[Vein of Galen aneurysmal malformation in a Neonate: a case report]. / Diagnostic Postnatal d'une Malformation Anevrismale de la Veine de Galien a Propos d'un cas.

The aneurysm of the Galen vein is a rare and complex congenital intracerabral vascular malformation. We report a case suspected by the obstetric ultrasound in the third trimester and confirmed by the transfontanellar Doppler ultrasound and brain CT-Scan in the asymptomatic 11-day old baby born at term.

L'anévrysme de la veine de Galien est une malformation vasculaire congénitale intra cérébrale rare et complexe. Nous rapportons un cas suspecté à l'échographie obstétricale du 3èmetrimestre, confirmé par l'échographie doppler transfontanellaire et la tomodensitométrie cérébrale chez un nouveau-né à J11 de vie, né à terme et asymptomatique.

Aspects echographiques des glandes parotides chez les personnes vivant avec le VIH (PVVIH) a Parakou (Benin)

Objectif: Decrire les aspects echographiques des glandes parotides chez des sujets infectes par le VIH au Centre Hospitalier Departemental du Borgou (CHD/B). Materiel et methode : Il s'est agi d'une etude transversale descriptive menee du15 janvier au 15 juin 2011. 200 personnes vivant avec le VIH ont beneficie d'une echographie mode B des glandes parotides. Resultats : L'echographie des glandes parotides etait anormale dans 91;5% des cas alors qu'une hypertrophie glandulaire clinique n'etait retrouvee que dans 11% des cas. Le diagnostic echographique portait sur les kystes lympho-epitheliaux (32%); l'agregation lymphocytaire (27%); l'infiltration graisseuse (26%) et les adenomegalies(6;5%). Chez les sujets sous traitement ARV; la prevalence des kystes lympho-epitheliaux etait moindre et celle de l'infiltration graisseuse plus elevee. Conclusion: L'absence de parotidomegalie chez les sujets VIH n'est pas synonyme de normalite et l'echographie reste le moyen ideal pour decrire les lesions parotidiennes que sont les kystes lympho-epitheliaux; l'agregation lymphocytaire l'infiltration graisseuse et les adenomegalies

[Osseus age of the black children of Benin. A population study of 600 children aged from 9 to 18 years and living in Cotonou]. / Age osseux du noir béninois. A propos de 600 enfants âgés de 9 à 18 ans et résidant à Cotonou.

PURPOSE: The purpose of this work is to study the skeleton maturation in the black population of Benin by means of Tanner Whitehouse method (TW2) in comparison with the populations of the developed countries. MATERIAL AND METHODS: The study was transversal and analytic. It included 297 boys and 303 girls aged from 9 to 18 years. This was conducted from October 2002 to May 2003 in Cotonou City, the economic capital of Benin. The corrected minimum size of the sample was 384 x 1.19. The sampling technique was chancy, multiphasic, stratified and in clusters. Every one of the 13 districts of Cotonou was considered as a stratum. The interpreter of the anteroposterior radiograph of the left wrist and hand was selected after an intra and extra observer test. The data treatment and analysis were performed by the logiciels Epi info and SPSS. The statistical tests used were Khi 2 test and Kappa index. RESULTS: The sample was mainly composed of pupils: 84.16% among the boys, 77.23% among the girls. 91.01% of the parents of the children had a middle standard of living. The skeleton maturation score increased with age in all TW2 methods. With the TW2 20 bone and RUS methods, the mature score was reached at percentile 50 among the boys at 18.5 years and among the girls at 17 years. It was precociously reached at percentile 97 respectively at 14 and 14.3 years among the boys and 12.7 years among the girls. With the Carpal bone method, the age of mature score at percentile 50 was 18.2years among the boys and 17.2 years among the girls. The early maturation was obtained at percentile 97 among the boys and the girls respectively at 13.2 and 12.5 years. DISCUSSION: The skeleton maturation score of the girls in Benin is I to 1.5 years higher than the one of the boys. With the TW2 bone and the RUS methods, the maturation shows a delay of 0.5 to 2.5 years at the percentile 50 and of 1.5 to 2 years at the percentile 97 in relation to the Belgian, British, Chinese, Korean, Japanese, and North American standards. These delays seem to be mainly due to the less favourable socioeconomic conditions in Benin. In the other hand, the more considerable delay of 1 to 4 years with the Carpal bone method remains to be elucidated. CONCLUSION: The osseous age stemming from this work is representative of the middle social stratums of the city backgrounds. It would gain to be completed by a similar work concerning the country backgrounds of Benin.

Outpatient management of fever in children with sickle cell disease (SCD) in an African setting.

Because hospitalization and intravenous antibiotics for treatment of a potentially fatal bacterial infection in febrile children with sickle cell disease (SCD) are difficult to apply, outpatient treatment has been considered in developed countries for selected patients. Eligibility criteria and procedures may differ in developing countries because of unique economic and social conditions. After clinical evaluation within 36 hr of the onset of a fever exceeding 38.5 degrees C, children with SCD who are being closely followed as a part of a SCD cohort in Cotonou (West Africa), were treated as outpatients. The antibiotic regimen consisted of intramuscular injection of ceftriaxone 50 mg/kg/day for 2 days followed by amoxicillin 25 mg/kg x 3/day x 4 days and oral hyper-hydration. Patients were observed for 6 hr and thereafter discharged with a medical control at day 2, day 8 + day 15. All 60 children included completed their treatment, and none were lost to follow-up. A definite or a presumed bacterial infection was the cause of the febrile episode in 76.7% of cases. An appreciable decrease in fever was observed from day 2 and only 2 patients were hospitalized at day 3, one for abdominal painful crisis and one other for persistent fever without documented infection. No severe bacterial infections, recurrence of febrile episode, nor death were encountered during the follow-up. The cost of this outpatient approach is US $30 per patient as compared to US $140 per patient if the patient had been hospitalized. Outpatient management of febrile episode in children with SCD is feasible and cost-effective in Sub-Saharan African. It requires, however, improved medical education on SCD and immediate medical attention after the onset of fever.

[Management of ectopic pregnancies at the university clinic of gynecology and obstetrics in Cotonou (Benin)]. / Prise en charge de la grossesse extra-utérine à la Clinique universitaire de gynécologie et d'obstétrique de Cotonou (Bénin).

In 1993 and 1994, there were 223 cases of ectopic pregnancy, resolved by surgery, at the University Clinic of Gynecology and Obstetrics of the National Teaching Hospital in Cotonou. This represents 4.57% of the number of deliveries. The study of 204 cases reveals the following characteristics: (i) There are clinical signs: pelvic pains and/or metrorrhagia in 97% of cases; (ii) Diagnosis was often late with a hemoperitoneum and required major intervention (salpingectomy). Ultrasound scanning allowed accurate diagnosis in 30.39% of cases. Celioscopy was necessary in 3.92% of cases; (iii) The life prognosis is usually good (1 death in 204 cases; i.e. 0.49%). The functional prognosis is difficult to estimate. The evolution of medical techniques, with the help of ultrasound scans facilitates early diagnosis and application of modern less traumatic therapies such as endoscopic surgery and conservative treatment.

[A 4-year evaluation of ultrasonographic studies of liver pathology at the CNHU at Cotonou: apropos of 632 tests]. / Bilan de quatre années d'exploration échographique de la pathologie hépatique au CNHU de Cotonou: à propos de 632 examens.

This four year evaluation at the CNHU in Cotonou had the aim to assess the frequency and to define any particular aspects of liver disease as diagnosed by ultrasound examination. The study included 632 patients, aged from 15 to 87 years, who came from throughout Benin for examination by abdominal echography. Abdominal pains, abdominal masses and hepatalgia were the most common justifications for the examination. However, there was no clinical information for 8.08% of the patients. Homogeneous hepatomegalies were comprised of steatosis (3.78%), cardiac congestive liver (2.69%) and cirrhosis (2.53%) which could be diagnosed only in homogeneous forms. The heterogeneous cirrhosis forms were compounded with hepatocellular carcinoma (5.06%) in diffuse and micronodular forms. To improve the diagnosis of these two diseases it is necessary to develop the biopsy-puncture procedure as part of the pathological examination.

[Ultrasonography and amebic abscess of the liver at the CNHU at Cotonou: apropos of 33 cases]. / Echographie et abcès amibien du foie au CNHU de Cotonou: à propos de 33 cas.

From the 1st of March, 1991 to the 31st of December, 1995, 577 patients had abdominal echographic examinations which enabled the diagnosis of 33 cases of liver amebic abscesses. This study evaluated to what extent echography can facilitate the diagnosis and surveillance of patients during treatment in a region where immunological diagnosis of amebiasis is not yet performed and where percutaneous puncture is just beginning. Patients were suffering from chronic hepatic pain and fever in 28 cases. Seventeen patients had hepatomegaly and 14 patients had lost weight. Echographic images changed with time. In the beginning, there were diverse blurred structures which were 4 to 6 cm in diameter. Subsequently, the content of the abscesses became more homogeneous and in 3 cases the posterior area intensified. Also, the evolution of the disease during treatment by metronidazole could be followed by progressive echographic imaging. All the patients recovered without after-effects and only four of them showed hyperechogenic cicatrization. Two patients had an evacuation of their abscess which resulted in distinct improvement. The authors recommend generalization of that technique in all the hospitals across the country. Echography can thus improve both the diagnosis of liver amebic abscesses and the surveillance during the treatment.

Apport de l'imagerie medicale dans le diagnostic d'une thrombose post-traumatique de la veine porte

L'etude rapporte le cas d'une thrombose d'une branche de la veine porte chez un sujet jeune. Le signe d'appel fut une douleur abdominale apres un tres leger traumatisme. Dans ce travail; l'accent est mis sur l'interet de l'echographie et de la tomodensitometrie dans le diagnostic

Evaluation et frequence des examens de radiologie au CNHU de Cotonou : etude retrospective sur 5 ans (1990-1994)

Dans la periode d'etude; (1990-1994); 61927 examens radiologiques ont ete realises dans le service de radiologie du Centre Nationale Hospitalier et Universitaire (CNHU). La grande majorite etait des examens radiologiques standards

Etude comparée de la numération formule sanguine chez les techniciens de radiologie et un groupe de personnes non exposées

L'analyse des resultats de la numeration formule sanguine realisee chez des techniciens de radiologie et des personnes non exposees aux irradiations a permis de montrer qu'il n'y a pas de modification significative de l'hemogramme entre les deux groupes. Les auteurs insistent neanmoins sur la necessite d'une surveillance hematologique reguliere afin de de prevenir les risques d'irradiation