Minor's syndrome: Dehiscence of the superior semicircular canal. A case report.

Superior semicircular canal (SSC) dehiscence syndrome, also known as Minor syndrome, is a rare condition characterized by vestibular and cochlear symptoms linked to a defect in the bony roof of the SSC. The prevalence is estimated at 0.5%, with a male predominance. Dehiscence may result from abnormal bone development, becoming symptomatic due to minimal trauma or pressure changes. Clinical presentation varies based on dehiscence size and location, with dizziness and oscillatory movements triggered by pressure changes or loud sounds being common symptoms. Other manifestations include conductive hearing loss due to the formation of a ``third window'' in the inner ear. Diagnosis typically involves computed tomography, distinguishing SSCDS from otosclerosis. Surgical treatment is reserved for cases of disabling vestibular pathology, often involving sealing the dehiscence through various approaches.

Endothelial cyst of the adrenal gland: A rare case report.

Adrenal gland cysts are rare and uncommon manifestations. Mostly asymptomatic, discovered incidentally during radiological studies or at autopsy, or without characteristic symptoms. The spectrum of these entities may include benign cysts or malignant cystic neoplasms. They are classified into four types: pseudocysts, endothelial cysts, epithelial cysts, and parasitic cysts. Though pseudocysts are reported to be the most frequently clinically recognized adrenal cysts in surgical series, endothelial cysts are more frequent in autopsy series. Even with advanced imaging modalities, it is still difficult to differentiate a benign adrenal neoplasm from a malignant one. As a result, getting a definitive diagnosis and starting treatment is challenging. In both symptomatic and asymptomatic cases with a large diameter or increasing sizes during follow-up, or with any abnormality of adrenal hormones, surgery is the treatment of choice in symptomatic. Herein, we present a 47-year-old female with a nonfunctional left adrenal endothelial cyst, who was incidentally found during a computerized tomography scan. The patient presented with left-sided nephritic colic due to renal lithiasis. The objective of this paper is to recall the clinical characteristics and to specify the diagnostic contribution of imaging as well as the therapeutic modalities of this entity.

Acute abdomen revealing abdominal tuberculosis complicated by a proximal jejunal perforation: Case report.

Abdominal tuberculosis (TB) remains a significant health concern globally, particularly in regions with high endemicity such as North Africa and Morocco. Despite advances in diagnostic modalities, the nonspecific presentation of abdominal TB poses challenges for timely diagnosis and management. Here, we report a case of abdominal TB in a critically state of a young man from Morocco, presenting with acute abdominal pain and signs of sepsis. Radiological investigations revealed features suggestive of intestinal perforation complicating peritoneal TB. Urgent laparotomy confirmed the diagnosis, yet the patient succumbed to advanced sepsis postoperatively. This case underscores the complexity of abdominal TB diagnosis and management, necessitating a high index of suspicion and multidisciplinary collaboration. With evolving surgical techniques and ongoing research efforts, optimizing strategies for early detection and treatment of abdominal TB remains imperative, particularly in endemic regions.

An unexpected complication: Air embolism during contrast-enhanced computed tomography.

Air embolism is often an iatrogenic complication that may occur in venous or arterial circulation depending on the port of entry. We present a case of a 40-year-old female who had a venous air embolism in the pulmonary artery as a consequence of the injection of a contrast agent. She experienced dyspnea and chest pain following a contrast-enhanced chest computed tomography imaging. She was successfully treated and discharged from our hospital. Early detection of this clinical condition is essential to prevent morbidity and mortality.

Hydatid cyst of the liver invading the inferior vena cava.

Hydatid disease is a parasitic infestation due to the development of Echinococcus granulosus in the organism. This disease is particularly frequent in Morocco where echinococcosis is endemic. The liver is the most common organ to be affected by hydatidosis, and several complications have been described. Vascular complications secondary to hepatic echinococcosis such as fistulization or rupture of hydatid liver cysts to the inferior vena cava (IVC) are an extremely rare and life-threatening condition. This report aims to describe a case of invasion of the IVC by a hydatid cyst of the liver resulting in portal hypertension in a 60-year-old female patient. The diagnosis was established in the preoperative phase by a CT scan. IVC invasion remains an infrequent complication that should be routinely looked for in patients with hydatid disease of the liver, and few cases have been reported in the literature to date.

Osseous hydatid disease: A mimic of other skeletal pathologies.

Hydatid disease is still endemic in several regions worldwide including Morocco, and is caused in most cases by the larval form of 2 species of the tapeworm Echinococcus: E. granulosus and E. multilocularis. Primary hydatid disease of the bone without systemic involvement is rare. The disease has a silent clinical evolution until it reaches complicated stages. Complications may include pathological fracture, neural deficit, infection, and fistulization of the abscess. Preoperative diagnosis is based on clinical history, imaging findings, and serological tests, which lack high sensitivity and specificity. Although the interpretation of imaging studies can prove to be very confusing because the bone changes evolve with time, and the nonspecificity of these findings often leads to a mistaken diagnosis. The diagnosis requires a high index of suspicion, especially in patients who reside in or travel to sheep-raising areas where hydatid disease is endemic. A high index of suspicion is necessary for the diagnosis, especially in patients that live in or travel to sheep-raising areas where hydatid disease is endemic. The treatment of choice remains surgical, following the principles of a locally malignant lesion. Chemotherapy (albendazole alone or in combination with praziquantel) is indicated when surgery is not possible or as an adjuvant treatment. The prognosis is often poor. We report the case of a 28-year-old woman with long-standing pain in the left hip joint in which the imaging findings were thought of as being either tuberculous or neoplastic. The result of a CT-guided biopsy concurred with an unexpected diagnosis of a hydatid cyst. This case highlights that in the absence of a high index of suspicion for echinococcal infection, the semblance of imaging findings of hydatid disease in the bone to those of other skeletal pathologies can lead to misinterpretation.

Carotid canal fracture with internal carotid artery transection: A deadly trauma.

Carotid artery injuries are rare with an incidence of 1%-2.6% in trauma patients. They are associated with high morbi-mortality rates, with mortality ranging from 19% to 43%. The diagnosis relies mainly on computed tomography angiography in the emergency setting; however, it is fundamental to be able to suspect carotid artery injuries on non-contrast computed tomography, as the latter is the routine imaging tool for trauma patients. We report the case of a young male, victim of a blunt high velocity motor-vehicle trauma. He was unconscious, with abundant epistaxis and hypovolemic shock. A fracture of the left carotid canal on non-contrast computed tomography was seen, raising concern for an arterial injury. A computed tomography angiography was performed subsequently revealing a transection of the internal carotid artery. This type of injury is highly lethal, and its management relies on urgent surgical intervention, and endovascular treatment, with the purpose of controlling the hemorrhage.

Myocardial Calcifications: An Exceptional Complication of Sepsis.

Myocardial calcifications (MCs) are a fatal condition that often complicates ischemic heart disease, cardiac surgery, rheumatic fever, or myocarditis. To date, cases where myocardial calcifications result from a septic state have rarely been reported. In this paper, we describe the primary imaging findings and discuss both proven and hypothetical mechanisms of MCs in the context of sepsis.

Pulmonary air leak syndrome in rheumatoid arthritis patient.

Pulmonary air leak syndromes involve dissection of air out of the normal pulmonary airspaces and include pulmonary interstitial emphysema, pneumothorax, pneumomediastinum, pneumopericardium, pneumoperitoneum, subcutaneous emphysema and systemic air embolism. It presents as a spontaneous extension of dissecting air without a history of a procedure or penetrating injury. Pulmonary air leak syndromes are extremely rare complications of systemic autoimmune connective tissue diseases. Few cases were reported in the literature regarding rheumatoid arthritis patients. The purpose of this article is to emphasize on this rare pulmonary complication and discuss the physiopathology of the disease and the different risk factors for a better management of these patients. We report the case of a 45-year-old female, with a history of proven rheumatoid arthritis under methotrexate and steroids, who presented with a spontaneous dissecting subcutaneous emphysema, pneumothorax, pneumomediastinum and pneumoperitoneum. The patient's condition improved after chest drainage and adjustment of her medical treatment.

Multiple brown tumors in primary hyperparathyroidism.

Brown tumors are benign bone tumors that rarely complicate hyperparathyroidism, manifesting as fibrous and erosive lesions secondary to rapid and localized osteoclast turnover. These lesions are typical of primary hyperparathyroidism, but they are not often observed. We present the case of a 72-year-old woman presenting with asthenia, bone pain, and hemiplegia. Biological analysis showed primary hyperparathyroidism, cervical ultrasound a right parathyroid adenoma that fixed on scintigraphy. When cross-sectional imaging was performed, it revealed multiple bone tumors of the axial and peripheral trunk with spinal cord compression which were diagnosed as brown tumors related to parathyroid adenoma. We illustrate through this case the importance of multidisciplinary imaging techniques before raising the diagnosis, especially in unusual pathologies such as brown tumors.

Polysplenia syndrome in adulthood: a case report.

Polysplenia syndrome mainly described in pediatrics; rarely and incidentally in adulthood. Most patients had their diagnosis done during childhood due to the frequent association to cardiac anomalies that speak for themselves earlier in life. Multiple spleens, cardiac defect and vascular malformation of the inferior vena cava with azygos or hemiazygos continuation are the most frequent observed malformations. Our patient was one this rarest adulthood incidental diagnosis, who presented in the emergency department for nephritic colic, and while imaging for this, multiples spleens and other visceral malformations were diagnosed. Hopefully, cardiac ultrasound hadn't showed any cardiac malformation and the patient was discharged aware of this condition. Through this publication we report the possible incidental diagnosis of polysplenia condition and highlight the fact that people with such important malformation can lead a normal life, and only awareness should be given for future surgeries, instrumental treatment or else.

Renal pelvic rupture: A case report of an unexpected cause.

INTRODUCTION: Renal pelvic rupture (RPR) is a rare condition, that is most usually caused by obstructive calculi. In another hand, primal ureteral tumors are also uncommon, with only a few cases reporting their involvement in a RPR. PRESENTATION OF CASE: We report a case with a multimodality discussion of an ureteral tumor, with a spontaneous renal pelvic rupture (RPR) forming a large retrorenal urohematoma. DISCUSSION: Only few series reported the subject of RPR in the English literature. Only some single cases reported the causality of urinary tract tumors in RPR. RPR is an imaging based diagnosis. Herein, upper urinary tract tumors show a variable appearances at imaging. CONCLUSION: By reporting this case, we highlight the role of both computed tomography (CT) and magnetic resonance (MR) imaging in the diagnosis of the RPR and their accuracy in the detection of the ureteral tumor. We also consolidate the effectiveness of the conservative attitude in the management of the RPR.

Common Carotid Artery Diaphragm presenting as transient syncope.

Carotid diaphragm usually can cause artery stenosis essentially affecting the internal carotid artery (ICA) beyond the bulb segment.  Patients are often middle aged and the onset of symptoms typically begins with syncopes leading to ischemic stroke.  More than 50 cases have been reported in which all lesions showed as stenosis located in the ICA, in this article, we report a rare common carotid artery (CCA) diaphragm revealed in a 59 year-old female suffering from transient syncopes. This is the third case reported in the literature.

A rectal foreign body: An unexpected cause of a rectovesical fistula with hematuria.

Cases of rectal foreign bodies (RFB) insertion are frequently encountred in the last years, leading to many complications, while many patients tends to obscure the context. This entity represent a particular form of rectal injuries that can be more lethal with the peritoneal involvement. However, combination of genitourinary injuries to rectal injuries doesn't worsen the prognosis. We report a case of a RFB injury leading to an extraperitoneal rectal injuri with a recto-vesical fistula that was managed effectively conservatively with successive CT Cystogram follow-ups.

Zinner's Syndrome: A Rare Diagnosis of Dysuria Based on Imaging.

Zinner's syndrome is a rare congenital malformation of the seminal vesicle and ipsilateral upper urinary tract, due to developmental arrest in early embryogenesis of the Müllerian duct. Clinical presentation is nonspecific and includes voiding symptoms such as dysuria, ejaculatory disorders, and hypogastric or perineal pain. The diagnosis is made with imaging techniques, notably Magnetic Resonance Imaging (MRI) which remains the gold standard exam for diagnosis confirmation and therapeutic management. Treatment options depend on the severity of symptoms, the size of the cyst, and the complications. Herein, we report a rare case of a 33-year-old young patient who presented recurrent dysuria and ejaculatory disorders for the last 5 years. Imaging studies revealed an empty left renal fossa, with cystic pelvic mass related to the seminal vesicle and which was compatible with the diagnosis of Zinner's syndrome. The patient underwent successful laparoscopic removal of the cyst and seminal vesicle, with total disappearance of urinary and sexual complaints with a 3-year follow-up.

Reorganization of the imaging units in the context of the COVID-19 pandemic: experience of the Ibn Sina University Hospital in Rabat.

The global health system is currently facing the new SARS-COV 2 pandemy. This exceptional situation requires, from our African health systems, to reorganize and readapt the usual protocols when they were carried out before the crisis and/or their urgent implementation otherwise. As imaging is one of the pillars of the diagnosis of infection with this emerging virus, it was essential to rethink the imaging department organization so as to dedicate a unit to COVID-19 activity while maintaining the usual emergency activity within the Ibn Sina university hospital in Rabat. The protection of exposed personnel and the bio-cleaning of radiology equipment and rooms also became an evidence. The active involvement of the administration, the Clinical Pharmacy Department and the Nosocomial Infections Control Committee is a key to the success of this reorganization.

Pituitary abscess: two case reports.

BACKGROUND: Pituitary abscess is a rare condition with nonspecific symptoms that can be delayed. Proper diagnosis needs to occur preoperatively so that the management can be set up accordingly. Accurate diagnosis is challenging because many differential diagnoses can exhibit the same magnetic resonance imaging features. CASE PRESENTATION: We report two cases of pituitary abscess. The first patient was a 66-year-old Arab woman who underwent a surgical procedure for a pituitary macroadenoma and presented 3 months later with chronic headaches and panhypopituitarism. A pituitary abscess was found on the follow-up magnetic resonance imaging. The second patient was a 64-year-old Arab man with no medical history who presented with a chiasmal syndrome with headaches and panhypopituitarism. Brain magnetic resonance imaging showed a heterogeneous pituitary mass that turned out to be a pituitary abscess intraoperatively. These two patients were treated with hormone substitution, endoscopic transsphenoidal drainage, and antibiotherapy, with excellent outcomes. CONCLUSIONS: Pituitary abscess is a rare and serious condition. Preoperative diagnosis can be challenging because of the many existing differential diagnoses upon imaging. Magnetic resonance imaging is the mainstay technique of imaging due to its multimodal nature. These cases demonstrate the variable patterns of a pituitary abscess seen on magnetic resonance imaging and the potential difficulties in achieving an accurate diagnosis preoperatively due to many other conditions potentially exhibiting the same magnetic resonance imaging features.

[A case of ileosigmoid knotting in the postpartum period]. / Un cas de nœud iléo-sigmoïdien chez une femme en post-partum.

Ileosigmoid knotting is a rare cause of intestinal obstruction. We report a case of ileosigmoid knotting occurred during the postpartum period. The diagnosis was made by means of CT scan data and confirmed intraoperatively.

Congenital unilateral facial palsy revealing a facial nerve agenesis: a case report and review of the literature.

Facial nerve aplasia is an extremely rare condition that is usually syndromic, namely, in Moebius syndrome. The occurrence of isolated agenesis of facial nerve is even rarer, with only few cases reported in the literature. We report a case of congenital facial paralysis due to facial nerve aplasia diagnosed on MRI, while no noticeable abnormality was detected on the temporal bone CT.