[A rare etiology of praevia barrier by the non gravid uterus in a duplex uterus (didelphys): ultrasound findings]. / Une étiologie rare d'obstacle praevia par l'utérus non gravide sur utérus double (didelphe): apport de l'échographie.

The Authors report a rare case of praevia barrier from a duplex uterus (didelphys). A 30 Year old pregnant woman was admitted for ultrasound examination. Her past history included two cesarean sections with a stillborn infant in one case and a live infant with psychomotor retardation in the other case. Third trimester ultrasound examination was consistent with a 36-37 weeks gestation. A 9.1 by 5.8 cm retro-cervical praevia mass was also noted deep in the pelvis. The mass was similar in appearance to myometrium. Elective cesarean section performed at 38 weeks of gestation delivered a normal healthy 2950 g male infant and revealed a second non gravid uterus corresponding to the mass seen at ultrasound. Pelvic examination confirmed a diagnosis of uterus didelphys (uterus duplex bicornis bicollis with vaginal septum) separated by a sagittal partition. The post-operative course was uneventful. Praevia barrier by a half uterus in a patient with duplex uterus is a rare condition that can easily be detected by careful ultrasound examination thus preventing complications at delivery.

[A rare cause of pulmonary metastasis: benign metastazing leiomyoma]. / Une étiologie rare de métastases pulmonaires: le léiomyome bénin métastasiant.

The authors report a rare cause of pulmonary metastasis of a benign tumor, uterine leiomyoma, observed in a black African woman. Plain chest radiograph showed multiple pulmonary nodules. These features were confirmed at CT. Transbronchial and surgical lung biopsies were consistent with pulmonary metastases from benign uterine leiomyoma. Hormonal treatment was instituted and resulted in regression of nearly all lesions at one year. Benign metastazing leiomyoma is a rare condition, in spite of the high rate of uterine leiomyoma in black African women.

[Cerebromeningeal tuberculosis: 15 pediatric cases]. / Tuberculose cérébroméningée: à propos de 15 cas pédiatriques.

Fifteen patients (9 girls and 6 boys) with different forms of cerebromeningeal tuberculosis (meningitis: 13 cases, tuberculoma: 2 cases) was reported. Their mean age was 6 years (4 months to 14 years). The initial diagnosis was difficult. Half patients had meningism, abnormal mental state and defects signs. The cerebrospinal fluid (CSF) leukocyte count was > 20/mm3, protein > 1 g/l (66%) and glucose < 2.2 mmol/l (80%). BK was isolated in 7 patients. Five patients (33%) died. Major neurological sequelae developed in 5 patients and 5 patients completely recovered. Factors predicting fatal outcome and permanent sequelae were: diagnosis delay, altered level of consciousness, hypotrophy and low glucose level in CSF.

[The value of ultrasound in the diagnosis of thyroid diseases in Mauritania (171 cases)]. / Apport de l'échographie dans le diagnostic de la pathologie thyroïdienne en Mauritanie: à propos de 171 cas.

We investigated thyroid abnormality in Mauritania by carrying out a prospective ultrasound study of 171 patients. One hundred and thirty four patients underwent thyroid hormone determination (T3, T4 and TSH) and 123 had complementary plain film X rays of the chest and neck. These ultrasound examinations accounted for 3.8% of all ultrasound examinations performed over the study period. Thyroid abnormalities were more frequent in young adults aged 20 to 40 years (67.4%) and in women (83%) in Mauritania. Thyroid diseases affected people from savanna and mountain regions in particular. Diffuse goiters were the most frequent problem (76.3%) and most were multinodular or heterogeneous forms with necrosis or hemorrhage. One case of homogeneous diffuse goiter was found to be an infiltrating vesicular adenocarcinoma with metastatic adenopathy. Nodular goiters were mostly cystic, with septation (51.9%) and could be mistaken for hydatid cysts, which are endemic to the region. Further study of these aspects of thyroid diseases in Mauritania are required.