third nerve palsy and bilateral proptosis: a case report

To report a case of pituitary adenoma apoplexy presenting with bilateral proptosis and bilateral third nerve palsy that developed after cardiovascular surgery. A 45-year-old man developed bilateral proptosis and bilateral third nerve palsy after a coronary artery bypass grafting operation. A pituitary macroadenoma with extension into the sphenoid sinus and cavernous sinus with bilateral involvement was resected on computed tomography scan by microscopic transsphenoidal procedure. Third nerve palsy improved partially on the first postoperative day and completely improved in the fourth month after the operation. This is a rare case of pituitary adenoma apoplexy that presented with bilateral third cranial nerve palsy

[Place of percutaneous nephrolithotomy in the treatment of kidney stones]

This is a minimally invasive surgical technique, which has its place as a first intention treatment of urolithiasis. Our object is to insist on the importance of this technique within the therapeutic arsenal of renal lithasis. This is a retrospective study of 300 cases of percutaneous nephrolithotomiers practiced in 270 patients in our department through a period of 23 years [1985-2008]: It concerned includes x 157 males and 113 females, the average age is 46 years old [17 years-75] - The calulus was pelvic in 188 cases [62.7%], lawer calyceal in 52 cases [17.3%] and a staghorn in 40 cases [13,3%]. All our patients were treated by the sawe technique. Our success rate was of 68,7%, the complications concerned zo cases that is a rate of 6.7%, without any deaths. The operation duration average was 188 minutes, and the postoperative hospitalisation period was seven days. The percutaneous ne phrolithotomy restes a recommended firts intention in the treatment of complex calculus in association with the complementary extracorporal lithority. The classical surgery has its place in the percutaneous nephrolithotomi failure cases, the residual calculus are the prerogative of extractor poreal lithoripsy

[Primary linitis of the rectum: a difficult diagnosis]

Introduction: Primary linitis of the rectum is a rare carcinoma characterised by the difficuly to be diagnosed Histologically

Case report: A 25 years old female patient, presented with a subocclusive syndrome, secondary to an anal stenosis at 6 cm from the anal margin, of an inflammatory look. Surgical exploration showed pseudo inflammatory rectal tumour, colstomy was performed. Analysis of surgical biopsy did not find tumoral cells. Eight months later, stenosis progressed and invated the anal margin and the recto- vaginal partition. TDM showed and abdomino- pelvic mass. The pathological biopsy study, found a signet cell carcinoma. The patient died six months later

Discussion: The discordance between the histological study of different biopsies of stenosis, with the clinical picture which did not evoke an intestinal inflammatory diseace, prevented us to do an radical sollution for our patient. In spite many profound surgical biopsises which had been done, diagnosis of linitis did not proved

Conclusion: In cases of rectal stenosis of inflammatory picture which is not supported with a convinced anatomopathological arguments we must think of specific colitis

Meningocele with Cervical Dermoid Sinus Tract Presenting with Congenital Mirror Movement and Recurrent Meningitis

Dermoid sinuses and meningoceles are seldom encountered in the cervical region. Besides, to the best of our knowledge, the coexistence of these types of congenital abnormalities with recurrent meningitis, as well as with mirror movement, has never been reported before. A 14-year-old female with the diagnosis of recurrent meningitis was referred to our clinic from the Department of Infectious Diseases. She had a cervical meningocele mass that was leaking cerebro-spinal fluid (CSF) and an associated mirror movement symptom. Spina bifida, dermoid sinus and meningocele lesions were demonstrated at the C2 level on computed tomography (CT) and magnetic resonance imaging (MRI). She underwent an operation to remove the sinus tract together with the sac, and at the same time the tethered cord between the sac base and the distal end of the spinal cord was detached. The diagnosis of dermoid sinus and meningocele was confirmed histopathologically. These kinds of congenital pathologies in the cervical region may also predispose the patient to other diseases or symptoms. Herein, a case of meningocele associated with cervical dermoid sinus tract which presented with recurrent meningitis and a rare manifestation of mirror movement is discussed. Neurosurgeons should consider the possible coexistence of mirror movement and recurrent meningitis in the treatment of these types of congenital abnormalities.

Tumeur d'abrikossof associee a un ulcere gastrique

Abrikossof tumor or a granulous cell myoblastoma is a rare affection. Its oesophagal localization is exceptional. [It was mere coincidence that the tumor was discovered during a radiological for gastric ulcer]. Generally, it is a benign tumor, treatment is surgery