Les aspects tomodensitométriques et le profil épidémio-clinique des tumeurs du foie en Afrique subsaharienne

Contexte : La pathologie tumorale hépatique est marquée par la hantise du cancer primitif avec son pronostic effroyable. Son exploration fait appel à l'imagerie médicale de façon incontournable notamment le scanner qui est de plus en plus disponible dans nos contrées.Objectif : Décrire le profil épidémio-clinique et les aspects scanographiques des tumeurs hépatiques rencontrées en Afrique subsaharienne notamment à Abidjan.Méthodologie : Etude rétrospective descriptive, basée sur les scanners hépatiques réalisés sur la période de janvier 2012 à Décembre 2012, selon le protocole de la triple acquisition après injection de produit de contraste iodé. Tous les examens ont été réalisés à l'aide d'un scanner Toshiba de 64 barrettes. Tous les patients ayant une tumeur hépatique dont le type a été confirmé à l'anatomopathologie ont été retenus.Résultats : L'âge moyen des patients était de 61,7 ans avec des extrêmes de 41 et de 82 ans. Le sex ratio était de 2/3. Les principales indications étaient les foies hétéronodulaires (38,9%) et les bilans d'extension (27,7%). Nous avons dénombré 25 cas de tumeurs hépatiques. Il s'agissait de tumeurs malignes dans 64% versus 36% de tumeurs bénignes. Les tumeurs malignes étaient représentées par les hépatocarcinomes (40%), les métastases (24%) et le cholangiocarcinome (4%). Les tumeurs bénignes quant à elles étaient les kystes biliaires (28%), et l'angiome (4%).Conclusion : Les tumeurs malignes du foie sont plus fréquemment explorées au scanner. Elles sont dominées par le carcinome hépatocellulaire dans un contexte de cirrhose

[Contribution of transvaginal ultrasound to hysterosalpingography in the etiological research on female infertility in Abidjan]. / Apport de l'echographie transvaginale associée a l'hystérosalpingographie dans la recherche etiologique de l'infertilité féminine a Abidjan (Côte d'Ivoire).

We performed hysterosalpingography (HSG) and transvaginal ultrasound (TVU) in 124 Ivorian women as part of an infertility evaluation. The aim was to investigate the causes of infertility and show the advantages of combining HSG and TVU as part of a comprehensive evaluation of infertility in African woman. TVU and HSG were normal in 35.5% of cases, while in 64.5% of cases, at least one disease was demonstrated. This included uterine pathology in 50.3%, tubal disease in 25.2%, ovarian pathology in 7.5% and peritoneal pathology in 7% of cases. Of all the diseases identified by the association HSG and TVU, 71.3% were found by TVU, while 61.5% were confirmed by HSG. TVU was more efficient in identifying uterine and ovarian pathologies while HSG excelled in tubal pathology. HSG and TUV had identical performances on the peritoneal pathology. The association HSG-ETV should be systematic in the full assessment of female infertility in sub-Saharan Africa.

[Renal insufficiency: comparison of ultrasound and laboratory profiles in HIV-negative and HIV-positive patients]. / Insuffisance rénale: comparaison des profils échographique et biologique de sujets VIH-négatifs et VIH-positifs.

The purpose of this study was to examine whether HIV infection affects either the echographic or laboratory profiles of renal insufficiency. This prospective study compared both echographic (kidney size, Hricak's cortical echogenicity grades) and laboratory (blood urea and creatine) profiles in two groups of patients with renal insufficiency: one group HIV-positive (25 cases) and the other HIV-negative (86 patients). Kidney size was generally normal in the HIV-negative group. In the HIV-positive group, it was either normal or enlarged, especially in thickness, with a spherical appearance. Echogenicity grades were high in both groups, and no HIV-positive patients were at grade I; 25.6% of the seronegative patients and 20% of seropositive patients were at grade II, and 57% and 68%, respectively, were at grade III. The correlation between ultrasound grades and laboratory results did not differ significantly between the two groups (p = 0.0669 for creatinemia and p = 0.0560 for uremia), although the rates tended to increase with echogenicity grade and were slightly lower in the HIV-positive group. The authors conclude that HIV infection does not seem to affect the ultrasound or laboratory profiles of renal insufficiency. Thickening of the kidney and any spherical aspect should however suggest to the practitioner that the renal insufficiency may be related to HIV.

[Pediatry imaging in Abidjan]. / Etat des lieux de l'imagerie pédiatrique à Abidjan (Côte d'Ivoire).

UNLABELLED: The purpose of this study was to inventory the infrastructure and equipment available in Abidjan for paediatric radiology, identify the principal problems of radiological exploration of children and offer suggestions to improve it. MATERIAL AND METHODS: We identified the functional radiological material and the practitioners working in radiological services from 1 July through 31 December 1997. We also examined the records of all paediatric examinations performed during a one-year period in Yopougon University Hospital. RESULTS: The population of Abidjan was estimated (by the National Institute of Statistics) at 3,323,214 in 1998, including 1,208,924 children (36%). There were 31 radiologists, that is, 1 per 101, 526 inhabitants, and 1 X-ray technician for 82,824 inhabitants. The equipment inventory revealed 1 ultrasound scan per 42,531 inhabitants, 1 standard imaging table per 112,403, 1 remote-control table per 242,000, 1 dental radiological system per 1,049,099, and 1 computed tomography system per 1,573,648. Children accounted for 17.4% (1836) of the 10,561 patients examined over one year at the teaching hospital, but there was no specific material for children's examinations. CONCLUSION: Neither human resources nor functional equipment are available in adequate numbers. Radiological equipment appropriate for paediatric exploration must be a priority in the future. .

[Systematic preventive antibiotic therapy during hysterosalpingography in an African tropical environment: is this practice justified?]. / La pratique de l'antibiothérapie préventive systématique au cours de l'hystérosalpingographie en milieu tropical africain est-elle justifiée ?

To find out whether preventive antibiotic therapy can be justified in the practice of hysterosalpingography in a tropical environment where the infectious risk is notoriatly high, the authors performed a prospective study concerning 49 females patients. The patients in genital activity period, were willing and volunteers and were aged from 20 to 44 years. They were examined by hysterosalpingography during a period of three months. Patients were distributed in two homogenous group, one group of 25 patients who had a preventive antibiotic therapy and the second group with 24 patients with no preventive antibiotic therapy. Hysterosalpingography examinations were performed with sterile and single-use equipment. All patients were clinically examined for medical record purposes: gynaecologic, obstetric, pelvic infection, oral contraception, previous hysterosalpingography. Biologic dosages were realized, including blood count and erythrocyte sedimentation, culture of vaginal sampling, C reactive protein rate. The results obtained showed no significant difference between the two groups. The authors conclude that hysterosalpingography can be also performed in a tropical environment without using systematic preventive antibiotic therapy provided that asepsisrules are strictly observed.